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Stearns SA, Farid AR, Jena AB. Divorce Among Surgeons and Other Physicians in the United States. Ann Surg 2025; 281:110-115. [PMID: 39258369 DOI: 10.1097/sla.0000000000006531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
OBJECTIVE To compare divorce prevalence among surgeons with that of nonsurgeon physicians. SUMMARY BACKGROUND DATA The demanding nature of a career in surgery uniquely challenges the social well-being of a surgeon; however, its impact on marital health has not yet been well described. METHODS A cross-sectional study was conducted using publicly available US Census data from 2017 to 2021 to investigate the prevalence of divorce across different occupations. Survey respondents were divided into 2 groups, surgeons and nonsurgeon physicians, with the remaining Census participants as a control. All participants under the age of 18 were excluded to focus on the US adult population. The lifetime prevalence of divorce was measured across occupations, and multivariable logistic regression analyses were performed to identify factors that were independently associated with divorce. Secondarily, the occurrence of more than one marriage was used to supplement the understanding of marital health. RESULTS A total of 3171 surgeons and 51,660 nonsurgeon physicians were identified, with both groups similarly aged (51.6 and 50.2 y, respectively) and predominately male (82.9% and 61.9%, respectively). In unadjusted analysis, 21.3% (676/3,171) of surgeons had undergone a divorce compared with only 17.9% (9252/51,660) of nonsurgeon physicians, a 19% increase in risk of divorce [risk ratio (RR)=1.19; 95% CI, 1.11-1.28]. Both surgeons and nonsurgeon physicians were significantly less likely to report being divorced compared with the general population. The increased divorce prevalence among surgeons persisted in multivariable analysis that adjusted for age, age at the time of marriage, sex, race, income, hours worked per week, and the number of children in the household, with surgeons experiencing a 22% increased prevalence of divorce over nonsurgical physicians [adjusted divorce prevalence of 21.8% vs 18.7%, respectively; odds ratio (OR)=1.22; 95% CI, 1.09-1.35]. In subgroup analysis, the finding of higher divorce prevalence for surgeons over nonsurgeon physicians was concentrated among men (adjusted divorce prevalence: 22.6% of male surgeons vs 18.9% of male nonsurgeon physicians; adjusted OR 1.26, 95% CI, 1.11-1.42), White (adjusted divorce prevalence: 22.4% of white surgeons vs 19.1% of White nonsurgeons; adjusted OR 1.22, 95% CI, 1.09-1.38) and Asian surgeons (adjusted divorce prevalence: 12.0% of Asian surgeons vs 8.1% of Asian nonsurgeons; adjusted OR 1.55, 95% CI, 1.06-2.26), with the effect not present in other measured subgroups. CONCLUSIONS Both surgeons and physicians have lower divorce prevalence than the general population. Surgeons exhibit higher prevalence of divorce compared with nonsurgeon physicians, with measured demographic and work characteristics insufficient to explain this difference.
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Affiliation(s)
- Stephen A Stearns
- Harvard Medical School, Boston, MA
- Massachusetts General Hospital, Boston, MA
| | - Alexander R Farid
- Harvard Medical School, Boston, MA
- Massachusetts General Hospital, Boston, MA
| | - Anupam B Jena
- Harvard Medical School, Boston, MA
- Massachusetts General Hospital, Boston, MA
- National Bureau of Economic Research, Cambridge, MA
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Karagöz A, Yavuz G, Çakmakkaya S, Eliçevik M, Celayir S. Choosing a pediatric surgery career: affecting factors and status assessment. Pediatr Surg Int 2024; 41:33. [PMID: 39699668 DOI: 10.1007/s00383-024-05928-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2024] [Indexed: 12/20/2024]
Abstract
PURPOSE This study aims to investigate the factors influencing career choices in pediatric surgery with a focus on gender and generational differences in Türkiye. METHODS A cross-sectional survey study was conducted. A questionnaire, consisting of 42 questions was developed and distributed to pediatric surgeons via email and other digital platforms. RESULTS The study included 121 participants (72 males, 49 females). During clinical internships, the recognition score for pediatric surgery specialty was significantly higher among those who volunteered in clinics or participated in surgical procedures (p < 0.05). Females had higher operating room participation compared to males (51.4% vs. 69.4%, p < 0.05). For career choice reasons, Baby Boomers (1943-1960) cited "affinity towards a specific clinic" (53.6%), while Millennials (1982-2004) prioritized the "TUS score effect" (50%) and "program's geographic location" (42.5%). Job satisfaction averaged 6.8/10, with dissatisfaction related to "harsh working conditions" and "low income." Regarding marital status, 87.5% of men and 59.2% of women were married (p < 0.05). Additionally, 23.6% of men and 55.1% of women had no children (p < 0.05). CONCLUSION Pediatric surgery faces persistent challenges across generations. mproving training conditions, creating a supportive work environment, and increasing student involvement in pediatric surgery practices are critical. Adjustments are needed for future Generation Z residents.
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Affiliation(s)
- A Karagöz
- Department of Pediatric Surgery, Cerrahpaşa Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, 34153, Turkey
| | - G Yavuz
- Department of Pediatric Surgery, Cerrahpaşa Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, 34153, Turkey.
