Mentoring, coaching and peer-support programs promoting well-being for physicians: A systematic review
Main Article Content
Abstract
Introduction As many as half of U.S. physicians experience impactful levels of burnout. In early-career physicians, the consequences of burnout are significant with linkage to poor professionalism and patient care. A nurturing peer community and physician mentoring may mitigate against burnout and its associated sequelae; however, such programs for early-career physicians are rare and their impact largely unknown. We aim to synthesize the current literature on the impact of longitudinal mentoring and coaching programs for physicians.
Methods The authors searched four bibliographic databases to conduct a systematic review following PRISMA guidelines. Included studies were published between 01 January 2000 to 30 October 2022 and peer-reviewed articles reporting original research. The review examined associations between either a career mentoring, coaching, or peer support theme and outcomes in the career path of physicians.
Results Review of 5528 records yielded 23 articles that met inclusion criteria, with about half describing U.S. programs and half completed since 2017. Of these, 14 studies were of “high” or “medium” quality, 7 studies involved primary care physicians and 3 studies focused only on early-career physicians. In mixed methods studies, participants consistently reported positive experiences from their mentorship involvement and the 8 randomized control or cohort studies also reported positive effects with the mentoring programs.
Conclusion Rigorous data supporting the value of mentorship, including the best approach to be used (coaching, mentorship, or peer support) is lacking. However, a growing database of quality studies affirms physician mentoring as important to physician retention, wellbeing and quality healthcare delivery.
Article Details
How to Cite
ELLIS, Mark R et al.
Mentoring, coaching and peer-support programs promoting well-being for physicians: A systematic review.
Medical Research Archives, [S.l.], v. 12, n. 9, sep. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5618>. Date accessed: 04 oct. 2024.
doi: https://doi.org/10.18103/mra.v12i9.5618.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Hodkinson A, Zhou A, Johnson J, et al. Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis. BMJ. 2022;378:e070442. doi:10.1136/bmj-2022-070442
3. West CP, Dyrbye LN, Sinsky C, et al. Resilience and burnout among physicians and the general US working population. JAMA Netw Open. 2020;3(7):e209385. doi:10.1001/jamanetworkopen.2020.9385
4. Baxter SL, Saseendrakumar BR, Cheung M, et al. Association of electronic health record inbasket message characteristics with physician burnout. JAMA Netw Open. 2022;5(11):e2244363. doi:10.1001/jamanetworkopen.2022.44363
5. Dillon EC, Tai-Seale M, Meehan A, et al. Frontline perspectives on physician burnout and strategies to improve well-being: interviews with physicians and health system leaders. J Gen Intern Med. 2020;35(1):261-267. doi:10.1007/s11606-019-05381-0
6. Abbasi J. Pushed to their limits, 1 in 5 physicians intends to leave practice. JAMA. 2022;327(15):1435-1437. doi:10.1001/jama.2022.5074
7. Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ. 2016;50(1):132-149. doi:10.1111/medu.12927
8. Dyrbye LN, Burke SE, Hardeman RR, et al. Association of clinical specialty with symptoms of burnout and career choice regret among US resident physicians. JAMA. 2018;320(11):1114-1130. doi:10.1001/jama.2018.12615
9. Ricker M, Maizes V, Brooks AJ, Lindberg C, Cook P, Lebensohn P. A longitudinal study of burnout and well-being in family medicine resident physicians. Fam Med. 2020;52(10):716-723. doi:10.22454/FamMed.2020.179585
10. Monrouxe LV, Bullock A, Tseng HM, Wells SE. Association of professional identity, gender, team understanding, anxiety and workplace learning alignment with burnout in junior doctors: a longitudinal cohort study. BMJ Open. 2017;7(12):e017942. doi:10.1136/bmjopen-2017-017942
11. Sherlock C, John C. Adaptation practice: Teaching doctors how to cope with stress, anxiety and depression by developing resilience. British Journal of Medical Practitioners. 2016;9(2):916-923.
