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Regan S, Russell S, Simone K, Parkman J, Sanaee M. A Pilot Study in Fatigue Risk Management Among Obstetrics and Gynaecology Residents at the University of Alberta. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102431. [PMID: 38447666 DOI: 10.1016/j.jogc.2024.102431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Combatting fatigue is an ongoing challenge in surgical residency programs impacting both patient care and resident well-being. There is a gap in understanding the nuances of fatigue perpetuation, especially where it relates to specific on-call duties. This pilot study seeks to explore the extent of sleep deprivation among Obstetrics and Gynecology (OBGYN) residents and identify obstacles to obtaining adequate rest. METHODS A survey was sent out to all OBGYN residents at the University of Alberta, collecting demographic and baseline sleep information and assessing perceived barriers to sleep. Residents then self-selected for participation in the second portion which involved recording all pages in a 12-hour shift and assigning an acuity rating to them. Mixed methods were used including thematic analysis of the page acuity survey and descriptive statistics for the primary survey. RESULTS In total, 21 residents completed the initial survey (67.7%) and 17 12-hour shifts were recorded. While junior residents (postgraduate year 1-2) and those carrying the low-risk pager slept less on call and had less sleep on days without call, barriers to sleep were not different when compared to senior residents and those carrying the high-risk pager. While low-risk and high-risk shifts had different primary contributors to fatigue (volume and acuity, respectively) both groups attributed fatigue to non-urgent pages. On review of pages, 49.4% were perceived as non-urgent. A total of 81% of residents supported the development of problem boards to reduce the number of non-urgent pages. CONCLUSIONS This pilot study demonstrated residents, regardless of seniority or shift, found non-urgent pages to be a significant contributor to on-call fatigue and supported the use of problem boards to reduce pages. Our approach can provide a framework for other institutions to learn more about resident fatigue and non-urgent paging in their program.
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Affiliation(s)
- Shauna Regan
- Department of Obstetrics and Gynecology, University of Alberta, AB
| | - Skye Russell
- Department of Obstetrics and Gynecology, University of Alberta, AB.
| | - Kristen Simone
- Department of Obstetrics and Gynecology, University of Alberta, AB
| | - Julia Parkman
- Department of Obstetrics and Gynecology, University of Alberta, AB
| | - May Sanaee
- Department of Obstetrics and Gynecology, University of Alberta, AB
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Smith RP, Rayburn WF. Burnout in Obstetricians-Gynecologists: Its Prevalence, Identification, Prevention, and Reversal. Obstet Gynecol Clin North Am 2021; 48:231-245. [PMID: 33573788 DOI: 10.1016/j.ogc.2020.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Studies indicate that burnout rates among obstetricians-gynecologists range from 40% to more than 75%, which is in the middle to upper one-third of medical specialties. Symptoms range from feelings of underappreciation and unresolved fatigue, to cynicism, depression, physical symptoms, and illness. Burnout is associated with poor job satisfaction, questioning career choices, and dropping out of practice, impacting workforce concerns and patient access. Awareness of the symptoms and some simple stress and fatigue reduction techniques can decrease the risk of being trapped in the downward spiral of burnout. Successful interventions range from more sleep, to hobbies and vacations, to skilled counseling.
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Affiliation(s)
| | - William F Rayburn
- University of New Mexico School of Medicine, University of New Mexico, Building No. 2, MSC09 53701, Albuquerque, NM 87131, USA
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Mohr-Sasson A, Cohen A, Baruch Y, Hochberg A, Gutzeit O, Pardo N, Mazaki-Tovi S, Sivan E. The influence of lifestyle of OB/GYN female residents on gynecological and obstetrical outcomes: A cross-sectional study. Eur J Obstet Gynecol Reprod Biol 2021; 263:62-66. [PMID: 34167035 DOI: 10.1016/j.ejogrb.2021.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To learn the influence of obstetrics and gynecology (OB/GYN) female residents' lifestyle on obstetric and gynecological characteristics compared to women matched by age from the general population. STUDY DESIGN A cross-sectional multicenter study including OB/GYN female residents from ten different hospitals in Israel, who completed an internet questionnaire published during 2017-2018, that were compared to women matched by age from the general population. Questions dealt with lifestyle habits, obstetrical and gynecological outcomes. Data are presented as median and inter-quartile range. RESULTS During the study period 97 women completed the questionnaire, of them 56 (57.7%) OB/GYN female residents and 41(42.3%) controls. No statistically significant differences were found between the groups regarding age, marital status, gravidity and parity. However, lifestyle characteristics reported by OB/GYN female residents differed compared to controls: OB/GYN female residents found their work more stressogenic [53 (94.6%) vs. 20 (48.8%); p = 0.001], suffered from deprived sleep [42(75.6%) vs. 13(31.8%); p = 0.001], were less punctilious on dental hygiene [13(23.2%) vs. 27(65.8%); p = 0.001] and reported maintaining a less healthy diet [35(62.5%) vs. 15(36.6%); p = 0.003]. Despite these differences, general happiness reported by both groups was comparable (35(62.5%) vs. 27(65.9%) for OB/GYN and control women respectively; p = 0.73). Pregnancy rate was found to be more than double in the resident's group [30 (53.6%) vs. 9 (22%); p = 0.002], with no differences in the rates of: complications during pregnancy [51(91.1%) vs. 38(92.7%); p = 0.78]; abortions [10 (17.9%) vs. 8 (19.5%); p = 0.84]; augmentation of labor [5 (9%) vs. 7 (17.1%); p = 0.18]; or cesarean deliveries [7(12.5%) vs. 7(17%); p = 0.48]. Logistic regression analysis found both parity and residency as independent variables significantly associated with pregnancy rate [(B = 0.69, p = 0.047), (B = 1.95, p = 0.016), respectively]. CONCLUSION Although resident women in OB/GYN reported on more adverse lifestyle parameters, comparable obstetric and gynecological outcomes were seen, with residency and parity being independently associated with higher pregnancy rate.
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Affiliation(s)
- Aya Mohr-Sasson
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Adiel Cohen
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel
| | - Yoav Baruch
- Lis Maternity and Women's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alyssa Hochberg
- Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ola Gutzeit
- Department of Obstetrics and Gynecology, Rambam Health Care Campus, Haifa, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Noam Pardo
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shali Mazaki-Tovi
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Sivan
- Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Naji L, Singh B, Shah A, Naji F, Dennis B, Kavanagh O, Banfield L, Alyass A, Razak F, Samaan Z, Profetto J, Thabane L, Sohani ZN. Global prevalence of burnout among postgraduate medical trainees: a systematic review and meta-regression. CMAJ Open 2021; 9:E189-E200. [PMID: 33688027 PMCID: PMC8034324 DOI: 10.9778/cmajo.20200068] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Burnout among postgraduate medical trainees (PMTs) is increasingly being recognized as a crisis in the medical profession. We aimed to establish the prevalence of burnout among PMTs, identify risk and protective factors, and assess whether burnout varied by country of training, year of study and specialty of practice. METHODS We systematically searched MEDLINE, Embase, PsycINFO, the Cochrane Database of Systematic Reviews, Web of Science and Education Resources Information Center from their inception to Aug. 21, 2018, for studies of burnout among PMTs. The primary objective was to identify the global prevalence of burnout among PMTs. Our secondary objective was to evaluate the association between burnout and country of training, year of study, specialty of training and other sociodemographic factors commonly thought to be related to burnout. We employed random-effects meta-analysis and meta-regression techniques to estimate a pooled prevalence and conduct secondary analyses. RESULTS In total, 8505 published studies were screened, 196 met eligibility and 114 were included in the meta-analysis. The pooled prevalence of burnout was 47.3% (95% confidence interval 43.1% to 51.5%), based on studies published over 20 years involving 31 210 PMTs from 47 countries. The prevalence of burnout remained unchanged over the past 2 decades. Burnout varied by region, with PMTs of European countries experiencing the lowest level. Burnout rates among medical and surgical PMTs were similar. INTERPRETATION Current wellness efforts and policies have not changed the prevalence of burnout worldwide. Future research should focus on understanding systemic factors and leveraging these findings to design interventions to combat burnout. STUDY REGISTRATION PROSPERO no. CRD42018108774.
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Affiliation(s)
- Leen Naji
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que.
| | - Brendan Singh
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Ajay Shah
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Faysal Naji
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Brittany Dennis
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Owen Kavanagh
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Laura Banfield
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Akram Alyass
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Fahad Razak
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Zainab Samaan
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Jason Profetto
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Lehana Thabane
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que
| | - Zahra N Sohani
- Departments of Family Medicine (Naji, Singh, Kavanagh, Profetto) and of Health Research Methods, Evidence and Impact (Naji, Alyass, Samaan, Thabane), McMaster University; Michael G. DeGroote School of Medicine (Shah); Departments of Vascular Surgery (Naji) and Medicine (Dennis); Health Sciences Library (Banfield), McMaster University, Hamilton, Ont.; Li Ka Shing Knowledge Institute (Razak), St. Michael's Hospital, Toronto, Ont.; Department of Psychiatry and Behavioural Neurosciences (Samaan), McMaster University, Hamilton, Ont.; Biostatistics Unit, St. Joseph's Healthcare - Hamilton (Thabane), Hamilton, Ont.; Faculty of Medicine (Sohani), University of Toronto, Toronto, Ont.; Department of Internal Medicine (Sohani), McGill University, Montréal, Que.