| | - S Çakmakkaya
- Department of Basic Medical Sciences, Cerrahpaşa Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, 34000, Turkey
| | - M Eliçevik
- Department of Pediatric Surgery, Cerrahpaşa Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, 34153, Turkey
| | - S Celayir
- Department of Pediatric Surgery, Cerrahpaşa Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, 34153, Turkey
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Küçükali H, Türkoğlu SN, Hasanli S, Dayanır Çok FN, Culpan HC, Hayran O. Comparison of the burnout among medical residents before and during the pandemic. J Psychosom Res 2023; 165:111118. [PMID: 36565658 PMCID: PMC9758755 DOI: 10.1016/j.jpsychores.2022.111118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 12/10/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aims to compare the level of burnout syndrome in medical residents before and during the COVID-19 pandemic and identify potential risk factors. METHODS This cross-sectional study was conducted on medical residents from three different university hospitals in Turkey in March 2021, one year after the pandemic hit Turkey. Burnout is measured by the Maslach Burnout Inventory which assesses three dimensions of it: emotional exhaustion, depersonalization, and personal accomplishment. Collected data were combined and compared with data from a previous study which was held in the same hospitals in December 2019, three months before the pandemic. RESULTS 412 medical residents from three universities participated. The mean age was 27.8 ± 2.4 and half of them were female. Compared to pre-pandemic levels, no significant differences in emotional exhaustion (pre:19.0 ± 7.6 post:18.8 ± 7.8), depersonalization (pre:7.3 ± 4.3 post:7.2 ± 4.4), and personal accomplishment (pre:20.8 ± 5.1 post:21.1 ± 5) scores were observed one year after pandemic. Adjusting for confounders, multiple linear regression models indicated that who are female, are in surgical specialty, have vulnerable cohabitant, and have more night shifts faces higher emotional exhaustion. Depersonalisation is higher among who spent more years in residency, have more night shifts, or COVID-19 outpatient duty. Females and those who have vulnerable cohabitant has lower levels of Personal Achievement. CONCLUSION This study does not support the hypothesis that pandemic increases the burnout levels. Yet it identifies a couple of pandemic related factors that are associated with burnout and confirming the association of several previously known factors.
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Affiliation(s)
- Hüseyin Küçükali
- Queen's University Belfast, Centre for Public Health, Belfast, UK; Istanbul Medipol University, School of Medicine, Department of Public Health, Istanbul, Türkiye.
| | - Sezanur Nazlı Türkoğlu
- Bezmialem Vakif University, School of Medicine, Department of Public Health, Istanbul, Türkiye.
| | - Shams Hasanli
- University of Health Sciences, Hamidiye International School of Medicine, Istanbul, Türkiye.
| | - Fatma Nur Dayanır Çok
- Dicle University, School of Medicine, Department of Public Health, Diyarbakir, Türkiye.
| | | | - Osman Hayran
- Istanbul Medipol University, School of Medicine, Department of Public Health, Istanbul, Türkiye.
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Zahavi E, Lev-Shalem L, Yehoshua I, Adler L. Methylphenidate use and misuse among medical residents in Israel: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2023; 21:5. [PMID: 36721145 PMCID: PMC9890881 DOI: 10.1186/s12960-023-00792-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Methylphenidate (MPH) and other stimulants may be misused, mainly as cognitive enhancers and recreational drugs. Data regarding misuse among medical residents are scarce. This study aimed to evaluate the prevalence of and main reasons for methylphenidate (MPH) use and misuse among Israeli medical residents. METHODS In this cross-sectional study, we sent an online questionnaire to medical residents who had completed their first residency exam and specialists with up to 2 years of experience. We asked about the use of MPH before and during residency and attitudes toward the use of MPH as a cognitive enhancer. We also added the Adult ADHD Self-Report Scale (ASRS) questionnaire, a validated tool used to screen for the presence of attention deficit hyperactivity disorder (ADHD). Users and misusers were classified based on self-report of use and formal ADHD diagnosis. Logistic regression analysis was used to evaluate factors associated with MPH misuse. RESULTS From March 2021 to August 2021, 370 physicians responded to our questionnaire (response rate 26.4%). Twenty-eight met the exclusion criteria and were not included. The respondents' average age was 36.5 years. Women comprised 63.5% of the respondents. Of the participants, 16.4% were classified as users and 35.1% as misusers. The prevalence of misusers was 45.6% among surgery and OB/GYN physicians, 39.4% among pediatricians and internists, and 24% among family physicians (P < 0.001). Misusers had a more liberal approach than others to MPH use as a cognitive enhancer. Factors associated with misuse of MPH included not being a native-born Israeli (OR-1.99, 95% CI 1.08, 3.67) and type of residency (OR-2.33, 95% CI 1.22, 4.44 and OR-4.08, 95% CI 2.06, 8.07 for pediatrics and internal medicine and surgery, respectively). CONCLUSION Very high levels of MPH misuse during residency may be related to stress, long working hours, night shifts, and the academic burden of the residency period. We believe that our findings should be considered by healthcare policymakers as they make decisions regarding the conditions of medical residencies. The use of MPH as a cognitive enhancer should be further studied and discussed.
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Affiliation(s)
- Eden Zahavi
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel
- Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Liat Lev-Shalem
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel
| | - Ilan Yehoshua
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel
- Faculty of Health Sciences, Siaal Research Center for Family Medicine and Primary Care, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Limor Adler
- Health Division, Maccabi Healthcare Services, 27 Ha'mered St., Tel Aviv, Israel.
- Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv, Israel.
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Suzuki M, Miyaji K, Matoba K, Abe T, Nakamaru Y, Watanabe R, Suzuki T, Nakazono A, Konno A, Hinder D, Psaltis AJ, Wormald PJ, Homma A. Mental workload during endoscopic sinus surgery is associated with surgeons' skill levels. Front Med (Lausanne) 2023; 10:1090743. [PMID: 37168266 PMCID: PMC10165102 DOI: 10.3389/fmed.2023.1090743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 04/04/2023] [Indexed: 05/13/2023] Open
Abstract
Introduction Surgeons' mental workload during endoscopic sinus surgery (ESS) has not been fully evaluated. The assessment was challenging due to the great diversity of each patient's anatomy and the consequence variety of surgical difficulties. In this study, we examined the mental workload of surgeons with various surgical skill levels during ESS under the standardized condition provided by novel-designed 3D sinus models. Materials and methods Forty-seven participants performed a high-fidelity ESS simulation with 3D-printed sinus models. Surgeons' mental workload was assessed with the national aeronautics and space administration-task load index (NASA-TLX). Associations between the total and subscales score of NASA-TLX and surgical skill index, including the board certification status, the number of experienced ESS cases, and the objective structured assessment of technical skills (OSATS), were analyzed. In addition, 10 registrars repeated the simulation surgery, and their NASA-TLX score was compared before and after the repetitive training. Results The total NASA-TLX score was significantly associated with OSATS score (p = 0.0001). Primary component analysis classified the surgeons' mental burden into three different categories: (1) the skill-level-dependent factors (temporal demand, effort, and performance), (2) the skill-level-independent factors (mental and physical demand), and (3) frustration. After the repetitive training, the skill-level-dependent factors were alleviated (temporal demand; z = -2.3664, p = 0.0091, effort; z = -2.1704, p = 0.0346, and performance; z = -2.5992, p = 0.0017), the independent factors were increased (mental demand; z = -2.5992, p = 0.0023 and physical demand; z = -2.2509, p = 0.0213), and frustration did not change (p = 0.3625). Conclusion Some of the mental workload during ESS is associated with surgical skill level and alleviated with repetitive training. However, other aspects remain a burden or could worsen even when surgeons have gained surgical experience. Routine assessment of registrars' mental burdens would be necessary during surgical training to sustain their mental health.
