@Article{info:doi/10.2196/45102,
author="Goldhaber, Nicole H
and Chea, Annie
and Hekler, Eric B
and Zhou, Wenjia
and Fergerson, Byron",
title="Evaluating the Mental Health of Physician-Trainees Using an SMS Text Message--Based Assessment Tool: Longitudinal Pilot Study",
journal="JMIR Form Res",
year="2023",
month="Jun",
day="2",
volume="7",
pages="e45102",
keywords="physician burnout; mental health; text-message assessment; text; mobile text; stress assessment; text message; pilot study; physician; burnout; United States; survey; trainee; stress; engagement; users; tracking",
abstract="Background: Physician burnout is a multibillion-dollar issue in the United States. Despite its prevalence, burnout is difficult to accurately measure. Institutions generally rely on periodic surveys that are subject to recall bias. SMS text message--based surveys or assessments have been used in health care and have the advantage of easy accessibility and high response rates. Objective: In this pilot project, we evaluated the utility of and participant engagement with a simple, longitudinal, and SMS text message--based mental health assessment system for physician-trainees at the study institution. The goal of the SMS text message--based assessment system was to track stress, burnout, empathy, engagement, and work satisfaction levels faced by users in their normal working conditions. Methods: Three SMS text message-based questions per week for 5 weeks were sent to each participant. All data received were deidentified. Additionally, each participant had a deidentified personal web page to follow their scores as well as the aggregated scores of all participants over time. A 13-question optional survey was sent at the conclusion of the study to evaluate the usability of the platform. Descriptive statistics were performed. Results: In all, 81 participants were recruited and answered at least six (mean 14; median 14; range 6-16) questions for a total of 1113 responses. Overall, 10 (17{\%}) out of 59 participants responded ``Yes'' to having experienced a traumatic experience during the study period. Only 3 participants ever answered being ``Not at all satisfied'' with their job. The highest number of responses indicating that participants were stressed or burnt out came on day 25 in the 34-day study period. There were mixed levels of concern for the privacy of responses. No substantial correlations were noted between responses and having experienced a traumatic experience during the study period. Furthermore, 12 participants responded to the optional feedback survey, and all either agreed or strongly agreed that the SMS text message--based assessment system was easy to use and the number of texts received was reasonable. None of the 12 respondents indicated that using the SMS text message--based assessment system caused stress. Conclusions: Responses demonstrated that SMS text message--based mental health assessments are potentially useful for recording physician-trainee mental health levels in real time with minimal burden, but further study of SMS text message--based mental health assessments should address limitations such as improving response rates and clarifying participants' sense of privacy when using the SMS text message--based assessment system. The findings of this pilot study can inform the development of institution-wide tools for assessing physician burnout and protecting physicians from occupational stress. ",
issn="2561-326X",
doi="10.2196/45102",
url="https://formative.jmir.org/2023/1/e45102",
url="https://doi.org/10.2196/45102",
url="http://www.ncbi.nlm.nih.gov/pubmed/37266985"
}