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Kirubarajan A, Got T, Park B, Li X, Sobel M. Interventions to Prevent and Treat Burnout in Obstetrics/Gynaecology: A Scoping Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:490-496. [PMID: 33373695 DOI: 10.1016/j.jogc.2020.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Obstetricians and gynaecologists are among the highest risk specialties for burnout. There is growing evidence that physician burnout can be both prevented and reduced. We sought to characterize the evidence base for interventions related to the prevention and treatment of burnout in obstetrics and gynaecology DATA SOURCES: We conducted a scoping review following PRISMA guidelines of 5 databases: (Medline-OVID, EMBASE, CINAHL, ClinicalTrials.gov, and PsycInfo) from inception to March 17, 2020. Citations of relevant articles were hand-searched to maximize sensitivity. STUDY SELECTION All interventional study designs were included. The target study population was obstetrics and gynaecology residents, learners, or staff. Published conference posters, papers, and abstracts were eligible for inclusion. DATA EXTRACTION AND SYNTHESIS All extraction and descriptive analysis was completed by two independent reviewers. Outcomes were summarized descriptively. Appraisal was completed using the Cochrane Risk of Bias tool and Risk of Bias Assessment tool for Non-randomized Studies. RESULTS Of the 1540 original database citations, 20 studies met our inclusion criteria. A total of 589 obstetrics/gynaecology participants were included. While there was an overall a lack of research in the field, there were several promising interventions that target residents. There were a combination of preventative interventions (e.g. yoga, nutritional programs, or narrative medicine initiatives) as well as treatments (e.g. counselling appointments or debrief sessions). The vast majority of these interventions focused on individual-specific interventions rather than structural changes. In addition, the majority of interventions appeared to be "proof of concept" and feasability-related studies, with many studies published as conference abstracts rather than peer-reviewed journal publications. CONCLUSIONS Institutions should continue to implement interventions that address burnout in obstetrics and gynaecology. Further research is required on long-term outcomes of interventions as well as structural strategies.
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Affiliation(s)
- Abirami Kirubarajan
- Faculty of Medicine, University of Toronto, Toronto, ON; Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON.
| | - Tiffany Got
- Faculty of Medicine, University of Toronto, Toronto, ON
| | - Bomi Park
- Faculty of Medicine, University of Toronto, Toronto, ON
| | - Xinglin Li
- Faculty of Medicine, University of Toronto, Toronto, ON
| | - Mara Sobel
- Department of Obstetrics & Gynecology, Sinai Health System, Toronto, ON
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Winkel AF. A National Curriculum to Address Professional Fulfillment and Burnout in OB-GYN Residents. J Grad Med Educ 2020; 12:461-468. [PMID: 32879687 PMCID: PMC7450736 DOI: 10.4300/jgme-d-19-00728.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/17/2020] [Accepted: 04/22/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Physician well-being is a priority in graduate medical education as residents suffer high rates of burnout. With complex stressors affecting the clinical environment, conflicting evidence exists as to whether a formal curriculum improves resident well-being. OBJECTIVE We assessed the feasibility and impact of a national pilot of a yearlong wellness curriculum for obstetrics and gynecology (OB-GYN) residents. METHODS The Council on Resident Education in Obstetrics and Gynecology Wellness Task Force developed a national multicenter pilot group of 25 OB-GYN programs to participate in a prospective cohort study. The curriculum included 6 interactive wellness workshops using uniform teaching materials delivered during didactic time. Prior to and following their participation in the curriculum, residents completed a survey containing demographic information and the Professional Fulfillment Index. RESULTS Among 592 eligible participants, 429 (72%) responded to the pretest and 387 (65%) to the posttest. Average age of respondents was 29.1 years (range = 24-52 years) and included 350 (82%) women and 79 (18%) men. At baseline, 254 of 540 (47%) respondents met criteria for burnout, and 101 (23%) met criteria for robust professional fulfillment. Residents participated in an average of 3.9 workshops. While aggregate posttest scores did not differ from baseline, residents attending 4 to 6 workshops had improved rates of burnout (40% vs 50%, P = .017) and robust professional fulfillment (28% vs 20%, P < .001) compared with those with lower attendance. CONCLUSIONS A wellness curriculum was a feasible addition to OB-GYN residency program curricula in programs across the country. Residents with higher attendance experienced improved professional fulfillment and less burnout.
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Hariharan TS, Griffin B. A review of the factors related to burnout at the early-career stage of medicine. MEDICAL TEACHER 2019; 41:1380-1391. [PMID: 31345077 DOI: 10.1080/0142159x.2019.1641189] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Background: Globally, burnout is an increasingly prevalent problem amongst young medical professionals. This review aims to understand the factors related to burnout in the early-career stage of medicine. Drawing on the widely used Job Demands-Resources Model, the antecedents of burnout were distinguished from its outcomes.Methods: The review adopted the PRISMA guidelines. Using specific search terms, peer-reviewed articles were obtained from a range of databases and assessed against selection criteria. To meet inclusion requirements, the study had to be published between 2000 and 2018, include a validated measure of burnout, and undertake empirical assessment of factors related to burnout in medical students and/or junior medical officers/residents. Additional studies were obtained and reviewed from the reference lists of selected articles.Results: Out of the 3796 studies that were initially found, 585 were assessed against the eligibility criteria leaving 113 studies for review. These studies highlighted the negative consequences of burnout in the early medical career. Also identified were work-specific and person-specific demands that likely lead to burnout and, work and person resources that appear to reduce burnout.Conclusion: This review provides a framework to explain the growing problem of burnout amongst early-career medical professionals. However, further research is necessary to overcome the current reliance on cross-sectional designs and small sample sizes.
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Affiliation(s)
| | - Barbara Griffin
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
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Bourne T, Shah H, Falconieri N, Timmerman D, Lees C, Wright A, Lumsden MA, Regan L, Van Calster B. Burnout, well-being and defensive medical practice among obstetricians and gynaecologists in the UK: cross-sectional survey study. BMJ Open 2019; 9:e030968. [PMID: 31767585 PMCID: PMC6887071 DOI: 10.1136/bmjopen-2019-030968] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 10/06/2019] [Accepted: 10/10/2019] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To determine the prevalence of burnout in doctors practising obstetrics and gynaecology, and assess the association with defensive medical practice and self-reported well-being. DESIGN Nationwide online cross-sectional survey study; December 2017-March 2018. SETTING Hospitals in the UK. PARTICIPANTS 5661 practising obstetrics and gynaecology consultants, specialty and associate specialist doctors and trainees registered with the Royal College of Obstetricians and Gynaecologists. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence of burnout using the Maslach Burnout Inventory and defensive medical practice (avoiding cases or procedures, overprescribing, over-referral) using a 12-item questionnaire. The odds ratios (OR) of burnout with defensive medical practice and self-reported well-being. RESULTS 3102/5661 doctors (55%) completed the survey. 3073/3102 (99%) met the inclusion criteria (1462 consultants, 1357 trainees and 254 specialty and associate specialist doctors). 1116/3073 (36%) doctors met the burnout criteria, with levels highest amongst trainees (580/1357 (43%)). 258/1116 (23%) doctors with burnout reported increased defensive practice compared with 142/1957 (7%) without (adjusted OR 4.35, 95% CI 3.46 to 5.49). ORs of burnout with well-being items varied between 1.38 and 6.37, and were highest for anxiety (3.59, 95% CI 3.07 to 4.21), depression (4.05, 95% CI 3.26 to 5.04) and suicidal thoughts (6.37, 95% CI 95% CI 3.95 to 10.7). In multivariable logistic regression, being of younger age, white or 'other' ethnicity, and graduating with a medical degree from the UK or Ireland had the strongest associations with burnout. CONCLUSIONS High levels of burnout were observed in obstetricians and gynaecologists and particularly among trainees. Burnout was associated with both increased defensive medical practice and worse doctor well-being. These findings have implications for the well-being and retention of doctors as well as the quality of patient care, and may help to inform the content of future interventions aimed at preventing burnout and improving patient safety.
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Affiliation(s)
- Tom Bourne
- Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium
| | - Harsha Shah
- Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK
| | - Nora Falconieri
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium
| | - Dirk Timmerman
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium
| | - Christoph Lees
- Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium
| | - Alison Wright
- Department of Obstetrics and Gynaecology, Royal Free Hospital, London, UK
| | - Mary Ann Lumsden
- Department of Obstetrics and Gynaecology, University of Glasgow, Glasgow, UK
| | - Lesley Regan
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Ben Van Calster
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
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Fernando BMS, Samaranayake DL. Burnout among postgraduate doctors in Colombo: prevalence, associated factors and association with self-reported patient care. BMC MEDICAL EDUCATION 2019; 19:373. [PMID: 31619216 PMCID: PMC6794729 DOI: 10.1186/s12909-019-1810-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/16/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Postgraduate doctors are prone to burnout due to occupational and educational stressors. Sri Lankan situation is unknown. This study determines burnout among postgraduate doctors in Colombo: Prevalence, associated factors, and association with self-reported patient care. METHODS A cross-sectional study was conducted among 278 postgraduate doctors from eight specialties working in Colombo district, attached to the main postgraduate training institute for medical professionals. A self-administered questionnaire was used. It comprised of the Copenhagen Burnout Inventory and an author-developed questionnaire, which was used to assess, associated factors and self-reported patient care. Prevalence of burnout was calculated. Associations were analysed using chi-square and binary logistic regression. RESULTS The response rate was 88.1% (n = 245). The prevalence of personal, work-related and client-related burnout was 41.6% (95% CI = 35.5-47.8%), 30.6% (95% CI = 24.8-36.4%), 8.9% (95% CI = 5.4-12.5%) respectively. Personal burnout was positively associated with, the trainee being a female, having a chronic disease, being involved in frequent unhealthy habits, having doctor parents, having home-work demands and having emotional demands. It was negatively associated with, having frequent healthy habits, being satisfied with skill development opportunities, and frequent use of deep studying. Work-related burnout was positively associated with, female gender, being involved in frequent unhealthy habits, having home-work demands and having emotional demands. It was negatively associated with, frequent use of deep methods of studying. Client-related burnout was positively associated with having emotional demands and negatively associated with being satisfied with training. The frequent self-reported, suboptimal patient-care practices: poor communication, poor clinical practice, poor response to patient's needs and poor communication during handing over were associated positively with client-related burnout. CONCLUSIONS Most postgraduate doctors in Colombo have high personal and work-related burnout but client-related burnout is less. The factors associated with burnout need to be addressed by the programme managers of the postgraduate courses. Preventive measures should be introduced to reduce burnout among future postgraduate trainees of Colombo.
