Social Support, Social Isolation, and Burnout: Cross-Sectional Study of U.S. Residents Exploring Associations With Individual, Interpersonal, Program, and Work-Related Factors

Association between learning environment and well-being of postgraduate residents in Kuwait

BACKGROUND

A positive educational environment in postgraduate medical education can immensely affect academic outcomes and lower residents' chances of burnout. However, no studies were conducted in Kuwait to examine the educational environment and its association with residents' well-being. This study aims to investigate the association between the current learning environment and the well-being of the trainees who are having rotations in hospitals in Kuwait.

METHODS

A cross-sectional survey was distributed to all residents currently enrolled in postgraduate medical and dental educational programs. The survey included the Postgraduate Hospital Educational Environment Measure (PHEEM) and the World Health Organization (WHO)-5 Well-Being Index. Pearson's correlation coefficient was used to measure the correlation between two quantitative variables, and linear regression analysis was used to assess factors associated with the well-being score.

RESULTS

The analysis included 184 residents. The mean scores for role autonomy perception, teaching perception, and social support perception were 31.28 ± 11.33, 35.15 ± 13.72, and 23.14 ± 8.57, respectively, with a mean total PHEEM score of 89.58 ± 32.2. Residents' well-being scores ranged from 5 to 25, with a mean of 12.26 ± 4.35. In regression analysis, increased role autonomy, teaching, and social support perception scores were associated with higher well-being. In a multivariable model, each one-unit increase in social support perception score was significantly associated with higher well-being by 0.16 (95%CI: 0.03 to 0.3, P = 0.014), which indicates the positive correlation between the social support elements in the educational environment and residents' well-being. However, the study's limitations, including small sample size and nonresponse bias, should be considered.

CONCLUSION

Assessing the hospital educational environment and residents' well-being has provided vital insights into the strengths and areas needing improvement in postgraduate medical education. Addressing identified areas for improvement can significantly enhance the educational environment, thereby improving trainee satisfaction and well-being. Future studies should focus on confirming the results of this study, assessing proper interventions to improve the educational environment and focusing on social support interventions to improve residents' well-being.

Assessment of psychological debriefing models' components & effective implementation, and its impact on healthcare professionals stress management skills, mental wellbeing, and clinical performance

INTRODUCTION

This study aims to assess various models of psychological debriefing, their benefits, and the impact of their implementation on medical trainees & healthcare professionals' stress management skills, mental well-being, and clinical performance.

METHODS

This review queried PubMed, ProQuest, Web of Science, and Google Scholar databases for articles regarding psychological debriefing in medical education published through May 2024. Included studies that assessed the utilization, implementation, and effectiveness of various psychological debriefing models in the hospital setting among nursing staff, medical trainees, and attending physicians. Outcomes evaluated were successful debriefing models, associated benefits, and attendees' attitudes toward implementation.

RESULTS

Sixteen studies were included. In all psychological debriefing models, attendees had improved coping skills following a challenging clinical scenario and supported the future use of these sessions. However, several barriers to the success of these sessions like untrained facilitators and insufficient time devoted have been noted.

CONCLUSION

Psychological debriefing sessions assisted attendees cope with stressful situations, improved self-confidence, and advocate for themselves. Different models of psychological debriefing can be implemented depending on the resources of each facility.

"I realized I was not alone": A mixed-methods investigation of the implementation of Ubuntu groups to reduce burnout and social isolation in an allopathic medical School in the Southeastern United States

PURPOSE/BACKGROUND

Healthcare providers experience higher rates of workplace burnout, a reality highlighted by the COVID-19 pandemic. In response, small groups, inspired by South African philosophy, Ubuntu, were introduced to decrease burnout and social isolation and build community and belonging. This study examines how participation in these groups can impact these measures.

METHODS

In this mixed-methods study, trained facilitators led small groups that utilized story-sharing to foster connections within the group and broader community. Quantitative and qualitative data were analyzed separately and merged to identify convergence.

RESULTS

Three main qualitative themes emerged: 1) seeking and building connections and community, 2) curiosity, learning, and growing, and 3) open-hearted and thriving. These themes were linked to quantitative outcomes, showing a statistically significant decrease in social isolation among staff/faculty and students. Furthermore, faculty/staff exhibited reduced burnout compared to students, while students reported increased feelings of belonging.

