• Mayo Clinic proceedings · Jan 2023

    Randomized Controlled Trial

    IMPACT: Evaluation of a Controlled Organizational Intervention Using Influential Peers to Promote Professional Fulfillment.

    • Mickey T Trockel, Nikitha K Menon, Maryam S Makowski, Louise Y Wen, Rachel Roberts, Bryan D Bohman, and Tait D Shanafelt.
    • Stanford University School of Medicine, Palo Alto, California. Electronic address: trockel@stanford.edu.
    • Mayo Clin. Proc. 2023 Jan 1; 98 (1): 758775-87.

    ObjectiveTo determine the effects of a popular opinion leader (POL)-led organizational intervention targeting all physicians and advanced practice providers (APPs) working within clinic groups on professional fulfillment (primary outcome), gratitude, burnout, self-valuation, and turnover intent.Patients And MethodsAll 20 Stanford University HealthCare Alliance clinics with ≥5 physicians-APPs were matched by size and baseline gratitude scores and randomly assigned to immediate or delayed intervention (control). Between July 10, 2018, and March 15, 2019, trained POLs and a physician-PhD study investigator facilitated 4 interactive breakfast or lunch workshops at intervention clinics, where colleagues were invited to discuss and experience one evidence-based practice (gratitude, mindfulness, cognitive, and behavioral strategies). Participants in both groups completed incentivized annual assessments of professional fulfillment, workplace gratitude, burnout, self-valuation, and intent to leave as part of ongoing organizational program evaluation.ResultsEighty-four (75%) physicians-APPs at intervention clinics attended at least 1 workshop. Of all physicians-APPs, 236 of 251 (94%) completed assessments in 2018 and 254 of 263 (97%) in 2019. Of 264 physicians-APPs with 2018 or 2019 assessment data, 222 (84%) had completed 2017 assessments. Modal characteristics were 60% female, 46% White, 49% aged 40 to 59 years, 44% practicing family-internal medicine, 78% living with partners, and 53% with children. Change in professional fulfillment by 2019 relative to average 2017 to 2018 levels was more favorable (0.63 points; effect size = 0.35; P=.001) as were changes in gratitude and intent to leave among clinicians practicing at intervention clinics.ConclusionInterventions led by respected physicians-APPs can achieve high participation rates and have potential to promote well-being among their colleagues.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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