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Johnson NR, Pelletier A, Chen X, Manning-Geist BL. Learning in a High-Stress Clinical Environment: Stressors Associated with Medical Students' Clerkship Training on Labor and Delivery. TEACHING AND LEARNING IN MEDICINE 2019; 31:385-392. [PMID: 30907690 DOI: 10.1080/10401334.2019.1575742] [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] [Indexed: 06/09/2023]
Abstract
Phenomenon: Obstetrics and gynecology can be a high-stress clinical environment for medical students due to the specialty's fast-paced and unpredictable nature. Little is known about learning stressors for medical students on the obstetrics and gynecology clerkship to inform stress-reducing interventions and improve learning experience. This study investigated (a) which aspects of the learning environment are most stressful for obstetrics and gynecology clerkship students, (b) how perceived learning stressors in this environment differ for medical students and teachers (residents, fellows, and faculty), and (c) what interventions students propose to address these stressors. Approach: From May 2015 to April 2016, we conducted semistructured individual interviews with 3rd-year medical students from obstetrics and gynecology clerkship cohorts (n = 52) as well as clerkship teachers (n = 10) at an academic medical center. Two investigators used a qualitative Framework Method approach to analyze the interview data and agree upon final themes. Findings: We identified labor and delivery as the most stressful learning environment and four labor and delivery-related themes of students' learning stressors: context (pace, logistics, nature of childbirth, and nonroutine schedule), learning tasks (student role and assignments and the amount of new knowledge and skills), communication (terminology used in conversation and interacting with the labor and delivery team), and clinical scenario (crisis, emergency, and patient refusal of student involvement). Whereas students identified context as causing most of the stress, teachers concentrated on stressors related to learning tasks. Insights: Learning stressors associated with students' educational experience in the clinical context of labor and delivery are challenging for medical students. In addition to the specific content of these challenges, the recognition that teachers' assumptions about sources of stressors are different from those of students is an important finding and has implications for changing the learning environment. Clerkship programs are encouraged to provide practical guidelines and embed an introduction of the clinical learning environment into the Obstetrics and Gynecology clerkship orientation curriculum.
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Affiliation(s)
- Natasha R Johnson
- a Department of Obstetrics and Gynecology , Brigham and Women's Hospital, Harvard Medical School , Boston , Massachusetts , USA
| | - Andrea Pelletier
- a Department of Obstetrics and Gynecology , Brigham and Women's Hospital, Harvard Medical School , Boston , Massachusetts , USA
| | - Xiaodong Chen
- a Department of Obstetrics and Gynecology , Brigham and Women's Hospital, Harvard Medical School , Boston , Massachusetts , USA
| | - Beryl L Manning-Geist
- a Department of Obstetrics and Gynecology , Brigham and Women's Hospital, Harvard Medical School , Boston , Massachusetts , USA
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Abstract
In this article we address the concept of burnout, first in the medical student setting, and then in the residency setting. We will review the prevalence followed by a discussion of risk factors, consequences, and finally thoughts on prevention and intervention.
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12
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Robson S, Cukierman R. Burnout, mental health and ‘wellness’ in obstetricians and gynaecologists: Why these issues should matter to our patients – and our profession. Aust N Z J Obstet Gynaecol 2019; 59:331-334. [DOI: 10.1111/ajo.12987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Steve Robson
- Australian National University Medical School Canberra Australian Capital Territory Australia
| | - Ronit Cukierman
- Centenary Hospital for Women and Children Canberra Australian Capital Territory Australia
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13
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Low ZX, Yeo KA, Sharma VK, Leung GK, McIntyre RS, Guerrero A, Lu B, Sin Fai Lam CC, Tran BX, Nguyen LH, Ho CS, Tam WW, Ho RC. Prevalence of Burnout in Medical and Surgical Residents: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091479. [PMID: 31027333 PMCID: PMC6539366 DOI: 10.3390/ijerph16091479] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 02/07/2023]
Abstract
The burnout syndrome is characterized by emotional exhaustion, depersonalization, and reduced personal achievement. Uncertainty exists about the prevalence of burnout among medical and surgical residents. Associations between burnout and gender, age, specialty, and geographical location of training are unclear. In this meta-analysis, we aimed to quantitatively summarize the global prevalence rates of burnout among residents, by specialty and its contributing factors. We searched PubMed, PsycINFO, Embase, and Web of Science to identify studies that examined the prevalence of burnout among residents from various specialties and countries. The primary outcome assessed was the aggregate prevalence of burnout among all residents. The random effects model was used to calculate the aggregate prevalence, and heterogeneity was assessed by I2 statistic and Cochran's Q statistic. We also performed meta-regression and subgroup analysis. The aggregate prevalence of burnout was 51.0% (95% CI: 45.0-57.0%, I2 = 97%) in 22,778 residents. Meta-regression found that the mean age (β = 0.34, 95% CI: 0.28-0.40, p < 0.001) and the proportion of males (β = 0.4, 95% CI = 0.10-0.69, p = 0.009) were significant moderators. Subgroup analysis by specialty showed that radiology (77.16%, 95% CI: 5.99-99.45), neurology (71.93%, 95% CI: 65.78-77.39), and general surgery (58.39%, 95% CI: 45.72-70.04) were the top three specialties with the highest prevalence of burnout. In contrast, psychiatry (42.05%, 95% CI: 33.09-51.58), oncology (38.36%, 95% CI: 32.69-44.37), and family medicine (35.97%, 95% CI: 13.89-66.18) had the lowest prevalence of burnout. Subgroup analysis also found that the prevalence of burnout in several Asian countries was 57.18% (95% CI: 45.8-67.85); in several European countries it was 27.72% (95% CI: 17.4-41.11) and in North America it was 51.64% (46.96-56.28). Our findings suggest a high prevalence of burnout among medical and surgical residents. Older and male residents suffered more than their respective counterparts.
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Affiliation(s)
- Zhi Xuan Low
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Keith A Yeo
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Vijay K Sharma
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Gilberto K Leung
- Department of Surgery, The University of Hong Kong, Hong Kong, China.
| | - Roger S McIntyre
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5G 2C4, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada.
- Department of Toxicology and Pharmacology, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Anthony Guerrero
- Department of Psychiatry, John A Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, USA.
| | - Brett Lu
- Department of Psychiatry, John A Burns School of Medicine, University of Hawaii, Honolulu, HI 96813, USA.
| | | | - Bach X Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
- Vietnam Young Physicians' Association, Hanoi 100000, Vietnam.
| | - Long H Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Cyrus S Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119228, Singapore.
| | - Wilson W Tam
- Alice Lee School of Nursing, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Biomedical Institute for Global Health Research and Technology, National University of Singapore, Singapore 119228, Singapore.
- Centre of Excellence in Behavioral Medicine, Nguyen Tat Thanh University (NTTU), Ho Chi Minh City 70000, Vietnam.
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Dhusia AH, Dhaimade PA, Jain AA, Shemna SS, Dubey PN. Prevalence of Occupational Burnout among Resident Doctors Working in Public Sector Hospitals in Mumbai. Indian J Community Med 2019; 44:352-356. [PMID: 31802799 PMCID: PMC6881898 DOI: 10.4103/ijcm.ijcm_78_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction: Burnout syndrome refers to a combination of physical fatigue and emotional exhaustion, which, in turn, affects the working efficiency of a person. In India, factors such as extensive working hours, poor facilities, and physical and emotional abuse of doctors by patients and seniors lead to the high prevalence of occupational burnout among medical practitioners. Materials and Methods: The sample consisted of 300 resident doctors working in public sector hospitals across Mumbai. The “Copenhagen Burnout Inventory” questionnaire was utilized to assess the prevalence of burnout. Questionnaires were made available personally or electronically. Burnout was recorded on three parameters, personal burnout, work-related burnout, and client-related burnout. Results: The average working hours recorded was 88 h/week. About 56.66% (n = 170) showed scores that indicate burnout. About 66.67% of respondents showed personal burnout, 57.14% had work-related burnout, and 16.67 had client-related burnout. Conclusion: The high prevalence of burnout syndrome among resident doctors in public sector hospitals is alarming as it not only takes a toll on the physical and mental health of the medical practitioners but also reduces their working efficiency and motivation. Stress management strategies should be propagated in hospitals to encourage work and personal life balance.
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Affiliation(s)
- Archana Hemant Dhusia
- Department of Oral and Maxillofacial Surgery and Dentistry, HBT Medical College and Dr. R. N. Cooper Hospital, Mumbai, Maharashtra, India
| | - Prita Abhay Dhaimade
- Department of Oral and Maxillofacial Surgery and Dentistry, King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Apurva Ambuj Jain
- Department of Oral and Maxillofacial Surgery and Dentistry, King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Samar Salim Shemna
- Department of Oral and Maxillofacial Surgery and Dentistry, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
| | - Prerana Nirmal Dubey
- Department of Oral and Maxillofacial Surgery and Dentistry, Lokmanya Tilak Municipal General Hospital, Mumbai, Maharashtra, India
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Rodrigues H, Cobucci R, Oliveira A, Cabral JV, Medeiros L, Gurgel K, Souza T, Gonçalves AK. Burnout syndrome among medical residents: A systematic review and meta-analysis. PLoS One 2018; 13:e0206840. [PMID: 30418984 PMCID: PMC6231624 DOI: 10.1371/journal.pone.0206840] [Citation(s) in RCA: 208] [Impact Index Per Article: 34.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Burnout is a psychological syndrome that is very common among medical residents. It consists of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). OBJECTIVE To estimate burnout among different medical residency specialties. METHODS A systematic review with meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of bibliographic databases and grey literature was conducted, from inception to March 2018. The following databases were accessed: Embase, PubMed, Web of Science, Google Scholar and Scopus, and 3,575 studies were found. Methodological quality was evaluated by Agency for Healthcare Research and Quality Methodology Checklist for Cross-Sectional/Prevalence Study. In the final analysis, 26 papers were included. Their references were checked for additional studies, but none were included. RESULTS 4,664 medical residents were included. High DP, EE and low PA proportions were compared. Specialties were distributed into three groups of different levels of burnout prevalence: general surgery, anesthesiology, obstetrics/gynecology and orthopedics (40.8%); internal medicine, plastic surgery and pediatrics (30.0%); and otolaryngology and neurology (15.4%). Overall burnout prevalence found for all specialties was 35.7%. CONCLUSION The prevalence of burnout syndrome was significantly higher among surgical/urgency residencies than in clinical specialties. PROSPERO REGISTRATION CRD42018090270.