CONCLUSION

Participation in Ubuntu groups positively influenced students' sense of belonging, reduced faculty/staff burnout, and alleviated social isolation for all participants. Future research should explore the potential of this intervention to further promote wellness on medical campuses. Programs emphasizing the well-being of individuals, including faculty, staff, and students, are crucial for supporting the overall health of medical communities and the wider society.

Sense of Belonging Among Medical Students, Residents, and Fellows: Associations With Burnout, Recruitment Retention, and Learning Environment

PURPOSE

This study examines sense of belonging (belongingness) in a large population of medical students, residents, and fellows and associations with learner burnout, organizational recruitment retention indicators, and potentially modifiable learning environment factors.

METHOD

All medical students, residents, and fellows at Mayo Clinic sites were surveyed between October and November 2020 with items measuring sense of belonging in 3 contexts (school or program, organization, surrounding community), burnout (2 Maslach Burnout Inventory items), recruitment retention indicators (likelihood of recommending the organization and accepting a job offer), potentially modifiable learning environment factors, and demographics (age, gender, race and ethnicity, LGBTQ+ identification, disability, socioeconomic background).

RESULTS

Of 2,257 learners surveyed, 1,261 (56%) responded. The percentage of learners reporting a somewhat or very strong sense of belonging was highest in the school or program (994 of 1,227 [81%]) followed by the organization (957 of 1,222 [78%]) and surrounding community (728 of 1,203 [61%]). In adjusted analyses, learners with very strong organization belongingness had lower odds of burnout (odds ratio [OR], 0.05; 95% CI, 0.02-0.12) and higher odds of being likely to recommend the organization (OR, 505.23; 95% CI, 121.54-2,100.18) and accept a job offer (OR, 38.68; 95% CI, 15.72-95.15; all P < .001). School or program and community belongingness also correlated strongly with these outcomes. In multivariable analyses, social support remained associated with higher odds of belongingness in all 3 contexts; favorable ratings of faculty relationships and leadership representation remained associated with higher odds of belongingness in 2 contexts (school or program and organization); and favorable ratings of diversity, equity, and inclusion learning climate remained associated with belongingness in 1 context (community).

CONCLUSIONS

Sense of belonging among medical students, residents, and fellows varies across contexts, correlates strongly with burnout and organizational recruitment retention indicators, and is associated with multiple potentially modifiable learning environment factors.

Reports of Burnout Among Historically Marginalized and Female Graduating Medical Students During the COVID-19 Pandemic

PURPOSE

To examine graduating medical student reports of burnout by sex, race and ethnicity, and sexual orientation and explore trends within intersectional demographic groups from 2019-2021 in a national sample.

METHOD

The authors obtained medical student responses to the 2019-2021 Association of American Medical Colleges (AAMC) Graduation Questionnaires (GQs) linked to data from other AAMC sources. The dataset included year of GQ completion, responses to a modified Oldenburg Burnout Inventory (exhaustion subscale range: 0-24; disengagement subscale range: 0-15), and demographics previously shown to relate to the risk of burnout in medical students, residents, or physicians. Multivariable linear regression analysis was performed to evaluate independent associations between demographics and burnout.

RESULTS

Overall response rate was 80.7%. After controlling for other factors, mean exhaustion scores were higher among Asian (parameter estimate [PE] 0.38, 95% confidence interval [CI] 0.21, 0.54), bisexual (PE 0.97, 95% CI 0.76, 1.17), and gay or lesbian (PE 0.55, 95% CI 0.35, 0.75) students than those who did not identify with each of those respective groups. Mean disengagement scores were lower among female (PE -0.47, 95% CI -0.52, -0.42), Hispanic (PE -0.11, 95% CI -0.22, -0.01), and White (PE -0.10, 95% CI -0.19, 0.00) students and higher among Asian (PE 0.17, 95% CI 0.07, 0.27), Black or African American (PE 0.31, 95% CI 0.18, 0.44), bisexual (PE 0.54, 95% CI 0.41, 0.66), and gay or lesbian (PE 0.23, 95% CI 0.11, 0.35) students than those who did not identify with each of those respective groups. From 2019-2021, mean exhaustion and disengagement scores were relatively stable or improved across nearly all intersectional groups.

CONCLUSIONS

Male, Asian, Black or African American, and sexual minority students had a higher risk of burnout, while female, Hispanic, White, and heterosexual or straight students had a lower risk of burnout.

