Impact of Curricular Transformation on Family Medicine Resident Burnout

NCT04451070 | Completed

• 1 other identifier: FWH20200114E
• Study Type: observational
• Target: 25
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine if the implementation of a Family Medicine residency curriculum that is based upon the principles of Clinic First, as originally described by the Center for Excellence in Primary Care at the University of California, San Francisco, results in a decrease in the extent of burnout among Family Medicine resident physicians at David Grant Medical Center on Travis Air Force Base in Fairfield, California. This is a descriptive study designed to assess the extent of burnout among Family Medicine resident physicians pre- and post-implementation of a Clinic First-inspired Family Medicine residency curriculum. The study will utilize the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSS (MP)), which is a validated instrument that was designed to assess (1) emotional exhaustion, (2) depersonalization, and (3) personal accomplishment among medical personnel.

Conditions

Burnout Among Family Medicine Resident Physicians

Keywords

Burnout; Family Medicine; Resident; Clinic First

Outcome Measures

Primary Outcomes (3)

• Family Medicine resident physician burnout, baseline

  Family Medicine resident physician burnout as measured by the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSS-MP). Participants will rate how often they experience each of the 22 symptom questions on a scale of 0 (never) to 6 (every day). Both a total score and an average score for each of the 3 subscales (ie, emotional exhaustion, depersonalization, and personal accomplishments) will be calculated.

  Baseline (before new curriculum was implemented)

• Family Medicine resident physician burnout, 3-6 months

  Family Medicine resident physician burnout as measured by the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSS-MP). Participants will rate how often they experience each of the 22 symptom questions on a scale of 0 (never) to 6 (every day). Both a total score and an average score for each of the 3 subscales (ie, emotional exhaustion, depersonalization, and personal accomplishments) will be calculated.

  3-6 months after new curriculum was implemented

• Family Medicine resident physician burnout, 9-12 months

  Family Medicine resident physician burnout as measured by the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSS-MP). Participants will rate how often they experience each of the 22 symptom questions on a scale of 0 (never) to 6 (every day). Both a total score and an average score for each of the 3 subscales (ie, emotional exhaustion, depersonalization, and personal accomplishments) will be calculated.

  9-12 months after new curriculum was implemented

Study Arms (1)

Family Medicine resident physicians

Family Medicine resident physicians at David Grant Medical Center who started their Family Medicine residency at David Grant Medical Center between June 2018 - June 2019 and are scheduled to graduate from Family Medicine residency between June 2021 - June 2022.

Other: Clinic First curriculum

Interventions

Clinic First curriculum OTHER

The Clinic First model was designed by the Association of Family Medicine Residency Directors (AFMRD) in collaboration with the University of California San Francisco's (UCSF) Center for Excellence in Primary Care. The components of the Clinic First model are summarized in the Association of American Medical Colleges' (AAMC) publication titled "High-Functioning Primary Care Residency Clinics: Building Blocks for Providing Excellent Care and Training". Using the principles of Clinic First, the authors of this study drafted a Family Medicine residency curriculum to be implemented at David Grant Medical Center at the beginning of the 2020-2021 academic year.

Family Medicine resident physicians

Eligibility Criteria

• Age: 25 Years - 64 Years
• Sex: all
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Family Medicine resident physicians in the Family Medicine residency program at David Grant Medical Center on Travis Air Force Base in Fairfield, California who fulfill the eligibility criteria as listed above.

You may qualify if:

• Family Medicine resident physicians at David Grant Medical Center
• Residents must have started their Family Medicine residency at David Grant Medical Center between June 2018 - June 2019
• Residents must be scheduled to graduate from Family Medicine residency between June 2021 - June 2022

You may not qualify if:

• Family Medicine resident physicians at David Grant Medical Center who started their residency before June 2018 or after June 2019.
• Family Medicine resident physicians at David Grant Medical Center who are scheduled to graduate from Family Medicine residency before May 2021 or after July 2022.