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Affiliation(s)
- Hugo Rodrigues
- Health Science Postgraduate Program, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Ricardo Cobucci
- Department of Obstetrics and Gynecology, Potiguar University, Natal, Brazil
| | - Antônio Oliveira
- Department of Pharmacy, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - João Victor Cabral
- Medical student, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Leany Medeiros
- Medical resident at Family Medicine Program, Hospital Santa Marcelina, São Paulo, Brazil
| | - Karen Gurgel
- Medical resident at Obstetrics and Gynecology Program, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Tházio Souza
- Medical resident at Obstetrics and Gynecology Program, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Ana Katherine Gonçalves
- Health Science Postgraduate Program, Universidade Federal do Rio Grande do Norte, Natal, Brazil
- Department of Obstetrics and Gynecology, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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Attenello FJ, Buchanan IA, Wen T, Donoho DA, McCartney S, Cen SY, Khalessi AA, Cohen-Gadol AA, Cheng JS, Mack WJ, Schirmer CM, Swartz KR, Prall JA, Stroink AR, Giannotta SL, Klimo P. Factors associated with burnout among US neurosurgery residents: a nationwide survey. J Neurosurg 2018; 129:1349-1363. [DOI: 10.3171/2017.9.jns17996] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 09/25/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVEExcessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, burnout has garnered much attention in recent years. Using a national survey, the authors formally evaluated burnout among neurosurgery trainees.METHODSAn 86-item questionnaire was disseminated to residents in the American Association of Neurological Surgeons database between June and November 2015. Questions evaluated personal and workplace stressors, mentorship, career satisfaction, and burnout. Burnout was assessed using the previously validated Maslach Burnout Inventory. Factors associated with burnout were determined using univariate and multivariate logistic regression.RESULTSThe response rate with completed surveys was 21% (346/1643). The majority of residents were male (78%), 26–35 years old (92%), in a stable relationship (70%), and without children (73%). Respondents were equally distributed across all residency years. Eighty-one percent of residents were satisfied with their career choice, although 41% had at some point given serious thought to quitting. The overall burnout rate was 67%. In the multivariate analysis, notable factors associated with burnout included inadequate operating room exposure (OR 7.57, p = 0.011), hostile faculty (OR 4.07, p = 0.008), and social stressors outside of work (OR 4.52, p = 0.008). Meaningful mentorship was protective against burnout in the multivariate regression models (OR 0.338, p = 0.031).CONCLUSIONSRates of burnout and career satisfaction are paradoxically high among neurosurgery trainees. While several factors were predictive of burnout, including inadequate operative exposure and social stressors, meaningful mentorship proved to be protective against burnout. The documented negative effects of burnout on patient care and health care economics necessitate further studies for potential solutions to curb its rise.
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Affiliation(s)
- Frank J. Attenello
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Ian A. Buchanan
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Timothy Wen
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Daniel A. Donoho
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Shirley McCartney
- 2Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon
| | - Steven Y. Cen
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | | | - Aaron A. Cohen-Gadol
- 4Goodman Campbell Brain and Spine, Department of Neurosurgery, Indiana University, Indianapolis, Indiana
| | - Joseph S. Cheng
- 5Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - William J. Mack
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | | | - Karin R. Swartz
- 7Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - J. Adair Prall
- 8Department of Neurosurgery, Littleton Adventist Hospital, Littleton, Colorado
| | - Ann R. Stroink
- 9Central Illinois Neuro Health Science, Bloomington, Illinois; and
| | - Steven L. Giannotta
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Paul Klimo
- 10Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee
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17
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Ebrahimi S, Kargar Z. Occupational stress among medical residents in educational hospitals. Ann Occup Environ Med 2018; 30:51. [PMID: 30101032 PMCID: PMC6083531 DOI: 10.1186/s40557-018-0262-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 08/01/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Occupational stress and its related psychological strain is a concern among resident doctors that may affect patient care adversely. Residents face many stresses because of their high job demands in delivery of hospital care. They are often subject to work load and pressure due to direct involvement with patients, prolonged working hours, poor job opportunities and low support. Their multiple educational and clinical roles can also affect their performance and quality of personal or professional life. The aim of this study was to evaluate the occupational stress among residents of various medical specialties.We aimed to explore the reasons of occupational stress in residents' life and determine how we can enhance the stress-coping strategies and create more suitable conditions. METHODS This cross-sectional analytical-descriptive study was conducted on all medical residents with various specialties in Shiraz University of Medical Sciences. Data was collected using Osipow occupational stress questionnaire and analyzed by SPSS software version 17. RESULTS The response rate was 88.8%. The average stress score of all residents was 156.35 out of 250. The highest and lowest average stress scores belonged to gynecology and dermatology specialties, respectively. The highest average score of the stress factors was related to the workload with the score of 35.09 of 50 (moderate to severe stress). The total stress score had a significant relationship with age (P = 0.030) and sex (P = 0.009) as well as lack of time to get the needed healthy meals (P = 0.047), high work hours (P < 0.01), surgical specialties (P < 0.01) and on call shift (P < 0.01). CONCLUSION Since most of the stressors were related to the workload, interventions such workload reduction, education about occupational stress and its management, promoting interpersonal relations and more supportive measures are recommended.
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Affiliation(s)
- Sedigheh Ebrahimi
- Department of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Kargar
- Department of Medical Ethics, Shiraz University of Medical Sciences, Shiraz, Iran
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18
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Abstract
It is estimated that 40% to 75% of obstetricians and gynecologists currently suffer from professional burnout, making the lifetime risk a virtual certainty. Although these statistics make for a dismal view of the profession, if the causes and symptoms can be identified simple steps can be implemented to reverse the threat. With a little care, the enjoyment of practice can be restored and the sense of reward and the value of service can be returned.
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Affiliation(s)
- Roger P Smith
- Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Road, BC-71, Room 337, Boca Raton, FL 33431, USA.
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19
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Winkel AF, Nguyen AT, Morgan HK, Valantsevich D, Woodland MB. Whose Problem Is It? The Priority of Physician Wellness in Residency Training. JOURNAL OF SURGICAL EDUCATION 2017; 74:378-383. [PMID: 27810465 DOI: 10.1016/j.jsurg.2016.10.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/03/2016] [Accepted: 10/09/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Physician wellness is associated with improved outcomes for patients and physicians. Wellness is a priority of the Accreditation Council on Graduate Medical Education, and many residencies have programs in place to improve wellness. This study sought to understand how stakeholders in graduate medical education perceive wellness among other educational priorities and whether these programs are improving the experience and training of residents. METHODS The Council on Resident Education in Obstetrics and Gynecology (OBGYN)/Association of Professors in Gynecology Wellness Task Force created a survey and distributed it electronically to all OBGYN residents and program directors (PDs) in 2015. The survey included demographics, questions about the priority of wellness in the educational programs, experience with wellness programming, and problems with resident wellness (burnout, depression, binge drinking, suicide/suicide attempts, drug use, or eating disorders). Data rated on a Likert scale were analyzed using Kruskal-Wallis and Mann-Whitney U tests. RESULTS Among 248 OBGYN PDs, 149 (60%) completed the survey. Of a total 5274 OBGYN residents nationally, 838 (16%) completed the survey. Most of the residents, 737 (89.4%) reported that they or a colleague experienced some problem with wellness. Many PDs also reported problems with wellness, but 46 (33.9%) reported not being aware of problems in the previous 5 years. When asked to rate the priority of wellness in resident education, <1% (1) PD stated that this was not a priority; however, 85 residents (10%) responded that wellness should not be a priority for residency programs. Resident reports of problems were higher as year in training increased (depression χ2 = 23.6, p ≤ 0.001; burnout χ2 = 14.0, p = 0.003; suicide attempt χ2 = 15.5, p = 0.001; drug use χ2 = 9.09, p = 0.028; and binge drinking χ2 = 10.7, p = 0.013). Compared with community programs, university programs reported slightly fewer problems with wellness (χ2 = 5.4, p = 0.02) and suicide/suicide attempts (χ2 = 13.3, p = 0.001). Most PDs reported having some programming in place, although residents reported lower rates of feeling that these programs addressed wellness. CONCLUSIONS There is a discrepancy between the perspective that residents and PDs have on resident wellness, and its priority within the residency program. PDs may not be aware of the scope of the problem of resident wellness. These problems increase with year of training, and may be more common in community programs. Current wellness programming may not be effective, and a significant minority of residents feels that wellness is beyond the scope of the training program.