"Hey, can I go home?": a qualitative case study of wellbeing and the work environment in surgical training

PURPOSE

Surgical trainees are at high risk of burnout and poor wellbeing during their training. A range of workplace factors have been linked to poor wellbeing, including excessive work hours, lack of support networks, and training program demands. However, little is understood about the individual experiences of Australian trainees and their perceptions of the impact of the work environment on wellbeing. The aim of this study was to explore the experiences of Australian surgical trainees regarding their wellbeing in the surgical learning environment.

METHODS

Eleven semi-structured interviews were conducted with Australian surgical trainees at the start of their training and 18 months later, exploring their perspectives of wellbeing in the workplace. Results were analyzed thematically using the Job Demands-Resources model as a scaffold.

RESULTS

Seven themes emerged: (1) relationships with colleagues, (2) work hours and workload, (3) the learning environment and supervision, (4) training program requirements, (5) moving around, (6) hospital and team administration, and (7) hospital facilities and programs. Participant experiences between training commencement and 18 months follow-up did not change.

CONCLUSION

Trainees have unique experiences of wellbeing in the workplace. Some workplace factors, such as relationships with colleagues, can be demands or resources depending on their nature. Effective leadership and administrative practices, mentorship, and proactive rostering act as resources for trainees to balance workplace demands, and these should be prioritized by hospitals and training institutions to improve and protect trainee wellbeing.

Running, walking, and cross-country skiing: how to shape adolescents' personalities through physical activity?

Adolescence is crucial for personality development, and sports play a significant role. This study investigates the impact of various sports on the personality traits of junior high and high school students in Shandong Province, focusing on neuroticism, extraversion, openness, agreeableness, and conscientiousness. Utilizing data from the "Database of Youth Health," we employed Seemingly Unrelated Regression (SUR) and Generalized Structural Equation Modeling (GSEM) to analyze the effects of physical activity on personality development. Findings reveal that walking significantly enhances openness and decreased neuroticism, while jogging/running substantially improves extraversion, agreeableness, and conscientiousness. Cross-country skiing, however, negatively impacts all assessed personality traits. In addition, the importance of gender differences in the relationship between physical activity and personality development was revealed. The results offer insights for promoting adolescent personality development through targeted sports activities.

Differences in Perceived Stress During the COVID-19 Pandemic Among Military Dental Postgraduate Residents

INTRODUCTION

In military training settings, stress can improve focus and motivation fostering effective learning. However, high perceived stress can be debilitating resulting in poor learning and clinical errors. Multiple studies have focused on medical residency stress; but there has been minimal focus on dental residents and even less on the impact of the unique stressors from the COVID-19 pandemic. The objectives of this study were to determine the impact of the COVID-19 pandemic on perceived stress of residents in a military dental residency training program and explore the association among perceived stress and anxiety, depression, sleep quality, and social support.

MATERIALS AND METHODS

Dental residents (N = 20) at the Naval Postgraduate Dental School participated in this study. Residents were assessed via self-report measures quarterly from March 2020 through June 2021. The assessment included measures of anxiety (GAD-7), depression (PHQ-9), perceived stress (PSS), fatigue (FSI), and social support (DUKE-SSQ).

RESULTS

Before the pandemic shutdown, 60% of participants reported high perceived stress. These residents reported an initial decrease in symptoms of anxiety, depression, and fatigue compared to residents reporting low pre-pandemic perceived stress but returned to baseline levels post-shutdown. Additionally, the high stress participants reported lower social support.

CONCLUSIONS

Based on pre-pandemic perceived stress, participants responded differently to the impact of the pandemic shutdown. The low baseline stress participants may have a more robust sense of grit and resilience. These findings suggest that postgraduate dental training programs should integrate coping skills training opportunities, especially for residents reporting high perceived stress before residency.

Promoting Surgical Resident Well-being Through Therapist-Facilitated Discussion Groups: A Quantitative and Qualitative Analysis

OBJECTIVE

To improve the well-being and sense of community of surgical trainees.

DESIGN

Residents were invited to participate in confidential discussion groups during protected education time to have a safe space to support each other through common struggles. The groups were facilitated by licensed mental health professionals with experience working with medical trainees. An anonymous voluntary wellness survey and a qualitative feedback survey were used to understand residents' experience participating in these discussion groups.

SETTING

Single large academic institution.

PARTICIPANTS

General surgery and obstetrics and gynecology residents.

