Using nominal group technique among resident physicians to identify key attributes of a burnout prevention program

Purpose: To identify preferred burnout interventions within a resident
physician population, utilizing the Nominal Group Technique. The results
will be used to design a discrete choice experiment study to inform the
development of resident burnout prevention programs. Methods: Three
resident focus groups met (10-14 participants/group) to prioritize a list
of 23 factors for burnout prevention programs. The Nominal Group Technique
consisted of three steps: an individual, confidential ranking of the 23
factors by importance from 1 to 23, a group discussion of each attribute,
including a group review of the rankings, and an opportunity to alter the
original ranking across participants. Results: The total number of
residents (36) were a representative sample of specialty, year of
residency, and sex. There was strong agreement about the most highly rated
attributes which grouped naturally into themes of autonomy, meaning,
competency and relatedness. There was also disagreement on several of the
attributes that is likely due to the differences in residency specialty
and subsequently rotation requirements. Conclusion: This study identified
the need to address multiple organizational factors that may lead to
physician burnout. There is a clear need for complex interventions that
target systemic and program level factors rather than focus on individual
interventions. These results may help residency program directors
understand the specific attributes of a burnout prevention program valued
by residents. Aligning burnout interventions with resident preferences
could improve the efficacy of burnout prevention programs by improving
adoption of, and satisfaction with, these programs.

目的：采用名义小组技术（Nominal Group Technique）确定住院医师群体偏好的职业倦怠干预措施。研究结果将用于设计离散选择实验研究，为住院医师职业倦怠预防项目的开发提供参考。方法：组织3个住院医师焦点小组（每组10-14名参与者），对23项职业倦怠预防项目相关因素进行优先级排序。名义小组技术包含三个步骤：参与者独立、保密地按重要性对23项因素进行1至23分的排名；针对每项因素开展小组讨论，包括集体回顾排名情况；为参与者提供调整初始排名的机会。结果：参与研究的36名住院医师在专业方向、住院医师年限及性别方面具有代表性。参与者对评分最高的因素达成强烈共识，这些因素自然归为自主性、意义感、胜任力及关联性四大主题。此外，部分因素存在分歧，这可能源于住院医师专业方向及后续轮转要求的差异。结论：本研究明确了需解决可能导致医师职业倦怠的多项组织因素。显然，需要针对系统层面和项目层面因素的复杂干预措施，而非仅关注个体层面的干预。研究结果可帮助住院医师项目主任了解住院医师重视的职业倦怠预防项目的具体属性。使职业倦怠干预措施与住院医师偏好保持一致，可通过提高干预措施的采纳率和满意度，提升其有效性。