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Affiliation(s)
| | - Anh T Nguyen
- Kaiser Permanente Santa Clara, Santa Clara, California
| | - Helen K Morgan
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Darya Valantsevich
- Council on Resident Education in Obstetrics and Gynecology, American College of Obstetricians and Gynecologists, Washington, DC
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20
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Alexandrova-Karamanova A, Todorova I, Montgomery A, Panagopoulou E, Costa P, Baban A, Davas A, Milosevic M, Mijakoski D. Burnout and health behaviors in health professionals from seven European countries. Int Arch Occup Environ Health 2016; 89:1059-75. [PMID: 27251338 DOI: 10.1007/s00420-016-1143-5] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 05/18/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Within an underlying health-impairing process, work stressors exhaust employees' mental and physical resources and lead to exhaustion/burnout and to health problems, with health-impairing behaviors being one of the potential mechanisms, linking burnout to ill health. The study aims to explore the associations between burnout and fast food consumption, exercise, alcohol consumption and painkiller use in a multinational sample of 2623 doctors, nurses and residents from Greece, Portugal, Bulgaria, Romania, Turkey, Croatia and Macedonia, adopting a cross-national approach. METHODS Data are part of the international cross-sectional quantitative ORCAB survey. The measures included the Maslach Burnout Inventory and the Health Behaviors Questionnaire. RESULTS Burnout was significantly positively associated with higher fast food consumption, infrequent exercise, higher alcohol consumption and more frequent painkiller use in the full sample, and these associations remained significant after the inclusion of individual differences factors and country of residence. Cross-national comparisons showed significant differences in burnout and health behaviors, and some differences in the statistical significance and magnitude (but not the direction) of the associations between them. Health professionals from Turkey, Greece and Bulgaria reported the most unfavorable experiences. CONCLUSIONS Burnout and risk health behaviors among health professionals are important both in the context of health professionals' health and well-being and as factors contributing to medical errors and inadequate patient safety. Organizational interventions should incorporate early identification of such behaviors together with programs promoting health and aimed at the reduction of burnout and work-related stress.
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Affiliation(s)
- Anna Alexandrova-Karamanova
- Health Psychology Research Center, PO Box 238, 1113, Sofia, Bulgaria. .,Department of Psychology, Institute for Population and Human Studies, Bulgarian Academy of Sciences, Acad. G. Bonchev Street, bl. 6, fl. 5/6, 1113, Sofia, Bulgaria.
| | - Irina Todorova
- Health Psychology Research Center, PO Box 238, 1113, Sofia, Bulgaria
| | - Anthony Montgomery
- Department of Education and Social Policy, University of Macedonia, 156 Egnatia Street, 540 06, Thessaloniki, Greece
| | - Efharis Panagopoulou
- Medical School, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Patricia Costa
- Business Research Unit - Instituto Universitário de Lisboa, Av. das Forças Armadas, Edificio ISCTE-IUL, 1649-026, Lisbon, Portugal
| | - Adriana Baban
- Department of Psychology, Babes Bolyai University, 37 Republicii Street, 400015, Cluj-Napoca, Romania
| | - Asli Davas
- Department of Public Health, Ege University, Halk Sagligi AD, 35100, Bornova, Izmir, Turkey
| | - Milan Milosevic
- School of Medicine, Andrija Stampar School of Public Health, University of Zagreb, Rockefellerova 4, 10000, Zagreb, Croatia
| | - Dragan Mijakoski
- Institute of Occupational Health of RM, WHO Collaborating Center, II Makedonska Brigada 43, Skopje, Republic of Macedonia
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Winkel AF, Jakalow H, Benton L, Moss H, Mitchell L, Feldman N. Retracted: Exploring resident reflections to understand burnout. CLINICAL TEACHER 2016; 13:168-168. [PMID: 27060687 DOI: 10.1111/tct.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/19/2015] [Indexed: 11/29/2022]
Abstract
Retraction: Winkel, A. F., Jakalow, H., Benton, L., Moss, H., Mitchell, L. and Feldman, N. (2016), Exploring resident reflections to understand burnout. The Clinical Teacher. doi: 10.1111/tct.12513 The above article, published online on 5th April 2016 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal Co-Editors, and John Wiley & Sons Ltd. The retraction has been agreed due to a change in the status of the research project's Institutional Review Board approval, leading to permission to use some of the data in this article being revoked.
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Affiliation(s)
- Abigail Ford Winkel
- Department of Obstetrics and Gynecology, New York University Langone Medical Center, New York, USA
| | - Holli Jakalow
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Laura Benton
- Department of Obstetrics and Gynecology, State University of New York Downstate Medical Center, Brooklyn, New York, USA
| | - Haley Moss
- Department of Obstetrics and Gynecology, New York University Langone Medical Center, New York, USA
| | - Lauren Mitchell
- Department of English, Vanderbilt University, Nashville, Tennessee, USA
| | - Nathalie Feldman
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Vermont Medical Center, Burlington, Vermont, USA
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Professional Burnout Among Plastic Surgery Residents: Can it be Prevented? Outcomes of a National Survey. Ann Plast Surg 2016; 75:2-8. [PMID: 25954838 DOI: 10.1097/sap.0000000000000530] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Plastic surgery residencies require significant investments of time and psychological resources. We herein determine the prevalence of burnout syndrome among plastic surgery residents and identify potentially protective factors. METHODS A national cross-sectional study was conducted among French plastic surgery residents in March 2013. We distributed a validated measure of burnout (Maslach Burnout Inventory) in addition to a general questionnaire collecting sociodemographic and professional information. RESULTS Fifty-two residents (61%) responded; their mean age was 29 years. A total of 25% and 13.5% of residents scored highly on the depersonalization and high-level emotional exhaustion burnout subscales, respectively, and 48.1% indicated perceived low-level personal accomplishment. The occurrence of a weekly ward round by a senior surgeon (reported by 67.3% of respondents) appears to protect against burnout (P = 0.007); regular staff meetings in the unit (75% of respondents) were also protective because they limited depersonalization (P = 0.048) and promoted personal accomplishment (P = 0.031). The number of hours worked/week was not significantly associated with burnout. Despite these data, 69.2% reported satisfaction with their careers. CONCLUSIONS Almost one third of plastic surgery residents exhibited a high degree of burnout; the risks were increased by being in the early years of training, feeling dissatisfied with career plans, and working in units in which senior surgeons did not make weekly ward rounds and in which regular staff meetings, which offer the opportunity to discuss cases or problems with other professionals, were not scheduled. Burnout increases the risk of medical errors and suicide among residents. Therefore, we suggest that screening for burnout is essential.
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Beyond the body: A systematic review of the nonphysical effects of a surgical career. Surgery 2016; 159:650-64. [DOI: 10.1016/j.surg.2015.08.017] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/06/2015] [Accepted: 08/15/2015] [Indexed: 12/21/2022]
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Alosaimi FD, Alghamdi AH, Aladwani BS, Kazim SN, Almufleh AS. Work-related stress and stress-coping strategies in residents and administrative employees working in a tertiary care hospital in KSA. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2015.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Burnout phenomenon in U.S. plastic surgeons: risk factors and impact on quality of life. Plast Reconstr Surg 2015; 135:619-626. [PMID: 25357156 DOI: 10.1097/prs.0000000000000855] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Recent studies by the American College of Surgeons reveal that nearly 40 percent of U.S. surgeons exhibit signs of burnout. The authors endeavored to quantify the incidence of burnout among U.S. plastic surgeons, determine identifiable risk factors, and evaluate its impact on quality of life. METHODS All U.S. residing members of the American Society of Plastic Surgeons were invited to complete an anonymous survey between September of 2010 and August of 2011. The survey contained a validated measure of burnout (Maslach Burnout Inventory) and evaluated surgeon demographics, professional and personal risk factors, career satisfaction, self-perceived medical errors, professional impairment, and family-home conflicts. RESULTS Of the 5942 surgeons invited, 1691 actively practicing U.S. plastic surgeons (28.5 percent) completed the survey. The validated rate of burnout was 29.7 percent. Significant risk factors for burnout included subspecialty, number of hours worked and night calls per week, annual income, practice setting, and academic rank. Approximately one-fourth of plastic surgeons had significantly lower quality-of-life scores than the U.S. population norm, and this risk increases in burned out surgeons. In addition to having lower career satisfaction and more work-home conflicts, plastic surgeons with burnout also had a nearly two-fold increased risk of self-reported medical errors and self-reported impairment. CONCLUSIONS Over one-fourth of plastic surgeons in the United States experience validated burnout, with concomitant attenuated career satisfaction and quality of life. Multivariate analysis identified predisposing factors that may aid in better understanding risk profiles that lead to burnout; therefore, efforts to understand and thereby avoid this burnout phenomenon are warranted.
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Ducarme G, Bricou A, Chanelles O, Sifer C, Poncelet C. Stress Experienced by Obstetrics and Gynecology Residents during Planned Laparoscopy: A Prospective, Multicentric, Observational, Blinded, and Comparative Study. Gynecol Obstet Invest 2015; 80:148-52. [DOI: 10.1159/000376575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 01/26/2015] [Indexed: 11/19/2022]
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Dabiran S, Nabaei B, Ghorbany M, Khajehnasiri F. Self-Reported Assessment of Health Status and Psychological Condition among Hospital Medical Residents in Iran. Health (London) 2015. [DOI: 10.4236/health.2015.77097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kotb AA, Mohamed KAE, Kamel MH, Ismail MAR, Abdulmajeed AA. Comparison of burnout pattern between hospital physicians and family physicians working in Suez Canal University Hospitals. Pan Afr Med J 2014; 18:164. [PMID: 25422682 PMCID: PMC4239452 DOI: 10.11604/pamj.2014.18.164.3355] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 03/20/2014] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The burnout syndrome is characterized by emotional exhaustion, depersonalization, and low personal accomplishment. It is associated with impaired job performance. METHODS This descriptive study examined 171 physicians for the presence of burnout and its related risk factors. The evaluation of burnout was through Maslach Burnout Inventory (MBI). The participant was considered to meet the study criteria for burnout if he or she got a "high" score on at least 2 of the three dimensions of MBI. RESULTS In the current study, the prevalence of burnout in hospital physicians (53.9%) was significantly higher than family physicians (41.94%) with (p=0.001). Participants who work in the internal medicine department scored the highest prevalence (69.64%) followed by Surgeons (56.50%) and Emergency doctors (39.39%). On the other hand, Pediatricians got the lowest prevalence (18.75%). Working in the teaching hospital and being married are strong predictors for occurrence of burnout. CONCLUSION There is a significant difference of burnout between hospital physicians and family physicians among the study subjects. Working in the teaching hospital and being married are strong predictors for occurrence of burnout.
