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Burnout is highly prevalent among oncology clinicians, including residents in training. This prospective, mixed-methods, quasi-experimental study will evaluate how burnout changes over 12 months during the first year of medical oncology residency and explore which work-related, professional identity, and program support factors influence this variation.
Residents will participate in a structured self-care and burnout prevention program with multiple modules (e.g., yoga, mindfulness, art therapy, music therapy, Balint groups, workshops, mentorship). Quantitative burnout outcomes will be measured using the Maslach Burnout Inventory (MBI-HSS), and qualitative insights will be collected through individual semi-structured interviews. The study will also describe sociodemographic characteristics, baseline burnout prevalence, participation/adherence, satisfaction, and implementation barriers/facilitators.
Population: first-year medical oncology residents affiliated with FALP. Design: prospective mixed-methods convergent parallel quasi-experimental study. Quantitative component uses MBI-HSS. Qualitative component consists of individual semi-structured interviews.
Program participation and attendance across modules will be tracked. Satisfaction and perceived usefulness will be assessed at program completion. Feedback from participants and faculty will be analyzed to identify barriers and facilitators and to optimize future cohorts. The burnout prevention program lasts 12 months; overall project execution is planned for 14 months to complete follow-ups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Self-Care and Burnout Prevention Program | Experimental | First-year medical oncology residents participate in a structured wellness program delivered over 12 months. Attendance is tracked, and feedback is collected to evaluate satisfaction and implementation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Self-Care and Burnout Prevention Program | Behavioral | (EN): Multi-component wellness program delivered over 12 months (e.g., yoga, mindfulness, art therapy, music therapy, Balint groups, workshops, mentorship). Attendance/adherence is tracked; participant feedback is collected to evaluate satisfaction and implementation barriers/facilitators. |
| Measure | Description | Time Frame |
|---|---|---|
| Burnout (MBI-HSS domains). Maslach Buront Inventory | Maslach Burnout Inventory-Human Services Survey (MBI-HSS) domains: Emotional Exhaustion, Depersonalization, and Personal Accomplishment. | Baseline and repeated every 3 mmonths during 12 months (per protocol schedule) |
| Measure | Description | Time Frame |
|---|---|---|
| Baseline burnout prevalence (baseline). | Maslach Burnout Inventory-Human Services Survey (MBI-HSS) domains: Emotional Exhaustion, Depersonalization, and Personal Accomplishment. at baseline | At Baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Attendance rate to scheduled program sessions (%) | Attendance will be calculated as: (number of scheduled sessions attended ÷ number of scheduled sessions offered) × 100 over the 12-month program. Attendance will be documented using program session attendance logs (and stored in REDCap). This aligns with the objective to characterize adherence/participation by quantifying attendance.Unit of Measure: Percent (%) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nicole M Caire, Medical Oncologist | Contact | +56974998222 | nicole.caire@falp.org | |
| Claudia C Chavez, Master of Science in Biostatis | Contact | +56966172416 | claudia.chavezo@falp.org |
| Name | Affiliation | Role |
|---|---|---|
| Nicole M Caire, Medical Oncologist | Fundacion Arturo Lopez Perez | Principal Investigator |
| Daniela A Reinhardt, Psychologist | Fundación Arturo Lopez Pérez | Study Chair |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37867478 | Background | Cufer T, Kosty MP; Curriculum Development Subgroup-ESMO/ASCO Global Curriculum Working Group. ESMO/ASCO Recommendations for a Global Curriculum in Medical Oncology Edition 2023. JCO Glob Oncol. 2023 Sep;9:e2300277. doi: 10.1200/GO.23.00277. | |
| 24515493 | Background | West CP, Dyrbye LN, Rabatin JT, Call TG, Davidson JH, Multari A, Romanski SA, Hellyer JM, Sloan JA, Shanafelt TD. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Intern Med. 2014 Apr;174(4):527-33. doi: 10.1001/jamainternmed.2013.14387. |
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Recruitment and Adherence rates to the program Baseline results of the MBI
Aggregate, de-identified data will be made available after completion of data collection and publication of the primary study results, approximately 6 to 12 months after study completion, and for 3 years after the study completion
Access will be granted to qualified researchers upon reasonable request for academic, non-commercial purposes. Requests must include a brief research proposal and will be subject to approval by the study investigators. Only aggregate, fully de-identified data will be shared, in accordance with institutional policies and ethical approvals.