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Affiliation(s)
- Masanobu Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- *Correspondence: Masanobu Suzuki,
| | - Kou Miyaji
- Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Kotaro Matoba
- Department of Forensic Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Takashige Abe
- Department of Urology, Hokkaido University Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Yuji Nakamaru
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Ryosuke Watanabe
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Takayoshi Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Akira Nakazono
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Atsushi Konno
- Graduate School of Information Science and Technology, Hokkaido University, Sapporo, Japan
| | - Dominik Hinder
- Department of Surgery–Otorhinolaryngology Head and Neck Surgery, Central Adelaide Local Health Network and the University of Adelaide, Adelaide, SA, Australia
| | - A. J. Psaltis
- Department of Surgery–Otorhinolaryngology Head and Neck Surgery, Central Adelaide Local Health Network and the University of Adelaide, Adelaide, SA, Australia
| | - P. J. Wormald
- Department of Surgery–Otorhinolaryngology Head and Neck Surgery, Central Adelaide Local Health Network and the University of Adelaide, Adelaide, SA, Australia
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
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The state of general surgery residents in Italy after COVID-19 outbreak: a nationwide cross-sectional study. Updates Surg 2023; 75:95-103. [PMID: 36057026 PMCID: PMC9440313 DOI: 10.1007/s13304-022-01370-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/25/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION A significant reorganization of working activities including those of teaching hospitals occurred after COVID-19 outbreak, leading to the need to re-assess the current status of training after the pandemic. This study aimed to investigate the state of general surgery (GS) residency in Italy. The impact of COVID-19 on GS residents was also assessed. METHODS Between October and November 2020, an anonymous online survey was distributed to GS residents across Italy. Email addresses were provided by the Regional Committees of the Italian Polyspecialistic Society of Young Surgeons. The residents completed a set of questions regarding their training schedule and three standardized questionnaires to measure burnout and psychological distress. RESULTS Overall, 1709 residents were contacted and 648 completed the survey. Almost two-thirds of the residents (68.4%, n = 443) reported to not reach the minimum annual operative case volume. According to ordinal logistic regression analysis, two of the most perceived effects of COVID-19 by trainees on training were reduction of surgical activities (OR = 2.21, p < 0.001) and increased concerns about future employment (OR = 1.14, p = 0.025). Loss of training opportunities was also associated with a significant increase of distress (OR = 1.26, p = 0.003) but not with burnout. CONCLUSIONS This study provided a snapshot of the situation of GS residents in Italy after COVID-19 outbreak. Reduction of activities due to pandemic highlighted the need to improve the level of surgical education in our country by implementing all the new available tools for training and ensuring at the same time the well-being of the residents.
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Abati E, Nelva Stellio L, Manini A, Moroni F, Azzalini L, Vilca LM. A cross-sectional survey study of the impact of COVID-19 pandemic on the training and quality of life of Italian medical residents in the Lombardy region. Ann Med 2022; 54:2326-2339. [PMID: 36001504 PMCID: PMC9415486 DOI: 10.1080/07853890.2022.2105392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION The reorganization of the healthcare system prompted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has posed unique challenges for Residency Training Programs worldwide. To mitigate its potential negative effects, it is crucial to assess how the pandemic influenced the activity and quality of life of residents. The purpose of this study was to assess the impact of the pandemic on residents' competencies, satisfaction, working load, training patterns and occupational exposure in the clinical, surgical, research and didactic fields and to quantify its effects on quality of life and risk perception. METHODS An online cross-sectional survey was distributed between 1 June 2020 and 31 July 2020 to 1645 residents enrolled in all Residency Programs of four Universities in northern Italy. The survey included questions about clinical, surgical, and research competencies, educational activity, and quality of life pre- and post-pandemic, and on policies and workplace interventions to reduce exposure to SARS-CoV-2. The main outcome measure was the variation in self-perceived clinical, surgical and research competencies and in specialistic training. Data were analysed using the statistical package R Core Team 4.0.0, estimating mean and standard deviation or median and interquartile range for continuous variables. Variables were compared using chi-square test, Fisher exact tests or McNemar test, as appropriate.A multivariate binary logistic regression analysis was performed to test the effect of different factors on the impact of coronavirus disease-2019 (COVID-19) on self-perceived clinical and research competencies and on didactic training. RESULTS A total of 498 residents completed the survey (response rate 30.3%). The mean age of respondents was 28.9 years, 62.9% were women, and 52.4% were enrolled in the first two years of Training Programs. On the first pandemic wave, over 60% of residents reported a negative impact of the pandemic on their specialistic training. In contrast, 40% of residents involved in clinical duties perceived an improvement in their clinical competences, especially those involved in COVID-19 care, and 34.5% perceived an improvement in their research competences, particularly junior residents, while only 3.5% reported an improvement in surgical skills. Most surgical residents (88.5%) reported a decrease in surgical activities, mainly due to reduced hospital bed capacity and reduction of elective surgery. Almost 90% of all residents experienced a reduction in their didactic activities, but 80% stated their Residency Program adopted virtual training methods. A statistically significant reduction in all examined quality of life items post-pandemic vs. pre-pandemic was found. Even though most survey participants reported the availability of personal protective equipment for residents, 44% considered themselves to be at higher risk of exposure compared to senior staff. CONCLUSION COVID-19 pandemic caused a significant disruption in surgical training, but it had a positive impact on clinical competencies among residents involved in COVID-19 and urgent care. The pandemic had a detrimental effect on all quality of life aspects, and most residents considered themselves at higher risk of SARS-CoV-2 infection compared to other healthcare professionals.Key MessagesCoronavirus disease-2019 (COVID-19) pandemic caused a significant disruption in surgical training, but it had a positive impact on clinical competencies among residents involved in COVID-19 and urgent care.Most residents experienced a reduction of didactic activities. Although the majority of training programs implemented virtual training methods to counteract the restrictions imposed by the pandemic, only half of the residents were satisfied of them.A vast proportion of residents had a high occupational exposure to SARS-CoV-2 and considered themselves at higher risk of COVID-19 infection compared to senior staff.The survey highlighted a statistically significant reduction in five key quality of life measures (i.e. sleep, mood, familiar relationships and social relationships quality and employment satisfaction) during the first wave, with mood and social relationships being the most affected. Notably, employment satisfaction was significantly higher in medical compared to surgical residents.