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Affiliation(s)
- Amany Ali Kotb
- Faculty of Medicine- Suez Canal University, Ismailia, Egypt
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Rua C, Body G, Marret H, Ouldamer L. [Prevalence of burnout among obstetrics and gynecology residents]. ACTA ACUST UNITED AC 2014; 44:83-7. [PMID: 24457022 DOI: 10.1016/j.jgyn.2013.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 11/25/2013] [Accepted: 12/04/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Prevalence assessment of burnout among obstetrics and gynecology residents and predisposing factors. PATIENTS AND METHODS Multicentric cross-sectional survey based on a questionnaire sent by email to the residents including demographics data and Maslach Burnout Inventory. RESULTS Mean burnout scores were 19.67±10.19 for emotional exhaustion, 33.94±5.01 for personal accomplishment and 8.72±6.10 for depersonalization, corresponding to a moderate burnout for each category. High scores of burnout were seen on 19.45 % of residents for emotional exhaustion, 33.33 % for depersonalization and 11.11 % for personal accomplishment. 36.11 % of residents showed evidence of high burnout in emotional exhaustion or depersonalization, and 5.55 % in the three dimensions. The number of semesters is correlated with depersonalization (P=0.01). CONCLUSION There is a strong personal accomplishment among obstetrics and gynecology residents; however, burnout and emotional exhaustion remains a reality during obstetrics and gynecology residency.
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Affiliation(s)
- C Rua
- Département de gynécologie, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France.
| | - G Body
- Département de gynécologie, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France
| | - H Marret
- Département de gynécologie, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France
| | - L Ouldamer
- Département de gynécologie, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnelé, 37044 Tours cedex, France
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Martinez de Tejada B, Jastrow N, Poncet A, Le Scouezec I, Irion O, Kayser B. Perceived and measured physical activity and mental stress levels in obstetricians. Eur J Obstet Gynecol Reprod Biol 2013; 171:44-8. [PMID: 23998555 DOI: 10.1016/j.ejogrb.2013.08.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 06/26/2013] [Accepted: 08/08/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Obstetric work generates important subjective and objective mental stress and is perceived as a physically demanding activity by obstetricians. The aim of this study was to quantify physical and mental stress levels in obstetricians at work and during leisure activities to investigate their association with overall physical activity levels and professional experience. STUDY DESIGN 18 obstetricians at the maternity unit of the University of Geneva Hospitals were enrolled in a prospective observational study. Physical activity and stress levels were measured in two different activity sectors (delivery room and outpatient clinic) and outside work. Physical activity was assessed by questionnaire, visual analogue scale (VAS), and accelerometer. Mental stress levels were assessed by validated questionnaires, VAS, measurement of urine catecholamines and salivary cortisol, and night-time heart rate variability indices. RESULTS Daily stress levels were higher at work compared to outside work (all, P = 0.002). Adrenalin (P = 0.002) and dopamine (P = 0.09) levels were elevated after a labour suite shift and a trend was observed for reduced heart rate variability during the night after this shift. The median average daily number of steps was 7132 (range, 5283-8649). Subjects reached a median of 32 min (range, 19-49 min) of moderate or higher intensity (≥ 1952 counts/min) daily physical activity. CONCLUSIONS Contrary to perception, obstetrics work is not physically demanding. It is, however, accompanied by important subjective and objective mental stress that may have a negative impact on health when combined with a lack of regular daily physical activity.
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Affiliation(s)
- Begoña Martinez de Tejada
- Department of Obstetrics and Gynecology, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Shams T, El-Masry R. Job Stress and Burnout among Academic Career Anaesthesiologists at an Egyptian University Hospital. Sultan Qaboos Univ Med J 2013; 13:287-95. [PMID: 23862036 DOI: 10.12816/0003236] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 10/19/2012] [Accepted: 10/27/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES There is compelling evidence that anaesthesiology is a stressful occupation and, when this stressful occupation is associated with an academic career, the burnout level is high. This study aimed to assess the predictors and prevalence of stress and burnout, associated sociodemographic characteristics, and job-related features. METHODS A cross-sectional survey study was carried out at Mansoura University Hospital in Egypt among 98 anaesthesiologists who had academic careers. The English version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) scale and the Workplace Stress Scale of the American Institute of Stress were used to measure job stress and burnout. Data were analysed according to the guidelines for data processing and an analysis of the scales used. RESULTS The participation rate of this study was 73.1%, where 69.4% were encountering job stress, while 62.2% experienced emotional exhaustion, 56.1% depersonalisation, and 58.2% reduced personal capacity. There was a significant positive correlation between job stress and MBI-HSS subscales. Residents and assistant lecturers were the most affected group. The strongest significant single predictor of all burnout dimensions was a lack of job support. CONCLUSION Stress and burnout among academic anaesthesiologists were caused by the lack of job support; this was especially true among residents and assistant lecturers. We can conclude that a well-organised institutional strategy to mitigate the heavy professional demands of academic anaesthesiologists' will relieve their stress and burnout.
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Affiliation(s)
- Tarek Shams
- Departments of Anesthesia & ICU, Mansoura University, Mansoura, Egypt
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McNeeley MF, Perez FA, Chew FS. The emotional wellness of radiology trainees: prevalence and predictors of burnout. Acad Radiol 2013; 20:647-55. [PMID: 23570939 DOI: 10.1016/j.acra.2012.12.018] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Revised: 12/08/2012] [Accepted: 12/08/2012] [Indexed: 11/28/2022]
Abstract
RATIONALE AND OBJECTIVES Burnout is a complex phenomenon characterized by emotional exhaustion, social detachment, and feelings of low personal achievement. In this study, we aim to establish the prevalence of burnout among radiology trainees and to explore the factors influencing its development. MATERIALS AND METHODS Survey data were collected from 266 trainee members of the Association of University Radiologists to assess financial status, attitudes toward money and compensation, and burnout symptomology. Descriptive and inferential statistics were used to analyze these data. RESULTS Most radiology residents reported high levels of personal achievement but routine symptoms of emotional exhaustion and depersonalization. Although increasing levels of household debt were correlated with symptoms of depersonalization and lower reported quality of life, we found that the subjective financial experience was a more reliable indicator of emotional well-being. Specifically, higher subjective self-assessments of financial strain were the best predictors of symptoms of depersonalization (P < .0001), emotional exhaustion (P < .0001), and lower self-reported quality of life (P < .0001). Additionally, residents with recent moonlighting activity reported higher levels of personal achievement (P < .05), lower levels of emotional exhaustion (P < .05), and greater quality of life (P < .05) when compared to non-moonlighters. CONCLUSIONS The unique nature of radiology training could mean that traditional assumptions regarding the development of trainee burnout do not necessarily apply. Finances may be an underappreciated influence on resident burnout, and subjective feelings of financial scarcity could outweigh the impact of objective indebtedness. Further study is needed to ensure that the emotional well-being of radiology trainees is optimally supported.
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Affiliation(s)
- Michael F McNeeley
- Department of Radiology, University of Washington, 1959 Pacific Ave NE, Box 357115, Seattle, WA 98195, USA.
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Aminazadeh N, Farrokhyar F, Naeeni A, Naeeni M, Reid S, Kashfi A, Kahnamoui K. Is Canadian surgical residency training stressful? Can J Surg 2012; 55:S145-51. [PMID: 22854151 DOI: 10.1503/cjs.002911] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Surgical residency has the reputation of being arduous and stressful. We sought to determine the stress levels of surgical residents, the major causes of stress and the coping mechanisms used. METHODS We developed and distributed a survey among surgical residents across Canada. RESULTS A total of 169 participants responded: 97 (57%) male and 72 (43%) female graduates of Canadian (83%) or foreign (17%) medical schools. In all, 87% reported most of the past year of residency as somewhat stressful to extremely stressful, with time pressure (90%) being the most important stressor, followed by number of working hours (83%), residency program (73%), working conditions (70%), caring for patients (63%) and financial situation (55%). Insufficient sleep and frequent call was the component of residency programs that was most commonly rated as highly stressful (31%). Common coping mechanisms included staying optimistic (86%), engaging in enjoyable activities (83%), consulting others (75%) and exercising (69%). Mental or emotional problems during residency were reported more often by women (p = 0.006), who were also more likely than men to seek help (p = 0.026), but men reported greater financial stress (p = 0.036). Foreign graduates reported greater stress related to working conditions (p < 0.001), residency program (p = 0.002), caring for family members (p = 0.006), discrimination (p < 0.001) and personal and family safety (p < 0.001) than Canadian graduates. CONCLUSION Time pressure and working hours were the most common stressors overall, and lack of sleep and call frequency were the most stressful components of the residency program. Female sex and graduating from a non-Canadian medical school increased the likelihood of reporting stress in certain areas of residency.
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Abut YC, Kitapcioglu D, Erkalp K, Toprak N, Boztepe A, Sivrikaya U, Paksoy I, Gur EK, Eren G, Bilen A. Job burnout in 159 anesthesiology trainees. Saudi J Anaesth 2012; 6:46-51. [PMID: 22412777 PMCID: PMC3299115 DOI: 10.4103/1658-354x.93059] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Anesthesiology may be stressful and most anesthesiologists develop mechanisms for coping. However, inexperienced trainee anesthesiologists seem to be vulnerable. We studied stress perception and job burnout in trainee anesthesiologists. Methods: Responses to perceived stress scale (PSS) and Maslach Burnout Inventory (MBI) were evaluated in 159 trainee anesthesiologists. Results: In our results, when perceived stress was increased, emotional exhaustion and depersonalization increased but personal accomplishment decreased, as expected. Perceived stress was very high in the early years of training. There was a negative correlation between age and emotional exhaustion and depersonalization, but positive correlation with personal accomplishment. Female anesthesiologists had higher personal accomplishment, but lower depersonalization points than male anesthesiologists in our study. There was no statistical association between marital status, PSS, and MBI; ≥2 children group had a significant high personal accomplishment but low depersonalization and emotional exhaustion scores. Line regression analysis showed a statistically significant relationship between PSS and emotional exhaustion and between age and depersonalization. Conclusions: Social factors such as gender and number of children affect the work life of our trainees.
