A mixed methods pilot study of an internal coaching program within an academic emergency department

Abstract

Background: Over 60% of emergency medicine physicians experience burnout. Professional coaching of physicians may reduce emotional exhaustion and burnout, while improving quality of life and resilience; however, few studies have specifically investigated coaching's impact on job satisfaction and burnout of emergency physicians. This study assesses the effects of a novel coaching program, which utilized internal professional coaches, on burnout and job satisfaction among emergency physicians in an academic emergency department.

Methods: In January 2022, an internal coaching program commenced for upper-level residents, fellows, and new faculty physicians. Participants engaged in individual coaching sessions, and group coaching sessions (n = 4) were offered to the entire department on a variety of topics (e.g., Leadership, Bedside Teaching). Quantitative data were collected to measure baseline and follow-up burnout and job satisfaction scores via the 2-Question Summative Score of Maslach Burnout Inventory [MBI] and Global Job Satisfaction [GJS] scales, respectively. Qualitative data gathered through surveys were inductively coded, leading to the identification of experiential themes.

Results: Thirty-two participants enrolled in individual coaching. Eighty-nine individual coaching sessions were delivered, totaling 69.34 h. Participants received a median of 2 (range:1-6) sessions. Department-wide baseline and follow-up survey response rates were 33.7% and 32.7%, respectively. Among all respondents, burnout symptoms did not change significantly (MBI: t(55) = 2.00, p = 0.15), but job satisfaction declined significantly, with mean GJS scores decreasing from 3.73 (SD = 0.70, 95% CI: 3.49-3.98) to 3.15 (SD = 0.91, 95% CI: 2.82-3.47). When analyzed by coaching participation, no significant differences were found in MBI (t(12) = 2.18, p = 0.71) or GJS (t(10) = 2.23, p = 0.75) scores between participants and non-participants. Thematic analysis highlighted benefits and challenges of the internal coaching program. Identified themes reinforced coaching best practices (e.g., solutions-focused sessions), provided context for future efforts (e.g., maintaining diverse perspectives), and highlighted advantages and disadvantages of internal coaches (e.g., familiarity versus privacy).

Conclusion: Our pilot study did not demonstrate a reduction in burnout or an increase in job satisfaction. However, internal coaching offers valuable opportunities for academic emergency departments, including unique benefits and challenges. Future research should explore system-level impacts on burnout and job satisfaction during coaching program implementation as well as cost-effectiveness.

Keywords: Academic medicine; Burnout; Coaching; Emergency medicine; Emergency physician; Job satisfaction; Professional development; Wellness.

Fig. 1

Coaching Program Timeline. *Pooled and paired responses compared between baseline and follow-up surveys. **/*** Not all individuals who participated in either or both individual or group coaching participated in the baseline or follow-up surveys; some participants attended more than 1 group coaching session