Impact of intrawork rest breaks on doctors’ performance and well-being: systematic review

Abstract

Objectives To summarise evidence on intrawork breaks and their associated effect on doctors’ well-being and/or performance at work.Design Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement guidelinesData sources Embase, PubMed, Web of Science (Core Collection) and PsychINFO were systematically searched on 6 June 2021.Eligibility criteria No restrictions were placed on language, study design or date of publication.Data extraction and analysis Methodological quality was appraised using Cochrane’s Risk of Bias (ROB-2), Cochrane’s Risk of Bias in Non-randomised Studies (ROBINS-I), and the Johanna Briggs Institute (JBI) checklists for cross-sectional, cohort and qualitative studies. Quantitative synthesis was not undertaken due to substantial heterogeneity of design and outcomes. Results are presented narratively.Results Database searches returned 10 557 results and searches of other sources returned two additional records. Thirty-two papers were included in the systematic review, comprised of 29 unique studies, participants and topics and 3 follow-up studies. A variety of well-being and performance outcome measures were used. Overall, findings indicate that intrawork breaks improved some measures of well-being and/or work performance. However, methodological quality was judged to be low with a high risk of bias in most included studies.Discussion Using existing evidence, it is not possible to conclude with confidence whether intrawork breaks improve well-being and/or work performance in doctors. There is much inconsistency regarding how breaks are defined, measured and the outcomes used to assess effectiveness. Future research should seek to: (a) define and standardise the measurement of breaks, (b) use valid, reliable outcome measures to evaluate their impact on well-being and performance and (c) minimise the risk of bias in studies where possible.PROSPERO registration number CRD42020156924; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=156924.