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Affiliation(s)
- Yesim Cokay Abut
- Vakif Gureba Education and Training Hospital, Department of Anesthesiology and Reanimation, Istanbul, Turkey
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Pilkington A, Hart J, Bundy C. Training obstetricians and gynaecologists to be emotionally intelligent. J OBSTET GYNAECOL 2011; 32:10-3. [DOI: 10.3109/01443615.2011.623806] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Winkel AF, Hermann N, Graham MJ, Ratan RB. No time to think: making room for reflection in obstetrics and gynecology residency. J Grad Med Educ 2010; 2:610-5. [PMID: 22132287 PMCID: PMC3010949 DOI: 10.4300/jgme-d-10-00019.1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Revised: 05/22/2010] [Accepted: 07/24/2010] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Reflective practice may help physicians identify and connect with what they value and find meaningful in their work. There are many practical obstacles in teaching narrative skills and reflection to residents in surgical subspecialties. We aimed to assess the feasibility of designing and implementing a writing workshop series within an obstetrics and gynecology curriculum. MATERIALS AND METHODS Between 2008 and 2009, a reflective writing workshop series was introduced into the didactic curriculum of an obstetrics and gynecology residency program. The course included reading fiction and creative writing. Workshops focused on topics residents identified. Residents answered a subjective questionnaire and also completed the Maslach Burnout Inventory and Interpersonal Reactivity Index to assess burnout and empathy. RESULTS Six 1-hour reflective writing workshops took place within the dedicated didactic time for residents. Of the 20 residents in the program, 10 junior residents and 8 senior residents evaluated the workshops. Ten residents participated in more than one workshop, an average of 3.6 workshops. Residents felt that the workshops were enjoyable, and some felt that they influenced their experience of residency, but few felt that it affected their work with patients. Trends in Maslach Burnout Inventory and Interpersonal Reactivity Index scores did not show statistical significance. CONCLUSION A practical curriculum for introducing reflective practice to obstetrics and gynecology residents is described. This model may be useful to educators looking to incorporate reflective practice into residency curricula and lead to collaborative work that may assess the impact of this work on the experience of residents and their patients.
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Affiliation(s)
- Abigail F. Winkel
- Corresponding author: Abigail F. Winkel, MD, Columbia University Medical Center, Department of Obstetrics & Gynecology, 622 West 168th Street, PH 16-29, New York, NY 10032, 212.305.2376,
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Wrenn K, Lorenzen B, Jones I, Zhou C, Aronsky D. Factors affecting stress in emergency medicine residents while working in the ED. Am J Emerg Med 2010; 28:897-902. [DOI: 10.1016/j.ajem.2009.05.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Revised: 04/16/2009] [Accepted: 05/11/2009] [Indexed: 10/19/2022] Open
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Primary language and cultural background as factors in resident burnout in medical specialties: a study in a bilingual US city. South Med J 2010; 103:607-15. [PMID: 20531049 DOI: 10.1097/smj.0b013e3181e20cad] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to identify the degree of burnout among resident physicians enrolled in seven postgraduate training programs at Texas Tech University Health Sciences Center (TTUHSC), Paul L. Foster School of Medicine, El Paso, Texas, as it related to residents' age, gender, marital status, number of hours worked per week, primary language, race/ethnicity, and cultural background. METHOD : The Maslach Burnout Inventory Human Service Survey (MBI) was administered to measure the level of burnout according to the prevalence of emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). RESULTS : Eighty-one percent of the residents at TTUHSC participated in the study. Residents raised in the United States or Canada comprised 28% and 35% of the study, and all reported English as their primary language. The EE scale was significant for obstetrics/gynecology (OB/GYN) residents (prevalence odds ratio [POR] = 13.55, P = 0.02) and psychiatry (PSY) residents (POR = 6.50, P = 0.03). Emergency medicine (EM) residents (POR = 23.35, P = 0.002), OB/GYN (POR = 10.89, P = 0.02), and general surgery (GS) (POR = 6.24, P = 0.03) residents had high DP. Internal medicine (IM) residents (primarily Spanish-speaking) reported significantly low EE (POR = 0.22, P = 0.03) and PA (POR = 0.09, P = 0.001) scores. Residents from the United States or Canada who reported English as their primary language and noted their race as white, had high EE (POR = 3.06, P = 0.03; POR = 5.61, P = 0.0001; POR = 2.91, P = 0.004), DP (POR = 3.19, P = 0.02; POR = 8.34, P < or = 0.0001; POR = 4.70, P < or = 0.0001) and PA (POR = 2.61, P = 0.02; POR = 2.35, P = 0.05, POR 0.29, P = 0.3) scores. CONCLUSION Using valid measures, this pilot study identified a statistically significant relationship between burnout and residents' race/ethnicity, primary language, and cultural background. Larger studies with similar focus would be necessary to generalize these findings. At-risk residents in bilingual locations should be provided with cultural awareness workshops, language assistance programs, as well as senior resident and faculty mentors.
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Fontán Atalaya IM, Dueñas Díez JL. [Burnout syndrome in an obstetrics and gynaecology management unit]. ACTA ACUST UNITED AC 2010; 25:260-7. [PMID: 20621532 DOI: 10.1016/j.cali.2010.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Revised: 01/15/2010] [Accepted: 05/02/2010] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the prevalence of the Burnout Syndrome among the members of an Obstetrics and Gynaecology Unit. MATERIAL AND METHODS Cross-sectional study using an anonymous questionnaire and socio-Spanish version of the Maslach Burnout Inventory. RESULTS The survey was answered by 21 doctors, 11 matrons, 14 DUE, 22 nurses, 2 administrative officers and 1 watchman, with a response rate of 43.2%. Average values were 20.1 points for the emotional exhaustion, depersonalization 7.6 points to 42.1 points and for personal fulfilment. We found higher values of emotional exhaustion and depersonalization in the group of doctors in relation to other professional groups. CONCLUSION We believe that 33.8% is an alarmingly high level of emotional exhaustion in the members of the present study, and this level is even higher in medical specialists (52.3%). Only the 2.8% of the professionals had high values in the three sub-scales.
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Affiliation(s)
- I M Fontán Atalaya
- Unidad Clínica de Gestión de Obstetricia y Ginecología, Hospital Universitario Virgen Macarena, Sevilla, España.
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[Residents, duties and burnout syndrome]. Rev Clin Esp 2010; 210:209-15. [PMID: 20381031 DOI: 10.1016/j.rce.2009.12.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2009] [Revised: 12/13/2009] [Accepted: 12/19/2009] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To investigate the degree of burnout among resident physicians of a university hospital and the factors associated with it. MATERIALS AND METHODS Maslach burnout Inventory (MBI) was sent to all residents, which assesses emotional exhaustion, depersonalization and personal accomplishment. Burnout exists when high degree of emotional exhaustion or depersonalization are obtained. Several variables were analyzed (age, sex, nationality, year of residency, speciality, total monthly calls and in emergency departments, days since last call, duty-free day after calls, position at calls). It's relationship with the score on the different dimensions of MBI and burnout was analyzed through the test of the chi-square, whereas the association between scores of MBI and the number of calls were analyzed using linear regression. RESULTS 132 of 290 residents answered (45.5%): 40.2% had a high emotional exhaustion and a 64.4% presented depersonalization. In total, 69.7% of the residents had burnout. There was no statistically association between the epidemiological variables and the different dimensions of the MBI. The total number of calls per month were significantly associated with emotional exhaustion (p<0.05). There wasn't any relation to the number of calls in emergency departments. Resident physicians who had 5 or more calls per month showed burnout more often than the rest (76.6% versus 60.0%, p<0.05). A trend towards a higher burnout was present among residents of Internal medicine and medical specialities than the rest (75.6% versus 60.0%, p=0.05). CONCLUSIONS The prevalence of burnout among the group of residents is high and relates mainly to the monthly number of calls.
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Ghetti C, Chang J, Gosman G. Burnout, psychological skills, and empathy: balint training in obstetrics and gynecology residents. J Grad Med Educ 2009; 1:231-5. [PMID: 21975984 PMCID: PMC2931236 DOI: 10.4300/jgme-d-09-00049.1] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To assess burnout, behavioral-medicine skills, and empathy among obstetrics and gynecology residents before and after implementation of Balint training. METHODS This was a prospective educational study. Balint training was introduced into the obstetrics and gynecology residency curriculum in July 2005. All 36 residents were approached for this study. The Psychological Medicine Inventory, the Maslach Burnout Inventory, and the Jefferson Scale of Physician Empathy were administered prior to initiating training and at 12 months. Baseline and 12-month scores were compared by Wilcoxon signed rank test. RESULTS Seventeen residents completed baseline and 12-month questionnaires: 6 were postgraduate year (PGY) 1, 3 were PGY-2, 6 were PGY-3, and 2 were PGY-4. At baseline, 70% of participating residents reported high burnout scores. Burnout and empathy remained unchanged at 12 months. Psychological medicine skills improved at 12 months. CONCLUSIONS This study showed that obstetrics and gynecology residents are at high risk for burnout. Interest and confidence in handling psychological aspects of patient care improved at 12 months after the introduction of Balint training.