RESULTS

677 resident responses to the wellness survey were collected between 2020 and 2023. Compared to residents who participated in < 5 discussion group sessions, residents participating in ≥ 5 sessions reported improved self-perception of their own competency and capability (p = 0.012), and in their ability to contribute to others' well-being (p = 0.045). They also reported considering more of their co-residents as friends (p = 0.002), increased willingness to discuss personal problems with their co-residents (p < 0.001), and were more likely to report recently working with peers to solve a common problem (p = 0.041). In a second qualitative survey (n = 53), resident feedback revealed an appreciation for the opportunity to discuss shared experiences, creating community, having a safe space and dedicated time for introspection, and receiving input from a therapist. Opportunities for improvement included providing more structure to the discussion, increasing the frequency of group meetings, and focusing on developing coping skills.

CONCLUSION

Therapist-facilitated discussion groups can improve aspects of trainees' mental well-being and help foster relatedness, community, and shared problem solving with peers. Residency programs should consider incorporating similar programs into their wellness initiatives.

Making space for stories: promoting physician and medical student well-being through successful medical education storytelling events

Storytelling events in medical education settings are a powerful way to share stories, build community, promote resilience, and foster well-being, but many educators are unsure how to go about creating an event. This paper outlines practical tips to empower readers to plan and carry out a successful, impactful storytelling event.

Gaining Respect and Mitigating Risk: A Qualitative Exploration of How New Attendings Navigate Interpersonal Relationships with Recent Resident Peers

Background

Physicians moving through training experience changes in personal and professional relationships, which can increase stress, uncertainty, and burnout. Social connection can be an important resource but can introduce complexity and conflict. This study aimed to explore how early-career attendings navigate and manage changing organizational and friendship roles with recent resident peers (near-peers) through this critical transition.

Methods

We conducted a reflexive thematic analysis of interviews with early-career attendings working with near-peers from the same institution where they trained. Twenty three of 27 (85%) eligible attendings from two United States health systems participated in semi-structured interviews between April and June 2023.

Results

Familiarity from working at the same institution where new attendings completed training made it more difficult to command authority. Early-career attendings at times struggled with insecurities about their ability to fulfill their new role and challenges from others in recognizing their new attending identity. These tensions could heighten emotions in the clinical setting and spill over into relationships with residents outside the workplace, impacting social lives and well-being. Early-career attendings engaged in strategies to manage the social realm of their transition with near-peers, including prioritizing their organizational role in the clinical setting and mitigating risks to their professional reputation by creating stronger boundaries between their personal and professional lives.

Conclusions

This study provides new insight into how attendings navigate changing personal and professional relationships with recent resident peers and offers strategies on how to manage the social realm of this liminal transition.

Interventions to Support Resident and Fellow Well-Being During the COVID-19 Pandemic: A Scoping Review

Background The COVID-19 pandemic led to rapid and wide-scale changes in graduate medical education and impacted the well-being of frontline physicians, including residents and fellows. While institutions and programs implemented initiatives to support the unique needs of trainees during the pandemic, there remains a gap in the literature in examining the approaches used, the domains of well-being addressed, and the effectiveness of these efforts. Objective To review the literature on interventions designed to promote resident and fellow well-being during the COVID-19 pandemic. Methods The authors conducted a scoping review of the literature published between January 1, 2020, and November 30, 2023, in PubMed, Scopus, Embase, PsycINFO, CINAHL, and ERIC to identify interventions to promote the well-being of trainees during the COVID-19 pandemic. Results Eighteen articles met inclusion criteria, mainly studies conducted in the United States (14 of 18, 77.8%). Most interventions targeted psychological well-being (16 of 18, 88.9%), with only a few studies that included interventions in the physical or social domains. Interventions entailed redeployment, schedule modifications, communication strategies, and expanded mental health support. Most interventions were limited to a few weeks' duration in the first surge phase of the pandemic. Only 11 studies (61%) reported outcome measures, and only 2 (11%) used instruments with validity evidence. Most studies did not report sufficient data to evaluate study quality. Conclusions While longer-term outcome data were often lacking, studies described a range of interventions to support resident well-being. Future research should focus on the effectiveness of well-being interventions and include cohorts from more diverse clinical settings.

Person-centered exploration of work-related stress patterns, predictors, and their association with subhealth in midwives: A cross-sectional study

BACKGROUND

Midwives experience elevated levels of work-related stress. However, there is limited understanding of the patterns of this stress, its sociodemographic and work-related determinants, and its association with sub-health.

