Design future resilience-intervention research as large pragmatic RCTs with sufficient follow-up and explicit resilience definitions¶

Strategy · All strategies
Evidence · 3 claims (3 for) · 1 study (1 quant-synthesis), q2 · 0 of 1 report an effect size · 3 claims rest on one study

Description¶

The review closes with design recommendations for future studies of resilience interventions in practicing physicians. It recommends that "future research include large pragmatic RCTs with sufficient follow-up time", and that trials define what they mean by resilience and whether the outcome measure actually measures resilience or another proxy outcome. It also calls for a consensus on the definition of resilience and how it is measured, and for longer follow-up to ensure effects are sustained.

Design Implications¶

Context¶

Requirements¶

• Trials should define what they mean by resilience and whether the outcome measure actually measures resilience or another proxy outcome

Constraints¶

• Current evidence base is heterogeneous, small, and of very low to low quality, so no specific intervention can yet be recommended

Target Learners¶

• physicians who have completed training and work in any setting

Target Learning Goals¶

• improve resilience and reduce negative outcomes including burnout, anxiety and depression

Claims¶

• Two small pilot RCTs measuring resilience with validated scales reported significant improvement [+W]
• The randomized trial providing analyzable burnout data showed no statistically significant improvement in any burnout subscale [+W]
• There is weak evidence to support one resilience intervention over another for physicians who have completed training [+W]

Related Strategies¶

• Future MBI trials for youth should use scaled-up definitive designs with active intervention controls and embedded mechanism measures
• Future psychiatry education technology studies should use active comparators, standardized assessment tools, and long-term follow-up
• Future active-learning research should use randomised controlled designs with larger samples and standardised outcome measures

Examples¶

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Key Sources¶

• Venegas Carolina Lavin, Nkangu Miriam N., Duffy Melissa C., Fergusson Dean A., Spilg Edward G. (2019). Interventions to improve resilience in physicians who have completed training: A systematic review. PLoS ONE. https://doi.org/10.1371/journal.pone.0210512