Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) groups for physician well-being: A randomized clinical trial (West et al., 2021)

Study Profile What's in a study profile?
Causal Study Rating:
Low Causal Evidence
Study Type:
Causal Impact Analysis
Outcome Findings:
Attitudes: Mod/high-Favorable impacts
Health and safety: Mod/high-Favorable impacts
Citation
West, C. P., Dyrbye, L. N., Satele, D. V., & Shanafelt, T. D. (2021). Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) groups for physician well-being: A randomized clinical trial. Mayo Clinic Proceedings, 96(10), 2606-2614. https://doi.org/10.1016/j.mayocp.2021.02.028

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There is no conflict of interest.

Highlights

  • The study’s objective was to examine the impact of the Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) group intervention on health and attitude outcomes.
  • The study used a randomized controlled trial to assign physicians to the COMPASS treatment group or the control group. The authors used surveys and statistical tests to compare the outcomes of the treatment and control groups at 6 and 12 months post-intervention.
  • The study found a significant relationship between COMPASS group participation and reduced burnout, depression, and likelihood of leaving the practice within two years.
  • This study receives a low evidence rating. This means we are not confident that the estimated effects are attributable to the COMPASS groups; other factors are likely to have contributed.

Features of the Intervention

The Colleagues Meeting to Promote and Sustain Satisfaction (COMPASS) group intervention addressed burnout, job satisfaction, and overall mental health among physicians. It offered a small-group setting where physicians discussed an assigned topic related to their experiences and well-being, without the presence of trained facilitators. The program included 12 sessions held every two weeks over six months. Each session featured a 15-minute discussion on a specific topic, followed by 45 minutes of shared meals and additional conversation without a facilitator. Although the physicians did not have designated time for these meetings, they were reimbursed for their meal costs.

Features of the Study

The study was a randomized controlled trial conducted in the Department of Medicine at the Mayo Clinic in Rochester, Minnesota between October 2013 and October 2014. Of the 125 physicians who consented to participate, 64 were randomly assigned to the treatment group and 61 were assigned to the control group. Physicians in the treatment group participated in the COMPASS group intervention, while those in the control group were offered the opportunity to participate after the study ended. Most of the participants were men (56.9%), worked in general medicine (46.3%), and were aged 31 to 40 years (32.5%). The overall burnout rate among the sample was 45.5%, with 39.8% showing signs of depression, and 25.2% likely to leave their current job within two years.

The primary data source was surveys administered at baseline and again at 6 and 12 months. The study used multiple instruments to develop the pre-post surveys. It included the Maslach Burnout Inventory subscales, which measure emotional exhaustion, depersonalization, and personal accomplishment, as well as overall burnout, depression, and overall Quality of Life. For attitudes, the Physician Job Satisfaction Scale was used to assess overall satisfaction and the likelihood of leaving the current practice within two years. The authors used statistical tests to compare differences in outcomes between the treatment and control groups while controlling for participants’ levels of distress at the study onset.

Findings

Health and safety

  • The study found significant relationships between COMPASS group participation and decreases in high emotional exhaustion, high depersonalization, and low personal accomplishment at both 6 and 12 months.
  • The study also found a significant relationship between COMPASS group participation and decreases in overall burnout and positive depression screen at 12 months. No significant relationship was found for these outcomes at 6 months.
  • However, the study did not find a significant relationship between COMPASS group participation and overall Quality of Life at any time point.

Attitudes

  • The study found a significant relationship between COMPASS group participation and a decrease in the likelihood of leaving the current practice within two years at both 6 and 12 months.
  • However, the study did not find a significant relationship between COMPASS group participation and overall job satisfaction at any time point.

Considerations for Interpreting the Findings

Although the study was a randomized controlled trial, it had high attrition in the treatment group. Additionally, the authors did not account for preexisting differences between the groups before program participation or include sufficient control variables for race/ethnic composition as required by the protocol. These preexisting differences between the groups—and not the COMPASS group—could explain the observed differences in outcomes. Therefore, this study is not eligible for a high or moderate causal evidence rating.

Causal Evidence Rating

The quality of causal evidence presented in this report is low because it was based on a randomized controlled trial with high attrition, and the authors did not ensure that the groups being compared were similar before the intervention. This means we are not confident that the estimated effects are attributable to the COMPASS groups; other factors are likely to have contributed.

Reviewed by CLEAR: June 2026

Research Guidelines

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Review Guidelines: Causal Evidence Guidelines