METHOD

This multi-center cross-sectional study, conducted in 21 hospitals in Zhuhai City, Guangdong Province, China, involved 300 midwives. Work-related stress levels in midwives were evaluated using the Chinese version of the Nursing Stress Scale, while social, physical and mental sub-health status was measured with the Sub-Health Measurement Scale. Utilizing latent profile analysis, the study aimed to categorize midwives into homogeneous profiles based on patterns of work-related stress.

RESULTS

Among the 300 midwives examined, three distinct profiles were identified: profile 1 (n=57, 19 %), characterized by low work-related stress; profile 2 (n=149, 50 %), representing the moderate work-related stress class; and profile 3 (n=94, 31 %), indicative of high work-related stress. Midwives in the high work-related stress profile tended to be younger, with lower monthly income, lower professional titles, and a higher likelihood of night shift work (all P<0.01). Significant and noteworthy trends were observed in sociodemographic characteristics (age, monthly income, and professional title) and work-related characteristics (night shift status). After controlling for confounders, the work-related stress profile demonstrated a negative association with social, physical and mental sub-health status.

CONCLUSION

This study highlights integrating stress domains and adopting a person-centered approach to examine midwives' work-related stress. Identifying predictors of profile membership and their relationship with sub-health can inform tailored interventions to reduce stress and improve midwives' well-being.

Signs, Sources, Coping Strategies, and Suggested Interventions for Burnout Among Preclerkship Students at a U.S. Medical School: A Qualitative Focus Group Study

PURPOSE

Research suggests that burnout can begin early in medical school, yet burnout among preclerkship students remains underexplored. This study aimed to characterize burnout signs, sources, coping strategies, and potential interventions among preclerkship students at one U.S. medical school.

METHOD

The authors conducted a qualitative study of preclerkship students at Mayo Clinic Alix School of Medicine (MCASOM) in June 2019. Participants completed 2 Maslach Burnout Inventory (MBI) items (measuring frequency of emotional exhaustion and depersonalization) and 2 free-text questions on burnout before participating in 1 of 3 semistructured focus groups. Focus group questions were derived from a literature review on medical student burnout with input from the MCASOM Student Life and Wellness Committee. Group discussions were recorded, transcribed, coded inductively, and analyzed iteratively (along with free-text comments) using a general inductive approach from a constructivist perspective.

RESULTS

Eighteen of 111 eligible students (16%) participated, with 5/18 (28%) reporting weekly emotional exhaustion and/or depersonalization on MBI items. Analysis of focus group transcripts showed that most students had experienced burnout symptoms during their first or second year, corresponding with school-related stressors and manifesting in cognitive-emotional, physical, and verbal-behavioral ways. Students identified systemic, institutional, and individual burnout drivers and discussed how these drivers interacted (e.g., high standards of excellence at the system level interacted with anxiety and maladaptive thinking at the individual level, creating pressure to always do more). Students used various coping strategies (e.g., self-care, peer support, reframing, and compartmentalization) but emphasized limitations of these strategies and recommended interventions directed toward systemic and institutional burnout drivers.

CONCLUSIONS

This study offers insights into burnout signs and sources among preclerkship medical students that can inform future large-scale studies. Results suggest that burnout emerges from dynamic interactions among systemic, institutional, and individual factors and may benefit from multipronged interventions.

The Mayo Leadership Impact Index Adapted for Matrix Leadership Structures: Initial Validity Evidence

Importance

Physician burnout has reached crisis levels. Supportive leadership is one of the strongest drivers of physician well-being, and monitoring supervisor support is key to developing well-being focused leadership skills. Existing measures of leader support were designed within "direct report" supervision structures limiting their applicability to matrixed leadership reporting structures where direct reports are not the predominant norm. Antecedently, no measure of leadership support is validated specifically for implementation in matrixed leadership structures.

Objective

Adapt and validate the Mayo Leadership Impact Index (MLII) for settings with matrixed leadership structures.

Design

A psychometric validation study utilizing classical test theory and item response theory.

Setting

A tripartite hospital system in the southwestern US.

Participants

Physician-respondents to a 2023 cross-sectional survey.

Main Outcomes and Measures

After pilot testing, the adapted MLII was examined using a unidimensional graded response model and confirmatory factor analyses. Convergent validity was investigated via correlations with professional fulfillment, perceived autonomy support, self-valuation, and peer connectedness/respect. Divergent validity was tested via correlations with burnout.