12. Rosta J, Aasland OG, Nylenna M. Changes in job satisfaction among doctors in Norway from 2010 to 2017: a study based on repeated surveys. BMJ Open. 2019;9(9):e027891. doi:10.1136/bmjopen-2018-027891
13. Hariharan TS, Griffin B. A review of the factors related to burnout at the early-career stage of medicine. Med Teach. 2019;41(12):1380-1391. doi:10.1080/0142159x.2019.1641189
14. Wu Y, Wu M, Wang C, Lin J, Liu J, Liu S. Evaluating the prevalence of burnout among health care professionals related to electronic health record use: systematic review and meta-analysis. JMIR Med Inform. 2024;12:e54811. doi:10.2196/54811
15. Babbott S, Manwell LB, Brown R, et al. Electronic medical records and physician stress in primary care: results from the MEMO Study. J Am Med Inform Assoc. 2014;21(e1):e100-106. doi:10.1136/amiajnl-2013-001875
16. Linzer M, Manwell LB, Williams ES, et al. Working conditions in primary care: physician reactions and care quality. Ann Intern Med. 2009;151(1):28-36, w26-29. doi:10.7326/0003-4819-151-1-200907070-00006
17. Rabatin J, Williams E, Baier Manwell L, Schwartz MD, Brown RL, Linzer M. Predictors and outcomes of burnout in primary care physicians. J Prim Care Community Health. 2016;7(1):41-43. doi:10.1177/2150131915607799
18. Kang C, Sarkar IN. Interventions to reduce electronic health record-related burnout: a systematic review. Appl Clin Inform. 2024;15(1):10-25. doi:10.1055/a-2203-3787
19. Sullivan AB, Davin SA, Lapin B, et al. Effects of flexible scheduling and virtual visits on burnout for clinicians: 1- year follow-up. Mult Scler Relat Disord. 2023;75:104721. doi:10.1016/j.msard.2023.104721
20. Prasad K, Poplau S, Brown R, et al. Time pressure during primary care office visits: a prospective evaluation of data from the healthy work place study. J Gen Intern Med. 2020;35(2):465-472. doi:10.1007/s11606-019-05343-6
21. Sambunjak D, Straus SE, Marusic A. Mentoring in academic medicine: a systematic review. JAMA. 2006;296(9):1103-1115. doi:10.1001/jama.296.9.1103
22. Wright WR, Jr., Dirsa AE, Martin SS. Physician mentoring: a process to maximize the success of new physicians and enhance synchronization of the group. J Med Pract Manage. 2002;18(3):133-137.
23. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71
24. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. doi:10.1186/s13643-016-0384-4
25. National Heart Lung and Blood Institute. Study quality assessment tools. National Institutes of Health. Accessed April 15, 2023. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools
26. Critical Appraisal Skills Programme. CASP: Qualitative Checklist. Accessed November 10, 2022. https://casp-uk.net/images/checklist/documents/CASP-Qualitative-Studies-Checklist/CASP-Qualitative-Checklist-2018_fillable_form.pdf
27. Connor MP, Bynoe AG, Redfern N, Pokora J, Clarke J. Developing senior doctors as mentors: a form of continuing professional development. Report of an initiative to develop a network of senior doctors as mentors: 1994-99. Med Educ. 2000;34(9):747-753. doi:10.1046/j.1365-2923.2000.00630.x
28. Cuaron JJ, Gillespie EF, Gomez DR, Khan AJ, Mychalczak B, Cahlon O. From orientation to onboarding: a survey-based departmental improvement program for new radiation oncology faculty physicians. JCO Oncol Pract. 2020;16(4):e395-e404. doi:10.1200/JOP.19.00641
29. Gordon L, Jindal-Snape D, Morrison J, et al. Multiple and multidimensional transitions from trainee to trained doctor: a qualitative longitudinal study in the UK. BMJ Open. 2017;7(11):e018583. doi:10.1136/bmjopen-2017-018583