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Affiliation(s)
- Elena Abati
- Department of Pathophysiology and Transplant (DEPT), Dino Ferrari Centre, Neuroscience Section, University of Milan, Milan, Italy
| | - Leonardo Nelva Stellio
- Department of Women, Mothers and Neonates, Buzzi Children's Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Arianna Manini
- Department of Pathophysiology and Transplant (DEPT), Dino Ferrari Centre, Neuroscience Section, University of Milan, Milan, Italy
| | - Francesco Moroni
- Università Vita-Salute San Raffaele, Milan, Italy.,Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Lorenzo Azzalini
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Luz Maria Vilca
- Unit of Obstetrics and Gynecology, Buzzi Children's Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
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Psychometric validation and cultural adaptation of the Italian medical student stressor questionnaire. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00922-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
AbstractMedical students encounter specific stressors that can lead to higher levels of psychological distress compared to their similar aged counterparts who study other subjects. The Medical Student Stressor Questionnaire (MSSQ) was developed to specifically identify stressors among medical students as well as measure the intensity of stress caused by the stressors. However, no Italian version has been validated to date. The aim of this study was to develop an Italian version of the MSSQ (MSSQ-I) and to assess its psychometric properties. The MSSQ has been translated and culturally validated into Italian. All medical students from the University of Brescia were asked to participate in a web-survey in which they were asked to complete the MSSQ-I. For the analysis of the stability over time, participating students were asked to complete again the MSSQ-I after about one month. Among 1754 medical students, 964 completed the MSSQ-I for the validation analyses. A first Confirmatory Factor Analysis and a subsequent Explanatory Factor Analysis outlined a slightly modified factor structure of the scale with five factors instead of six as in the original scale. The internal consistency on the overall scale was high (α = 0.94), as well as the internal consistency of each of the new factors: (α > 0.83 for the first four factors and α = 0.67 for the fifth). External validity analysis confirmed moderate/high concurrent validity. These results suggest that the MSSQ-I can be used as a tool to identify stressors among Italian medical students, although further research is needed to confirm its individual test-retest reliability.
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Sharaf AM, Abdulla IH, Alnatheer AM, Alahmari AN, Alwhibi OA, Alabduljabbar Z, Alhamzah H, Alkholaiwi FM. Emotional Intelligence and Burnout Among Otorhinolaryngology-Head and Neck Surgery Residents. Front Public Health 2022; 10:851408. [PMID: 35669762 PMCID: PMC9165730 DOI: 10.3389/fpubh.2022.851408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/27/2022] [Indexed: 12/05/2022] Open
Abstract
Background Burnout syndrome is common among surgical residents, negatively affecting their mental health, physical wellbeing, and work performance. We investigated the relationship between emotional intelligence (EI) and burnout among Otorhinolaryngology-Head and Neck surgery residents. Methods This cross-sectional study examined 51 residents across different Otorhinolaryngology-Head and Neck surgery programs at various hospitals in Saudi Arabia using a survey conducted between January 2021 and March 2021. The questionnaire had different validated measurements of burnout and included the Trait EI Questionnaire-Short Form, Maslach Burnout Inventory-Human Services survey, and questions regarding demographics and job satisfaction. Results Of all the residents, 17.6% had a high risk of burnout, 39.2% had emotional exhaustion (EE), 29.4% had depersonalization (DP), and 43.1% had a low sense of personal accomplishment (PA). A statistically significant negative association was observed between the total EI score and EE (r = -0.577, p < 0.001) and DP (r = -0.765, p < 0.001), indicating that higher total EI scores were associated with lower EE levels. Conclusions Positive associations existed between high levels of EI, PA, and satisfaction with both surgical skills and specialty choice. Therefore, residency programs should use EI modifiers as tools to reduce the risk of burnout.