Results

Of the three candidate revisions of the MLII, the 9-item adaptation was selected for its superior validity/reliability indices. Standardized Cronbach's and Ordinal alpha coefficients were 0.958 and 0.973, respectively. CFA loadings exceeded 0.70 (p < 0.001), and coefficients of variation (R2) exceeded 0.60 for all items. GRM slope parameters indicated "high" to "very high" item discrimination. Items 2, 5, and 8 were the most informative. Positive correlations of the adapted MLII with professional fulfillment, perceived autonomy support, and peer connectedness/respect were observed, supporting convergent validity. Negative correlation with overall burnout supports divergent validity.

Conclusions and Relevance

The findings provide evidence of the adapted MLII's validity, reliability, and appropriateness for implementation within matrixed leadership settings. Prior to this study, no leadership support measure had been validated for use among the growing number of healthcare systems with matrixed leadership reporting structures.

Evaluation of radiology resident well-being at a single institution with a dedicated wellness curriculum

INTRODUCTION

Increasing rates of physician burnout over recent years have resulted in the need for formal tools and programming dedicated to physician well-being. The Accreditation Council for Graduate Medical Education (ACGME) has taken measures to prioritize trainee well-being by revising its common program requirements. Widespread departmental initiatives have been developed in line with these changes. At the authors' institution, a committee was developed to design and implement a holistic wellness curriculum for radiology trainees.

OBJECTIVE

The objective of this study was to assess overall well-being in a cohort of radiology residents at a training program with a dedicated wellness curriculum.

METHODS

A wellness curriculum for radiology residents was developed and implemented. Over a 3-year period, data was collected using the Maslach Burnout Inventory (MBI), Brief Resilience Scale (BRS).

RESULTS

Rates amongst respondents were low, compared to average, for emotional exhaustion (below 17, average 25.2), depersonalization (6, average 10), and of personal accomplishment were moderate to high (37.5, average 32.9). PGY-4 level residents had the highest rates of burnout (p = 0.042 for depersonalization, p = 0.006 for emotional exhaustion). PGY-4 residents also had the lowest rates of resilience based on the BRS, and PGY-3 the highest (p = 0.037). There were no statistically significant differences between gender or differing relationship status for MBI or BRS. The most commonly cited barriers to wellness practices included fatigue, competing responsibilities, and not knowing where to start.

CONCLUSION

Radiology residents at a single institution with a dedicated wellness curriculum demonstrated overall lower rates of burnout compared to their peers.

Teaming beyond the clinical environment - building collective commitment across graduate medical education

This commentary provides evidence and expert opinion on effective relationships and communication strategies for trainee and graduate medical education leaders. The authors also argue that consistent communication and alignment of goals between trainee leadership and graduate medical education leadership are essential components of a successful collaboration that promotes trainee well-being.

Cultural adaptation and validation of Japanese medical resident version of the workplace social capital scale: a cross-sectional study

BACKGROUND

The Workplace Social Capital (WSC) Scale is the most frequently used tool for measuring social capital at work in Western countries. However, there are no corresponding tools for assessing WSC among medical trainees in Japan. Thus, this study was conducted to develop the Japanese medical resident version of the WSC (JMR-WSC) Scale and examine its validity and reliability.

METHODS

The Japanese version of the WSC Scale by Odagiri et al. was reviewed and the scale was partially modified for use in the Japanese context of postgraduate medical education. To verify the validity and reliability of the JMR-WSC Scale, a cross-sectional survey was performed in 32 hospitals across Japan. Postgraduate trainees (years 1-6) at the participating hospitals responded to the online questionnaire on a voluntary basis. We tested the structural validity through confirmatory factor analysis. We also examined criterion-related validity and internal consistency reliability of the JMR-WSC Scale.

RESULTS

In all, 289 trainees completed the questionnaire. The results of confirmatory factor analysis supported the JMR-WSC Scale's structural validity on the same two-factor model as that of the original WSC Scale. Logistic regression analysis showed that, after adjustment for gender and postgraduate years, trainees with good self-rated health had a significantly elevated odds ratio for good WSC. Cronbach's alpha coefficients showed acceptable internal consistency reliability.

CONCLUSIONS

We successfully developed the JMR-WSC Scale and examined its validity and reliability. Our scale could be used to measure social capital in postgraduate medical training settings in Japan to help prevent burnout and reduce patient safety incidents.