30. Mann R, Ball K, Watson G. Mentoring for NHS general practitioners: a prospective pilot study of an action learning approach. Educ Prim Care. 2011;22(4):235-240. doi:10.1080/14739879.2011.11494006
31. McKimm J, Povey J. Evaluating the impact of a coaching pilot on the resilience and retention of UK general practitioners. BMJ Leader. 2018;2(4):144-148. doi:10.1136/leader-2018-000089
32. Menzin AW, Kline M, George C, Schindler J, Yacht AC, Fornari A. Toward the Quadruple Aim: impact of a humanistic mentoring program to reduce burnout and foster resilience. Mayo Clin Proc Innov Qual Outcomes. 2020;4(5):499-505. doi:10.1016/j.mayocpiqo.2020.05.001
33. Sharieff GQ. MD to MD coaching: improving physician-patient experience scores: what works, what doesn't. J Patient Exp. 2017;4(4):210-212. doi:10.1177/2374373517715008
34. Steven A, Oxley J, Fleming WG. Mentoring for NHS doctors: perceived benefits across the personal-professional interface. J R Soc Med. 2008;101(11):552-557. doi:10.1258/jrsm.2008.080153
35. Tom W, Tom W, Albarran D, Salman N, Van Groenou A. Ensuring mentorship of new physicians in their first year: constructs for new mentoring processes. Perm J. 2019;23. doi:10.7812/tpp/18-122
36. Welch JL, Jimenez HL, Walthall J, Allen SE. The women in emergency medicine mentoring program: an innovative approach to mentoring. J Grad Med Educ. 2012;4(3):362-366. doi:10.4300/jgme-d-11-00267.1
37. West CP, Dyrbye LN, Rabatin JT, et al. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med. 2014;174(4):527-533. doi:10.1001/jamainternmed.2013.14387
38. West CP, Dyrbye LN, Satele DV, Shanafelt TD. Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) groups for physician well-being: a randomized clinical trial. Mayo Clin Proc. 2021;96(10):2606-2614. doi:10.1016/j.mayocp.2021.02.028
39. Wilkie T, Tajirian T, Stergiopoulos V. Advancing physician wellness, engagement and excellence in a mental health setting: a Canadian perspective. Health Promot Int. 2022;37(1). doi:10.1093/heapro/daab061
40. Tietjen P, Griner PF. Mentoring of physicians at a community-based health system: preliminary findings. J Hosp Med. 2013;8(11):642-643. doi:10.1002/jhm.2094
41. Dyrbye LN, Shanafelt TD, Gill PR, Satele DV, West CP. Effect of a professional coaching intervention on the well-being and distress of physicians: a pilot randomized clinical trial. JAMA Intern Med. 2019;179(10):1406-1414. doi:10.1001/jamainternmed.2019.2425
42. Sekerka LE, Chao J. Peer coaching as a technique to foster professional development in clinical ambulatory settings. J Contin Educ Health Prof. 2003;23(1):30-37. doi:10.1002/chp.1340230106
43. Gardiner M, Kearns H, Tiggemann M. Effectiveness of cognitive behavioural coaching in improving the well-being and retention of rural general practitioners. Aust J Rural Health. 2013;21(3):183-189. doi:10.1111/ajr.12033
44. Saperstein AK, Viera AJ, Firnhaber GC. Mentorship and job satisfaction among Navy family physicians. Mil Med. 2012;177(8):883-888. doi:10.7205/milmed-d-11-00362
45. McGonagle AK, Schwab L, Yahanda N, et al. Coaching for primary care physician well-being: A randomized trial and follow-up analysis. J Occup Health Psychol. 2020;25(5):297-314. doi:10.1037/ocp0000180
46. Hernandez-Lee J, Pieroway A. Mentorship for early career family physicians: is there a role for the first five years in family practice committee and the CFPC? Can Fam Physician. 2018;64(11):861-862.
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