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Affiliation(s)
- Abdulelah M. Sharaf
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Isra H. Abdulla
- College of Medicine, Al-Maarefa University, Riyadh, Saudi Arabia
| | - Abdullah M. Alnatheer
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Aghadir N. Alahmari
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Omar A. Alwhibi
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | | | - Hamzah Alhamzah
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Feras M. Alkholaiwi
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia
- Department of Otorhinolaryngology–Head and Neck Surgery, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
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Shawahna R, Maqboul I, Ahmad O, Al-Issawy A, Abed B. Prevalence of burnout syndrome among unmatched trainees and residents in surgical and nonsurgical specialties: a cross-sectional study from different training centers in Palestine. BMC MEDICAL EDUCATION 2022; 22:322. [PMID: 35473599 PMCID: PMC9041277 DOI: 10.1186/s12909-022-03386-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Burnout is a psychological syndrome that involves physical, mental, and emotional exhaustion. This study was conducted to determine the prevalence of burnout among unmatched trainees and residents in surgical and nonsurgical specialties in Palestine. Additionally, this study also sought to identify the associated variables and predictors of higher burnout scores. METHODS This study was conducted in a cross-sectional design using a questionnaire in the period between October 2020 and March 2021. The questionnaire collected sociodemographic characteristics of the residents and trainees in 18 different training centers/hospitals. The Copenhagen Burnout Inventory was used to determine burnout among the residents and trainees. Pearson's correlations, analysis of variance, Student's t-test, and multiple linear regressions were used to analyze the data. RESULTS The study tool was completed by 250 residents and trainees in surgical and nonsurgical specialties (response rate = 83.3%). Of all participants, 203 (81.2%) reported a moderate-severe degree of burnout in the personal domain, 188 (75.2%) reported a moderate-severe degree of burnout in the work-related domain, and 97 (38.8%) reported moderate-severe degree of burnout in the client-related domain. There was a moderate and positive correlation between personal and work-related burnout scores (Pearson's r = 0.69, p-value < 0.001), and client-related burnout scores (Pearson's r = 0.52, p-value < 0.001). Similarly, there was a moderate and positive correlation between work-related and client-related burnout scores (Pearson's r = 0.57, p-value < 0.001). The multiple linear regression model showed that higher burnout scores were predicted by being married, not having another paid employment, inability to financially support oneself, frequent consumption of tea/coffee, dissatisfied with the training/job, thinking to change the profession, and long working hours. CONCLUSION The findings of this study indicated that burnout was highly prevalent among residents and trainees in surgical and nonsurgical specialties in Palestine. Decision-makers in healthcare authorities, hospital managers, professional groups, directors of residency programs, and educators/trainers should consider addressing burnout and improving the well-being of residents and trainees in surgical and nonsurgical specialties in Palestine. Future studies are still needed to determine which interventions could be effective in reducing burnout among residents and trainees in surgical and nonsurgical specialties in Palestine.
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Affiliation(s)
- Ramzi Shawahna
- Department of Physiology, Pharmacology and Toxicology, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
- An-Najah BioSciences Unit, Centre for Poisons Control, Chemical and Biological Analyses, An-Najah National University, Nablus, Palestine.
| | - Iyad Maqboul
- Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine.
- An-Najah National University Hospital, Nablus, Palestine.
| | - Ola Ahmad
- Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Afnan Al-Issawy
- Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
| | - Batoul Abed
- Department of Medicine, Faculty of Medicine & Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
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Wellness in Graduate Surgical Medical Education. CURRENT SURGERY REPORTS 2022. [DOI: 10.1007/s40137-022-00313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Daryanto B, Rahmadiani N, Amorga R, Kautsarani I, Susilo H, Persada Isma SP. Burnout syndrome among residents of different surgical specialties in a tertiary referral teaching hospital in Indonesia during COVID-19 pandemic. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022; 14:100994. [PMID: 35155847 PMCID: PMC8824714 DOI: 10.1016/j.cegh.2022.100994] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/22/2022] [Accepted: 02/04/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Burnout is experienced frequently by residents, especially during COVID-19 pandemic. Impacts of the pandemic on clinical workload and training program of the residents has also resulted in burnout, which may impact their clinical performance and safety. Therefore, this paper aims to assess burnout syndrome among surgical residents in Indonesia during COVID-19 pandemic. Methods A cross-sectional survey was conducted on 120 surgical residents (from orthopedics, general surgery, and urology department) of a tertiary referral teaching hospital in Malang using web-based questionnaire. Personal data form and Maslach Burnout Inventory (MBI) for medical personnel were used. There are 3 subscales of MBI: emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). Comparative and correlative analysis were performed to analyze the socio-demographic, academic, and work-related factors in relation to the subscales scores of MBI-HSS and the presence of burnout. Results Burnout were experienced by 56.67% of residents in this study. There were statistically significant association regarding burnout and marital status, residency specialty, year of residency, and working hours upon analysis of mean and classification of subscale scores of MBI with the examined factors. Conclusion This study showed that burnout is a major issue in surgical residents during COVID-19 pandemic and may be associated with certain socio-demographic, academic, and work-related factors. Further studies to identify factors contributing to burnout in residents during COVID-19 pandemic are needed. It is imperative to formulate resident-centered strategies to prevent and address burnout among residents to ensure their overall well-being during this pandemic.
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Affiliation(s)
- Besut Daryanto
- Department of Urology, Saiful Anwar General Hospital, Malang, Indonesia
| | - Nayla Rahmadiani
- Department of Anatomic Pathology, Saiful Anwar General Hospital, Malang, Indonesia
| | - Reza Amorga
- Department of Urology, Saiful Anwar General Hospital, Malang, Indonesia
| | - Intan Kautsarani
- Department of Ophthalmology, Saiful Anwar General Hospital, Malang, Indonesia
| | - Hery Susilo
- Department of Oncology Surgery, Saiful Anwar General Hospital, Malang, Indonesia
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13
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The Role of Burnout in the Association between Work-Related Factors and Perceived Errors in Clinical Practice among Spanish Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094931. [PMID: 34066327 PMCID: PMC8124853 DOI: 10.3390/ijerph18094931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to evaluate the prevalence of burnout syndrome in a sample of residents from different specialties, to determine the influence of work-related factors on the development of burnout, and to examine the mediating role of burnout in the relation between such work factors and perceived errors in clinical practice. A total of 237 Spanish residents participated (Mage = 28.87, SD = 3.84; 73.8% females). The Maslach Burnout Inventory and an ad hoc questionnaire were administered to assess burnout and work-related factors. Comparison analyses and mediational models were conducted. Half of the residents reported high levels of burnout (48.9%). Burnout was significantly associated with perceived errors in clinical practice. Significant differences were found between residents with lower and higher burnout levels, showing that those with higher burnout were less satisfied with the working conditions. Burnout mediated the associations between adjustment of responsibility, support among residents, satisfaction with teaching and rotations, general satisfaction, and perceived errors in the clinical practice. Adjusted levels of responsibility and workload, enhanced supervision, and more social support from colleagues predict lower levels of burnout, which may result in fewer errors in clinical practice. Consequently, such work-related factors should be taken into account as a preventive strategy for burnout and errors in the clinical practice so adequate patient care, good mental health of future specialists, and, therefore, higher quality of public health care can be ensured.
