Official Title
The Role of Virtual Peer Support Platforms for Reducing Stress and Burnout Among Frontline Healthcare Workers During COVID-19: A Randomized Controlled Trial
Brief Summary

Physician burnout has a significant impact on the wellness and productivity of physicians as well as patient health outcomes. Managing burnout among frontline workers is critical to Canada's response to the COVID-19 pandemic, in order to support frontline workers and reduce inefficiencies and medical errors frequently linked to burnout, ultimately improving our ability to detect, treat and manage COVID-19 cases. Therefore, this trial aims to assess the effects of an 8-session intervention over 3 months for burnout in physician residents in residency programs in Canada and the United States of America during the COVID-19 pandemic. This trial will provide evidence to inform health system management and public health response early and effectively so as to maintain the integrity of our workforce during and post-pandemic. The virtual delivery platform renders the proposed intervention easily disseminated internationally, in low- middle- and high- income countries and across urban and rural cities.

Detailed Description

Physician burnout has come to the forefront of discourse within the medical field due to its
significant impact on the wellness and productivity of physicians as well as patient health
outcomes. Burnout is defined as physical, mental and emotional exhaustion resulting from
persistent exposure to an emotionally demanding trigger, and is comprised of three
dimensions: emotional exhaustion (EE), depersonalization (DP) and lack of personal
accomplishment (PA). Residency is a particularly stressful time; the junior physician is
tasked with a tremendous responsibility of providing high quality care while learning and
integrating new skills during training. Adapting to these job demands has a direct
consequence on one's emotional reserve and ability to establish a healthy home-work
interface. Recent data indicates 47% of residents around the world suffer from burnout, and
that rates are highest in North America.

During times of lethal pandemics, healthcare workers (HCWs) have a duty to serve on the
frontlines. Within three months of the first report of COVID-19, a global pandemic was
declared and social separation and economic shutdowns were enforced around the globe.
Meanwhile, resident physicians were redeployed to the frontlines by their training
institutions, inevitably jeopardizing their speciality training. In addition to the
detrimental personal and substantial financial stressors generally incurred by persons during
a pandemic, residents bear the burden of caring for others and witnessing tragic outcomes
thus putting them at risk of "accelerated burnout". HCWs on the frontlines during times of
crisis and natural disaster historically suffer from more severe emotional distress,
depression, anxiety, and social isolation. This is consistent with findings from a recent
study of frontline workers in Wuhan, China during the COVID-19 pandemic, and reports of
suicide among frontline workers attributed to COVID-19 associated stressors.

Many studies have aimed to delineate contributors of burnout and common themes that have
emerged include excessive workloads, feeling unsupported, lack of autonomy, and lack of
work-home integration. In addition to traditional causes of burnout, the heightened risk of
occupational exposure to infection, process inefficiencies, limited resources, and financial
instability have been established as additional stressors among HCWs during COVID-19. These
factors, in addition to social stigmatization and ostracism by family and the fearful public
have also been cited as major contributors to stress among HCWs during the SARS pandemic, the
Ebola epidemic, and among HCWs caring for AIDS patients during the late 1980s.

Addressing burnout among frontline workers is essential to supporting Canada's response to
the COVID-19 pandemic, in order to 1) keep our frontline workers on the frontlines, and 2)
reduce inefficiencies and medical errors frequently linked to burnout, ultimately improving
our ability to detect, treat and manage COVID-19 cases. Therefore, this trial aims to test
the effects of a 3 month, 8-session intervention to reduce burnout in physician residents in
residency programs in Canada and the United States of America during the COVID-19 pandemic.
This trial will provide evidence to inform health system management and public health
response early and effectively so as to maintain the integrity of our workforce during and
post-pandemic.

Unknown status
Burnout

Behavioral: Virtual Peer Support Platform

The intervention program will consist of 8 virtual 30-minute sessions delivered across three months. Sessions will follow a structured format including: check-in, issue identification & context, facilitated discussion, environmental strategies, occupational strategies, experiential component, as well as summary and sign-out. Meetings will finish with a stress relieving activity, to be performed together on the web-based platform. The facilitated discussions will follow important themes including focus on self, patients, and external stressors.

Behavioral: Control Period

The control period will be the time prior to randomization and commencement of the intervention, whereby residents will receive a 30 minute break each week during their academic half-day.

Eligibility Criteria

Inclusion Criteria:

- Physician residents across all medical specialties at McMaster University, McGill
University, and Stanford University.

- Must be able to provide written informed consent

Exclusion Criteria:

- Residents who are on prolonged leave (>4 weeks)

Eligibility Gender
All
Eligibility Age
Minimum: 18 Years ~ Maximum: N/A
Countries
Canada
Locations

St. Joseph's Healthcare Hamilton
Hamilton, Ontario, Canada

Contacts

Jacqueline Hudson
9055221155 - 39215
jhudson@mcmaster.ca

Zainab Samaan, MBChB, PhD
samaanz@mcmaster.ca

Zainab Samaan, MBChB, PhD, Principal Investigator
St. Joseph's Healthcare Hamilton

St. Joseph's Healthcare Hamilton
NCT Number
Keywords
Physician
burnout
Covid-19
public health response
Stress
depression
virtual peer support platforms
frontline healthcare workers
MeSH Terms
COVID-19
Burnout, Psychological