JMIR Publications

ABSTRACT

Background:

Burnout among medical practitioners is a prevalent problem with significant adverse outcomes. Symptoms can emerge as early as undergraduate medical training, leading to calls for the development of effective preventive interventions. Psychological flexibility (PF) is a skillset that has demonstrated benefits with respect to burnout and wellbeing, and could be a potential focus of preventive interventions aiming to buffer adverse impacts of non-modifiable aspects of medical work, and promote sustainable career wellbeing.

Objective:

This study will assess the efficacy of an App-delivered Acceptance and Commitment Training (ACT) intervention for medical students, with respect to burnout, wellbeing and PF outcomes. We will examine whether changes in burnout and wellbeing outcomes following the intervention are mediated by changes in PF. Potential benefits of an individualised version of the App compared with a non-individualised version will be evaluated.

Methods:

This study will adopt a 3-arm parallel randomised controlled methodology. We aim to recruit 153 medical students who will engage in an App-delivered ACT intervention. Following a brief introductory educational session, participants will be randomly allocated to one of the three intervention arms (individualised, non-individualised, waiting list) using a 1:1:1 allocation ratio. The intervention will run for 5 weeks, during which participants in the individualised and non-individualised arms will complete a concepts training session (Part 1: Learn the Concepts). Completion of Part 1 unlocks a training dashboard that allows participants to access short PF behaviour skills-training activities “on demand” (Part 2: Learn the Behaviours). For participants in the individualised group, Part 2 training activities will be matched to the PF process they report having the most difficulty with in that moment. For the non-individualised group, Part 2 activities will be delivered randomly from any of the six PF skillsets.

Results:

Burnout, wellbeing, and PF will be assessed at baseline and post-intervention. Quantitative analyses will be conducted, including descriptive and inferential statistics. We hypothesise that the ACT intervention will be effective in improving burnout, wellbeing, and PF, and that the individualised intervention will demonstrate superior efficacy compared with non-individualised. We predict that changes in burnout and wellbeing following the ACT intervention will be mediated by changes in PF.

Conclusions:

This study will provide important information that could guide stakeholder decision-making regarding burnout-prevention and wellbeing initiatives for medical practitioners and students. Identifying PF as a mediating process would provide support for preventive intervention programs that train individuals to strengthen this resource before burnout symptoms emerge. This would be an important step in addressing, and potentially offsetting, the significant personal, organisational, economic and societal costs of burnout among medical professionals. Demonstrating the superiority of an individualised version of the App over a non-individualised version would have implications for enhancing intervention efficacy using scalable interventions. Clinical Trial: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621000911897 https://www.anzctr.org.au/ACTRN12621000911897.aspx