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| ID | Term |
|---|---|
| D000077062 | Burnout, Psychological |
| D002055 | Burnout, Professional |
| ID | Term |
|---|---|
| D013315 | Stress, Psychological |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D000073397 | Occupational Stress |
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| ID | Term |
|---|---|
| D012648 | Self Care |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D012046 | Rehabilitation |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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This is a prospective, single-center, quasi-experimental interventional study using a mixed-methods longitudinal design. All eligible first-year medical oncology residents participate in a structured well-being and burnout prevention program delivered over a 12-month period. The intervention consists of recurrent, multimodal group-based sessions (including mindfulness, yoga, art and music therapy, reflective practice, and facilitated group discussions), integrated into the residency curriculum. There is no randomization or parallel control group; each participant serves as their own comparator over time. Quantitative outcomes are assessed repeatedly using validated instruments (Maslach Burnout Inventory), complemented by qualitative data obtained through semi-structured individual interviews. This design allows evaluation of temporal changes in burnout dimensions and exploration of contextual and experiential factors influencing professional well-being.
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|
| throughout 12 months (complete duration of the program) |
| Overall program satisfaction score assessed by post-program satisfaction survey (Likert 1-5) | Participants will complete a post-program quantitative satisfaction survey at program completion. Overall satisfaction will be rated on a 5-point Likert scale (1 = very dissatisfied, 5 = very satisfied). Results will be summarized as mean (SD) and/or median (IQR).Unit of Measure: Score (1-5) | At program completion (12 months) |
| Identification of barriers and facilitators to implementation | To identify barriers and facilitators to program implementation and participation, explored through qualitative analysis of semi-structured interviews and participant feedback, including organizational, workload-related, personal, and contextual factors influencing engagement and feasibility. | Throughout 12 months (complete duration of the program) |
| Participants completing ≥75% of scheduled program sessions (%) | A participant will be considered adherent if they complete at least 75% of the scheduled program sessions during the 12-month period. The outcome will be reported as the proportion of participants meeting this threshold. This is consistent with the protocol criterion of ≥75% session completion.Unit of Measure: Percent (%) | Throughout 12 months (complete duration of the program) |
| Perceived usefulness of the program assessed by post-program usefulness survey (Likert 1-5) | Participants will complete a post-program quantitative usefulness survey at program completion. Perceived usefulness will be rated on a 5-point Likert scale (1 = not useful at all, 5 = extremely useful). Results will be summarized as mean (SD) and/or median (IQR).Unit of Measure: (1-5) | At program completion (12 months) |
| Qualitative feedback on satisfaction and usefulness assessed by end-of-program open-ended survey responses (themes) | Qualitative feedback regarding satisfaction, perceived usefulness, and perceived impact of program components will be collected through open-ended questions at program completion. Responses will be analyzed using thematic analysis to identify key themes (barriers, facilitators, perceived relevance/acceptability/impact).Unit of Measure: Themes (qualitative) | At program completion (12 months) |
| Victor M Tapia, Drama Therapist |
| Fundacion Arturo Lopez Perez |
| Study Chair |
| 39085974 | Background | Kannai R, Krontal S, Freud T, Biderman A. Balint groups: an effective tool for improving health professionals' perceived well-being. Isr J Health Policy Res. 2024 Aug 1;13(1):31. doi: 10.1186/s13584-024-00618-8. |
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| 32223701 | Background | Hlubocky FJ, Taylor LP, Marron JM, Spence RA, McGinnis MM, Brown RF, McFarland DC, Tetzlaff ED, Gallagher CM, Rosenberg AR, Popp B, Dragnev K, Bosserman LD, Dudzinski DM, Smith S, Chatwal M, Patel MI, Markham MJ, Levit K, Bruera E, Epstein RM, Brown M, Back AL, Shanafelt TD, Kamal AH. A Call to Action: Ethics Committee Roundtable Recommendations for Addressing Burnout and Moral Distress in Oncology. JCO Oncol Pract. 2020 Apr;16(4):191-199. doi: 10.1200/JOP.19.00806. Epub 2020 Mar 30. |
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| D009784 |
| Occupational Diseases |