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14
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Burhamah W, AlKhayyat A, Oroszlányová M, Jafar H, AlKhayat A, Alabbad J. The predictors of depression and burnout among surgical residents: A cross-sectional study from Kuwait. Ann Med Surg (Lond) 2021; 65:102337. [PMID: 33996067 PMCID: PMC8093889 DOI: 10.1016/j.amsu.2021.102337] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Surgical residency often poses a challenge to residents, with long working hours and a stressful work environment. Surgical residents are at an increased risk of burnout and depression. Such mental health burdens could go so far as to affect treatment outcomes. AIM To assess the prevalence and risk factors for depression and burnout among residents across surgical specialties in Kuwait. MATERIALS AND METHODS An online questionnaire was sent to the residents enrolled to the surgical residency programs in Kuwait, from the period of January 2020-February 2020. Variables collected included; age, gender, marital status, smoking history, exercise, specialty, year of training, on-call frequency, assessment of burnout (using the abbreviated Maslach Burnout Inventory (aMBI)) and assessment of depressive symptoms (using the Patient Health Questionnaire-9 (PHQ-9) score). RESULTS A total of 85 surgical residents between the age of 20 and 40 years responded. Most (64.7%) were male and 35.3% female. More than half were married (51.8%) and 41.2% were single. The majority of the residents were in general surgery (43.5%), with the least being in otolaryngology (7.1%) and neurosurgery (5.9%). The prevalence of depressive symptoms was 55.3%, and 51.8% had a high overall burnout score. CONCLUSION Addressing burnout at all stages during residency training is paramount in improving standard of care as well as increasing the wellness of residents.
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Affiliation(s)
- Waleed Burhamah
- Department of General Surgery, Mubarak AlKabeer Hospital, Kuwait
| | | | - Melinda Oroszlányová
- College of Engineering and Technology, American University of the Middle East, Kuwait
| | | | - Ali AlKhayat
- Department of General Surgery, Mubarak AlKabeer Hospital, Kuwait
| | - Jasim Alabbad
- Department of General Surgery, Mubarak AlKabeer Hospital, Kuwait
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15
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Copeland AE, Mackinnon V, Axelrod DE, Farrokhyar F, Avram R, Coroneos CJ. Job Satisfaction Among Plastic Surgery Residents in Canada. Plast Surg (Oakv) 2021; 30:151-158. [PMID: 35572079 PMCID: PMC9096853 DOI: 10.1177/22925503211007237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: Resident wellness is a focus of medical training and is prioritized in both
Canadian and American accreditation processes. Job satisfaction is an
important component of wellness that is not examined in the literature. The
purpose of this study was to analyze job satisfaction in a national sample
of plastic surgery residents, and identify factors that influence
satisfaction. Methods: We designed a cross-sectional survey adapted from existing instruments, with
attention to thorough item generation and reduction as well as pilot and
clinical sensibility testing. All plastic surgery residents at Canadian
institutions were surveyed regarding overall job satisfaction as well as
personal- and program-specific factors that may affect satisfaction.
Predictors of satisfaction were identified using multivariable regression
models. Results: The response rate was 40%. Median overall job satisfaction was 4.0 on a
5-point Likert scale. Operative experience was considered both the most
important element of a training program, and the area in most need of
improvement. Senior training year (P < .01), shorter
commute time (P = .04), fewer duty hours
(P = .02), fewer residents (P <
.01), and more fellows (P < .01) were associated with
significantly greater job satisfaction. Conclusions: This is the first study to gather cross-sectional data on job satisfaction
from a national sample of plastic surgery residents. The results from this
study can inform programs in making tangible changes tailored to their
trainees’ needs. Moreover, our findings may be used to inform a
prospectively studied targeted intervention to increase job satisfaction and
resident wellness to address North American accreditation standards.
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Affiliation(s)
- Andrea E. Copeland
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Victoria Mackinnon
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Daniel E. Axelrod
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Forough Farrokhyar
- Department of Health, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ronen Avram
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Christopher J. Coroneos
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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Colonnello V, Carnevali L, Russo PM, Ottaviani C, Cremonini V, Venturi E, Mattarozzi K. Reduced recognition of facial emotional expressions in global burnout and burnout depersonalization in healthcare providers. PeerJ 2021; 9:e10610. [PMID: 33520445 PMCID: PMC7811292 DOI: 10.7717/peerj.10610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/30/2020] [Indexed: 11/20/2022] Open
Abstract
The healthcare provider profession strongly relies on the ability to care for others' emotional experiences. To what extent burnout may relate to an actual alteration of this key professional ability has been little investigated. In an experimentally controlled setting, we investigated whether subjective experiences of global burnout or burnout depersonalization (the interpersonal component of burnout) relate to objectively measured alterations in emotion recognition and to what extent such alterations are emotion specific. Healthcare workers (n = 90) completed the Maslach Burnout Inventory and a dynamic emotion recognition task in which faces with neutral emotional expressions gradually changed to display a specific basic emotion (happiness, anger, fear, or sadness). Participants were asked to identify and then classify each displayed emotion. Before the task, a subsample of 46 participants underwent two salivary cortisol assessments. Individuals with global burnout were less accurate at recognizing others' emotional expressions of anger and fear, tending to misclassify these as happiness, compared to individuals without global burnout. Individuals with high burnout depersonalization were more accurate in recognizing happiness and less accurate in recognizing all negative emotions, with a tendency to misclassify the latter as positive ones, compared to healthcare workers with moderate/low depersonalization. Moreover, individuals with high depersonalization-but not participants with global burnout-were characterized by higher cortisol levels. These results suggest that the subjective burnout experience relates to an actual, but selective, reduction in the recognition of facial emotional expressions, characterized by a tendency to misclassify negative emotional expressions as positive ones, perhaps due to an enhanced seeking of positive social cues. This study adds to the understanding of emotional processing in burnout and paves the way for more nuanced studies on the role of altered processing of threat signals in the development and/or persistence of burnout.
