Examination of the Acceptability and Feasibility of a Virtually Delivered Facilitator-Led and Self-Directed Cognitive Behavioral Skills Intervention in a Sample of Physicians and Medical Learners: Mixed Methods Evaluation.

Background: The prevalence of various mental health conditions is higher among physicians and medical learners. One common barrier to receiving adequate care includes a lack of time to see a provider and follow treatment plans. As such, virtual forms of cognitive behaviour therapy with mindfulness (CBTm) were introduced to mitigate these barriers and provide care in an efficient and effective manner. Objective: The objective of this study was to determine the acceptability and feasibility of a 5-session CBTm program, delivered in 2 virtual formats within a population of medical learners and physicians. Methods: Participants signed up to the program using an online link and were able to choose a preferred format to participate in the CBTm program. One option was a virtual, facilitator-led class that was held once a week for 5 weeks, in a group setting (CBTm facilitator-led). Another option included a self-directed course that had identical content to the live classes but was independently completed by the participant using an online platform (CBTm self-directed). Feedback forms were collected from participants after every class and analyzed using quantitative and qualitative methods. Thematic analysis was used to qualitatively analyze open-ended questions from participant feedback forms. In addition, the mean values of questionnaire items were used to determine participant satisfaction with the program. Results: The results indicated a good level of interest in both CBTm facilitator-led (n=15) and CBTm self-directed (n=94) groups. Of those who registered for the program, 13.8% (15/109) registered for CBTm facilitator-led and 86.2% (94/109) chose the self-directed version. The percentage of participants who participated in the majority of classes was 80% (12/15) for the CBTm facilitator-led group and 45.7% (43/94) for the CBTm self-directed group. The mean age of participants was 44.86 (SD 12.15 years), and the highest rate of uptake was among female physicians. Quantitative mean scores of participant feedback forms also showed a high level of satisfaction. For example, the Client Satisfaction Questionnaire 8 (CSQ-8) was analyzed, and the results indicated mean total scores of 28.00 (SD 3.24) and 26.46 (SD 3.55) for CBTm facilitator-led and CBTm self-directed, respectively. In addition, many themes emerged from thematic analysis and were subsequently categorized into 3 major categories. This included perceived strengths, perceived weaknesses, and suggested revisions to improve the program. Perceived strengths included improved mental health, helpful course content, and improved patient care. Perceived weaknesses included individual barriers to participation, content downfalls, and format-specific barriers. Suggested revisions included improving adherence to homework and virtual delivery of the program. Conclusions: In conclusion, the results indicate that the self-directed and facilitator-led versions of CBTm were acceptable and feasible in this population of physicians and medical learners.