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

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.

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.

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).

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.