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Affiliation(s)
- Valentina Colonnello
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Luca Carnevali
- Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parma, Italy
| | - Paolo Maria Russo
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Valeria Cremonini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Emanuele Venturi
- IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Katia Mattarozzi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Gleason F, Baker SJ, Wood T, Wood L, Hollis RH, Chu DI, Lindeman B. Emotional Intelligence and Burnout in Surgical Residents: A 5-Year Study. JOURNAL OF SURGICAL EDUCATION 2020; 77:e63-e70. [PMID: 32819871 DOI: 10.1016/j.jsurg.2020.07.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/26/2020] [Accepted: 07/30/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE We sought to characterize the interactions of burnout with internal and external factors over the past 5 years for surgery residents at our institution. We hypothesized that burnout levels would be consistent among years, inversely related to emotional intelligence (EI) and job resources, and directly related to disruptive behaviors. DESIGN General surgery residents at a single institution were invited to complete a survey each year from 2015 to 2019 that included a combination of the 22-item Maslach-Burnout Inventory, 30-item trait EI questionnaire, as well as focused questions assessing disruptive behaviors (8 items), job resources (8 items), and demographic characteristics. Burnout was defined as scoring high in depersonalization (≥ 10 points) or emotional exhaustion (≥ 27 points). Student's t tests and Wilcoxon tests were used to compare continuous variables; chi-square and Fisher's exact tests were used to compare categorical variables, as appropriate. Spearman's rho was used to calculate correlation. A logistic regression and separate linear regression model were constructed to assess relation of variables to burnout. SETTING The general surgery residency program at the University of Alabama at Birmingham, Birmingham, Alabama, a large tertiary care academic center. RESULTS An average of 47 surveys were completed each year, for a total of 236 (response rate 81%). One hundred seventeen (58.5%) met criteria for burnout. Burnout rates each year ranged from 68% to 53%, with the lowest value occurring in 2019. Incidence of burnout was lowest among the postgraduate year (PGY) 1 class and highest among the PGY5 class (38% versus 64%, p = 0.02). Individuals without burnout had higher scores for EI overall (5.7 versus 5.3, p < 0.001) as well as in each of its 4 subcomponents (p < 0.001). Individuals who were subjected to disruptive behaviors, particularly others taking credit for work and public humiliation, were more likely to experience burnout (p = 0.02). Those with burnout also had significantly lower scores in each of the 4 domains of the Job Resources model (p < 0.01). On multivariate logistic regression, increasing PGY level remained a significant predictor of burnout risk. Each of the sub-domains of EI and jobs resources inversely corelated with burnout, while disruptive behaviors directly correlated with burnout. ON subsequent multivariable linear regression, resident well-being and professional development remained independent predictors of lower burnout scores. CONCLUSIONS Burnout is prevalent among trainees at our institution, but a trend toward improvement has been shown over 5 years. Burnout rates increase each year of surgical training beyond PGY2. Factors that mitigate burnout include resident well-being and professional development. Disruptive behaviors lead to increase burnout rates.
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Affiliation(s)
- Frank Gleason
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Tara Wood
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Lauren Wood
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Daniel I Chu
- University of Alabama at Birmingham, Birmingham, Alabama
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18
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Mullins CH, Gleason F, Wood T, Baker SJ, Cortez AR, Lovasik B, Sandhu G, Cooper A, Hildreth AN, Simmons JD, Delman KA, Lindeman B. Do Internal or External Characteristics More Reliably Predict Burnout in Resident Physicians: A Multi-institutional Study. JOURNAL OF SURGICAL EDUCATION 2020; 77:e86-e93. [PMID: 33077415 DOI: 10.1016/j.jsurg.2020.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/17/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Surgical residents have been shown to experience high rates of burnout. Whether this is influenced predominately by intrinsic characteristics, external factors, or is multifactorial has not been well studied. The aim of this study was to explore the relationship between these elements and burnout. We hypothesized that residents with higher emotional intelligence scores, greater resilience and mindfulness, and better work environments would experience lower rates of burnout. METHODS General surgery residents at 7 sites in the US were invited to complete an electronic survey in 2019 that included the 2-item Maslach Burnout Inventory, Brief Emotional Intelligence Scale, Revised Cognitive and Affective Mindfulness Scale, 2-Item Connor-Davidson Resilience Scale, Utrecht Work Engagement Scale, and Job Resources scale of the Job Demands-Resources Questionnaire. Individual constructs were assessed for association with burnout, using multivariable logistic regression models. Residents' scores were evaluated in aggregate, in groups according to demographic characteristics, and by site. RESULTS Of 284 residents, 164 completed the survey (response rate 58%). A total of 71% of respondents were at high risk for burnout, with sites ranging from 57% to 85% (p = 0.49). Burnout rates demonstrated no significant difference across gender, PGY level, and respondent age. On bivariate model, no demographic variables were found to be associated with burnout, but the internal characteristics of emotional intelligence, resilience and mindfulness, and the external characteristics of work engagement and job resources were each found to be protective against burnout (p < 0.001 for all). However, multivariable models examining internal and external characteristics found that no internal characteristics were associated with burnout, while job resources (coeff. -1.0, p-value <0.001) and work engagement (coeff. -0.76, p-value 0.032) were significantly protective factors. Rates of engagement overall were high, particularly with respect to work "dedication." CONCLUSIONS A majority of residents at multiple institutions were at high risk for burnout during the study period. Improved work engagement and job resources were found to be more strongly associated with decreased burnout rates when compared to internal characteristics. Although surgical residents appear to already be highly engaged in their work, programs should continue to explore ways to increase job resources, and further research should be aimed at elucidating the mediating effect of internal characteristics on these external factors.
