What Contributes to Clinician Wellbeing? An Evidence and Gap Map of Clinician Experiences in Primary Care

Background: Clinician wellbeing is important for optimal health system performance. To improve their wellbeing and resilience, the National Academy of Medicine (NAM) recommends addressing upstream drivers, detailed in their framework of both external ( learning and practice environment, organisational factors, healthcare responsibilities, society and culture, and rules and regulations ) and individual ( personal factors, skills and abilities) factors that influence clinician wellbeing. Qualitative research that reports clinician self-reported experiences can provide insight into the factors that contribute to their wellbeing. Extant qualitative literature reviews report on work-related experiences affecting the wellbeing of specific types of clinicians in specific contexts, but none captures a holistic picture of clinician experiences in providing care. Objective: Map qualitative evidence on primary care clinician self-reported experiences related to wellbeing to the NAM framework factors, and create an interactive database to support future evidence syntheses and interventions. Methods: Using an evidence and gap map approach, we searched MEDLINE, Embase, PsycINFO, and CINAHL (2013–2023) for qualitative and mixed-methods studies. We included studies from Canada, Australia, Belgium, or France that described self-reported experiences of primary care clinicians (family physicians and general practitioners, nurses and nurse practitioners, pharmacists, midwives, social workers). We coded the experiences in each study according to reporting clinician type and NAM factors. We generated the interactive map, with integrated bibliographic database, using EPPI-Reviewer and EPPI-Mapper. Results: From 6,133 records we included 652 publications. Most were Australian (54%) or Canadian (34%). The majority (57%) reported experiences of family physicians/general practitioners, while social workers and midwives were underrepresented (3% and 2%, respectively). Clinician-reported experiences focused mainly on learning and practice environment , organisational , and healthcare responsibilities factors. Experiences related to skills and abilities , society and culture , personal factors , and rules and regulations , were less common, with slight variations across clinician groups. Conclusions: This evidence and gap map provides a comprehensive overview of qualitative evidence of primary care clinician-reported experiences related to wellbeing. External factors were more frequently mentioned, offering insight that can inform system-level interventions. Future qualitative syntheses of the mapped evidence can inform research and policy that better support clinician wellbeing.