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Affiliation(s)
- Chiara Ghetti
- Corresponding author: Chiara Ghetti, MD, Division of Urogynecology, Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, 412.641.1441,
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IsHak WW, Lederer S, Mandili C, Nikravesh R, Seligman L, Vasa M, Ogunyemi D, Bernstein CA. Burnout during residency training: a literature review. J Grad Med Educ 2009; 1:236-42. [PMID: 21975985 PMCID: PMC2931238 DOI: 10.4300/jgme-d-09-00054.1] [Citation(s) in RCA: 339] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Burnout is a state of mental and physical exhaustion related to work or care giving activities. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. This article reviews the relevant literature on burnout in order to provide information to educators about its prevalence, features, impact, and potential interventions. METHODS Studies were identified through a Medline and PsychInfo search from 1974 to 2009. Fifty-one studies were identified. Definition and description of burnout and measurement methods are presented followed by a thorough review of the studies. RESULTS An examination of the burnout literature reveals that it is prevalent in medical students (28%-45%), residents (27%-75%, depending on specialty), as well as practicing physicians. Psychological distress and physical symptoms can impact work performance and patient safety. Distress during medical school can lead to burnout, which in turn can result in negative consequences as a working physician. Burnout also poses significant challenges during early training years in residency. Time demands, lack of control, work planning, work organization, inherently difficult job situations, and interpersonal relationships, are considered factors contributing to residents' burnout. Potential interventions include workplace-driven and individual-driven measures. Workplace interventions include education about burnout, workload modifications, increasing the diversity of work duties, stress management training, mentoring, emotional intelligence training, and wellness workshops. Individual-driven behavioral, social, and physical activities include promoting interpersonal professional relations, meditation, counseling, and exercise. CONCLUSIONS Educators need to develop an active awareness of burnout and ought to consider incorporating relevant instruction and interventions during the process of training resident physicians.
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Affiliation(s)
- Waguih William IsHak
- Corresponding author: Waguih William IsHak, MD, Cedars-Sinai Medical Center, Department of Psychiatry, 8730 Alden Drive, Thalians W-157, Los Angeles, CA 90048, 310.423.3515,
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Demirci S, Yildirim YK, Ozsaran Z, Uslu R, Yalman D, Aras AB. Evaluation of burnout syndrome in oncology employees. Med Oncol 2009; 27:968-74. [DOI: 10.1007/s12032-009-9318-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 04/19/2009] [Indexed: 11/29/2022]
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Abstract
OBJECTIVES The Accreditation Council for Graduate Medical Education (ACGME) mandates that residency Program Directors (PD) monitor resident well-being, including stress. Burnout, as a measure of work-related stress, is defined by a high degree of emotional exhaustion and depersonalization, and a low degree of personal accomplishment using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). The purpose of this study is to describe the use of the MBI-HSS as a method of monitoring stress levels in an academic otolaryngology residency training program and introduce this survey as a tool for wider use in meeting ACGME requirements. METHODS The MBI-HSS was administered to residents in an academic otolaryngology residency training program on three separate occasions: at the beginning, middle, and end of different academic years. In addition, at the time of the third administration, the MBI-HSS was completed by faculty and staff in the same department. Surveys were completed and collected anonymously. Responses were scored against normative data from the MBI-HSS overall sample and the medicine subscale. Low, average, and high levels of burnout were identified for the individual categories of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA); average levels for each category were calculated. RESULTS Twenty-two residents completed the first survey, taken near the end of an academic year; 19 completed the second administration in the middle of the following academic year; and 24 completed the third survey at the beginning of the subsequent academic year. Thirteen faculty and 23 staff also completed the third survey. We found that three, one, and one residents reported high levels of burnout on the first, second, and third surveys, respectively. These figures compare to one faculty member and no staff members in the same department reporting high levels of burnout. CONCLUSIONS The MBI-HSS is an established and validated tool for identifying burnout in resident physicians. Residency PDs may find the MBI-HSS useful as an aid in monitoring resident well-being and stress. In our own department, we found levels of burnout comparable to those previously reported for residents and faculty in this specialty.
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Affiliation(s)
- Justin D Hill
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa 52242-1078, USA
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Eckleberry-Hunt J, Lick D, Boura J, Hunt R, Balasubramaniam M, Mulhem E, Fisher C. An exploratory study of resident burnout and wellness. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2009; 84:269-77. [PMID: 19174684 DOI: 10.1097/acm.0b013e3181938a45] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE Physicians have a higher rate of burnout compared with the general population, and burnout's origin can be traced to residency training. Little evidence exists documenting the causes of burnout, and there is even less evidence on protective factors. The goal of this exploratory study was to determine which resident-identified stressors are associated with the presence of burnout and which resident-identified wellness factors are associated with the absence of burnout. METHOD In the fall of 2006, residents from 13 specialties completed a demographics questionnaire, a survey of factors that promote burnout and wellness, and the Maslach Burnout Inventory. RESULTS From a pool of 395 residents, 150 (38%) completed the questionnaires. Of 32 burnout factors, 27 were significantly associated with at least one burnout scale. Pessimism was the only burnout factor associated with all three burnout scales; 11 other burnout factors were associated with at least two burnout scales. Of 29 wellness factors, 25 were significantly associated with at least one burnout scale, indicating a lack of burnout. Use of prescription medications was the only wellness factor associated with all three burnout scales, indicating low burnout. Thirteen other wellness factors were associated with at least two of the scales. CONCLUSIONS Significantly more research is needed to further define and measure wellness. Program directors should consider multiple burnout and wellness factors associated with burnout (or its absence) when designing treatment interventions. The aim should be to identify and bolster wellness factors that protect from burnout while minimizing the stressors that cause it.
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Affiliation(s)
- Jodie Eckleberry-Hunt
- Behavioral Medicine, William Beaumont Hospital Family Medicine Residency Program, Sterling Heights, Michigan, USA.
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Gulalp B, Karcioglu O, Sari A, Koseoglu Z. Burnout: need help? J Occup Med Toxicol 2008; 3:32. [PMID: 19061497 PMCID: PMC2621227 DOI: 10.1186/1745-6673-3-32] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2008] [Accepted: 12/05/2008] [Indexed: 11/19/2022] Open
Abstract
Background Burnout syndrome is a psychological situation induced with working, especially in high-risk parts of the hospitals that affects the physical and mental conditions of the staff. The aim is to identify the characteristics of the staff related to Burnout Syndrome in the Emergency Department (ED). Methods The study includes the Maslach Burnout Inventory and other new individual research questions. The responders were the volunteers and comprised physicians, nurses, nurses' aides from EDs of all urban state hospitals of Adana (43.3%). Burnout scores were analyzed with regard to individual characteristics; supplementary work, marital status, the number of children, occupation, salary, career satisfaction, satisfaction in private life. Mann-Whitney U test and Kruskall-Wallis test were performed using SPSS 15.00. Results There were no relation between Burnout scores and supplementary work, marital status, number of children, occupation, salary, private life satisfaction, except for career satisfaction. Conclusion Presence and severity of Burnout syndrome were linked to career satisfaction without personal features and salaries. All branches of healthcare occupations in ED seem to have been affected by Burnout Syndrome similarly.
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Affiliation(s)
- Betul Gulalp
- Department of Emergency Medicine, School Of Medicine, Baskent University, Adana, Turkey.
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Chia ACL, Irwin MG, Lee PWH, Lee THW, Man SF. Comparison of Stress in Anaesthetic Trainees between Hong Kong and Victoria, Australia. Anaesth Intensive Care 2008; 36:855-62. [DOI: 10.1177/0310057x0803600617] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A postal survey was sent to anaesthetic trainees in Hong Kong and Victoria, Australia to compare work-related stress levels. Demographic data were collected. Anaesthetist-specific stressors, Maslach Burnout Inventory and Global Job Satisfaction scores were used for psychological testing. The response rates from Hong Kong and Melbourne were 64 of 133 (48.1%) and 108 of 196 (55.1%), respectively. Victorian respondents were older with greater family commitments, but more advanced in fulfilling training requirements. Hong Kong respondents, being faced with both the challenge of dual College requirements, exhibited consistently higher indices of stress (P <0.001) and less job satisfaction (P <0.001). Common occupational stressors related to dealing with critically ill patients and medicolegal concerns. Higher stress scores observed in Hong Kong trainees related to service provision and a perceived lack of resources. Despite the complex nature of stress, its antecedents and manifestations, an inverse relationship between emotional exhaustion and job satisfaction was evident in correlation analysis (P <0.001). This survey suggests that stress was present in some trainees in both areas. Hong Kong trainees may benefit from local development to address mental wellbeing as being important to fulfil this highly competitive training program.
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Affiliation(s)
- A. C. L. Chia
- , Department of Anaesthesia and Pain Management, Royal Melbourne Hospital
| | - M. G. Irwin
- Department of Anaesthesiology, Queen Mary Hospital, University of Hong Kong
| | - P. W. H. Lee
- Department of Psychiatry, Queen Mary Hospital, University of Hong Kong
| | - T. H. W. Lee
- Department of Anaesthesia, St Vincent's Hospital
| | - S. F. Man
- Department of Anaesthesiology, Queen Mary Hospital, University of Hong Kong
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Residents’ perceptions of the ideal clinical teacher—A qualitative study. Eur J Obstet Gynecol Reprod Biol 2008; 140:152-7. [DOI: 10.1016/j.ejogrb.2008.03.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2007] [Revised: 01/31/2008] [Accepted: 03/23/2008] [Indexed: 11/22/2022]
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Fontán Atalaya IM, Dueñas Díez JL. Síndrome de burnout en los ginecólogos del Hospital Universitario Virgen Macarena de Sevilla. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s0304-5013(08)72327-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Enhancing our practice environment in order to support a long, fulfilling, and productive career. Obstet Gynecol 2008; 112:7-9. [PMID: 18591300 DOI: 10.1097/aog.0b013e31817f219b] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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