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Affiliation(s)
- C Haddon Mullins
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Frank Gleason
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Tara Wood
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Samantha J Baker
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | | | | | - Gurjit Sandhu
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Amanda Cooper
- Department of Surgery, Penn State, Hershey, Pennsylvania
| | - Amy N Hildreth
- Department of Surgery, Wake Forest University, Winston-Salem, North Carolina
| | - Jon D Simmons
- Department of Surgery, University of South Alabama, Mobile, Alabama
| | - Keith A Delman
- Department of Surgery, Emory University, Atlanta, Georgia
| | - Brenessa Lindeman
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
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Kashat L, Carter B, Mosha M, Kavanagh KR. Mindfulness Education for Otolaryngology Residents: A Pilot Study. OTO Open 2020; 4:2473974X20945277. [PMID: 32844140 PMCID: PMC7416142 DOI: 10.1177/2473974x20945277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/01/2020] [Indexed: 12/30/2022] Open
Abstract
This pilot project was designed to (1) implement a mindfulness-based wellness curriculum
for otolaryngology residents, (2) determine the impact of a mindfulness-based curriculum
on resident mood, and (3) examine the use of mindfulness among otolaryngology residents.
Otolaryngology residents participated in a 6-week course guided by the Headspace
mindfulness mobile application. Resident use of mindfulness was measured by the validated
Mindful Attention Awareness Scale (MAAS). Changes in mood before and after each session
were assessed using the validated Positive and Negative Affect Schedule (PNAS). Residents
reported a statistically significant decrease in postsession negative affect scores
(P < .001). A moderate positive correlation was noted between
mindfulness scores and presession positive mood (Pearson r = 0.597,
P < .001). This pilot study supports the feasibility and impact of
including mindfulness training as part of a resident wellness curriculum.
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Affiliation(s)
- Lawrence Kashat
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | | | - Maua Mosha
- Connecticut Children's, Hartford, Connecticut, USA
| | - Katherine R Kavanagh
- University of Connecticut School of Medicine, Farmington, Connecticut, USA.,Connecticut Children's, Hartford, Connecticut, USA
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20
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Pawłowicz E, Nowicki M. Burnout syndrome among nephrologists - a burning issue - results of the countrywide survey by the Polish Society of Nephrology. BMC Nephrol 2020; 21:177. [PMID: 32398009 PMCID: PMC7218642 DOI: 10.1186/s12882-020-01829-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 04/26/2020] [Indexed: 11/23/2022] Open
Abstract
Background Burnout syndrome in physicians is associated with adverse patient safety events, poorer quality of care and reduced patients’ satisfaction. There has been scarce information on the risk factors of burnout affecting professionals working in the renal care settings. As yet the phenomenon has not been studied in the population of Polish nephrologists therefore a nationwide cross-sectional study was established by the Polish Society of Nephrology to assess the prevalence of the syndrome. Methods The survey, that consisted of the abbreviated Maslach Burnout Inventory, questions about strategies for dealing with burnout symptoms and demographic data, was distributed during two main national meetings that gather nephrologists in Poland. 177 participants filled out the survey – 64% of participants were women, 88% were specialists and 12% - doctors in training. Results 52% of participants demonstrated a high level of depersonalization and almost half of the study group showed high level of emotional exhaustion. Reduced personal accomplishment was more pronounced in doctors working mostly in dialysis units compared to other nephrologists (p = 0.017). 37% of participants reported that they treat some patients as they were impersonal objects and 48% felt emotionally drained from their work. 59% of participants would like to take part in the remedy program. Conclusions Burnout syndrome seems to be an important problem in the population of Polish nephrologists. Doctors working mostly in dialysis settings might be at increased risk of reduced personal accomplishment. The results of the survey may be useful to prepare burnout remedy program.
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Affiliation(s)
- Ewa Pawłowicz
- Medical University of Lodz, Department of Nephrology, Hypertension and Kidney Transplantation, Pomorska Str. 251, 92-213, Lodz, Poland.,Polish Society of Nephrology
| | - Michał Nowicki
- Medical University of Lodz, Department of Nephrology, Hypertension and Kidney Transplantation, Pomorska Str. 251, 92-213, Lodz, Poland. .,Polish Society of Nephrology , .
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Cortez AR, Winer LK, Kassam AF, Hanseman DJ, Kuethe JW, Sussman JJ, Quillin RC. Exploring the relationship between burnout and grit during general surgery residency: A longitudinal, single-institution analysis. Am J Surg 2019; 219:322-327. [PMID: 31623881 DOI: 10.1016/j.amjsurg.2019.09.041] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/24/2019] [Accepted: 09/30/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND How burnout changes during general surgery residency remains unknown. METHODS From 2015 to 2018, general surgery residents completed the Maslach Burnout Inventory and Grit Scale. Statistical analyses were adjusted for repeated measures and compared to the incoming intern level. RESULTS Fifty-five residents participated in this study. Burnout rates varied by program level, with an increased risk occuring in the third clinical year (OR = 11.7, p = 0.03). Emotional exhaustion (EE) peaked during the first and third clinical years, depersonalization (DP) peaked during the first and second clinical years, and personal achievement (PA) reached a nadir during the third clinical year (all p < 0.05). Residents with burnout had lower grit scores compared to those without burnout (3.71 vs 4.02, p < 0.01). Increasing grit was linearly associated with decreasing EE, decreasing DP, and increasing PA (all p < 0.05). CONCLUSIONS Burnout varies throughout surgical residency, and grit is inversely related to burnout.
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Affiliation(s)
- Alexander R Cortez
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
| | - Leah K Winer
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Al-Faraaz Kassam
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Dennis J Hanseman
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Joshua W Kuethe
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Jeffrey J Sussman
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - R Cutler Quillin
- Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, OH, USA
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