Exploring the feasibility of a web-based positive psychology program among anaesthesiologists: an explanatory sequential mixed-methods pilot study

BMC Med Educ. 2026 May 18. doi: 10.1186/s12909-026-09459-2. Online ahead of print.

ABSTRACT

BACKGROUND: Physician burnout is a global crisis, with Hong Kong doctors reporting a personal burnout rate as high as 72%. Anaesthesiology is considered a high-risk specialty, with high risk of depression and suicide. Time constraints preclude engagement of healthcare professionals with structured psychological interventions despite their known benefits. Web-based positive psychology interventions (PPI) offer an accessible alternative for busy clinicians. This mixed-methods study aimed to evaluate the feasibility and acceptability of culturally adapted, web-based PPIs for anaesthesiologists in Hong Kong, and through exploratory efficacy assessment, to explore whether PPIs that are focused on personal growth vs. workplace application may have an effect on well-being.

METHODS: An explanatory sequential mixed-methods feasibility randomized controlled trial with exploratory efficacy outcomes was employed for this study. Fellows and members of the Hong Kong College of Anaesthesiologists were randomized (1:1:1) to two experimental groups (Exp1 individual-oriented PPI/Exp2 workplace-oriented PPI) or wait-list control. The intervention consisted of an induction workshop followed by 4 web-based modules with bite-sized exercises and WhatsApp peer discussions over 10 weeks. Primary outcomes (PERMA-Profiler, GAD-7, PHQ-9, PSS-10, Copenhagen Burnout Inventory) and secondary outcomes (SCS-SF, WAMI, WGS) were measured at baseline, post-intervention and one-year follow-up. Semi-structured interviews were conducted to explore feasibility and participant perceptions.

RESULTS: One hundred two participants were recruited for the study. Quantitative outcomes were interpreted as exploratory given the limited sample size. Linear mixed model analysis did not demonstrate significant, sustained improvements in primary outcomes across time points between groups. However, Exp1 showed a significant reduction in depression and increase in meaningful work immediately post-intervention, although this was not sustained at one-year follow-up. Qualitative analysis identified six themes, affirming that the blended web-based approach was feasible. Participants’ intrinsic motivation and the perceived applicability to professional and personal domains were key enablers of PPIs. PPIs facilitated participants’ competence in the face of clinical challenges, and enabled relational building in the workplace. Implementation challenges included waning engagement due to busy schedules and concerns regarding psychological safety within WhatsApp group chats.

CONCLUSIONS: Bite-sized, web-based positive psychology interventions appear feasible and acceptable for time-constrained clinicians such as anaesthesiologists in Hong Kong. In this exploratory feasibility trial, PPIs designed to support the basic psychological needs described in self‑determination theory showed preliminary short‑term benefits for well‑being, but future large-scale efficacy trials should evaluate whether such effects can be sustained through complementary system-level measures, including leadership and organizational initiatives that provide autonomy-supportive environments for healthcare professionals.

TRIAL REGISTRATION: The study was registered on ClinicalTrials.gov (ClinicalTrials.gov ID: NCT06148454) on November 19, 2023.

PMID:42151903 | DOI:10.1186/s12909-026-09459-2