Sponsors & Collaborators

• David Grant U.S. Air Force Medical Center: lead

Study Sites (1)

David Grant Medical Center

Fairfield, California, 94535, United States

Location

Related Publications (10)

• 1. Accreditation Council for Graduate Medical Education. "The ACGME Releases 'CLER National Report of Findings 2019: Initial Visits to Sponsoring Institutions With 2 or Fewer Core Residency Programs'." PR Newswire: Press Release Distribution, Targeting, Monitoring and Marketing, Accreditation Council for Graduate Medical Education, 22 Aug. 2019, www.prnewswire.com/newsreleases/the-acgme-releases-cler-national-report-of-findings-2019-initial-visits-to-sponsoringinstitutions-with-2-or-fewer-core-residency-programs-300905975.html.

  BACKGROUND

• 2. Wagner, Robin. David Grant Medical Center Clinical Learning Environment Review (CLER) Site Visit Report. Accreditation Council for Graduate Medical Education, 2019, pp. 1-21, David Grant Medical Center Clinical Learning Environment Review (CLER) Site Visit Report.

  BACKGROUND

• 3. "ACGME Program Requirements for Graduate Medical Education in Family Medicine." Accreditation Council for Graduate Medical Education , 1 July 2019, www.msm.edu/Education/GME/Documents/FamilyMedicine/ACGME_Requirements_120_family_medicine_2016.pdf.

  BACKGROUND

• 4. Bodenheimer, Thomas, et al. High-Functioning Primary Care Residency Clinics: Building Blocks for Providing Excellent Care and Training. Association of American Medical Colleges, 2016, pp. 1-62, High-Functioning Primary Care Residency Clinics: Building Blocks for Providing Excellent Care and Training.

  BACKGROUND

• 5. "Clinic First Collaborative." Association of Family Medicine Residency Directors (AFMRD), 2020, www.afmrd.org/page/afmrdmembership.

  BACKGROUND

• Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009 Nov 14;374(9702):1714-21. doi: 10.1016/S0140-6736(09)61424-0.

  PMID: 19914516 BACKGROUND

• 7. "Burn-out an 'Occupational Phenomenon': International Classification of Diseases." World Health Organization, World Health Organization, 28 May 2019, www.who.int/mental_health/evidence/burn-out/en/.

  BACKGROUND

• Dupras DM, West CP. Training for Careers in Primary Care: Time for Attention to Culture. J Gen Intern Med. 2015 Sep;30(9):1243-4. doi: 10.1007/s11606-015-3416-1. No abstract available.

  PMID: 26173533 BACKGROUND

• 9. Shapiro, Miriam, and Alice Fornari. Factors Influencing Primary Care Residency Selection among Students at an Urban Private Medical School. 1st ed., vol. 25, The Einstein Journal of Biology and Medicine, 2010, pp. 19-24, Factors Influencing Primary Care Residency Selection among Students at an Urban Private Medical School.

  BACKGROUND

• Alavi M, Ho T, Stisher C, Richardson E, Kelly C, McCrory K, Snellings J, Zurek K, Boltz MW. Factors That Influence Student Choice in Family Medicine A National Focus Group. Fam Med. 2019 Feb;51(2):143-148. doi: 10.22454/FamMed.2019.927833.

  PMID: 30736039 BACKGROUND

MeSH Terms

Conditions

Burnout, Psychological

Condition Hierarchy (Ancestors)

Stress, Psychological; Behavioral Symptoms; Behavior

Study Officials

• Courtney E Halista, MD

  Family Medicine Faculty Physician at David Grant Medical Center

  PRINCIPAL INVESTIGATOR

• Heather A Dalton, MD

  Family Medicine Faculty Physician at David Grant Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 12 Months
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: June 25, 2020
• First Posted: June 30, 2020
• Study Start: June 26, 2020
• Primary Completion: June 4, 2021
• Study Completion: June 4, 2021
• Last Updated: June 14, 2021

Record last verified: 2021-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)