Burnout in Canadian urology: Cohort analysis from the 2018 Canadian Urological Association census

Kidney stone disease Practice patterns among urologists in Canada

INTRODUCTION

Despite kidney stone disease (KSD) guidelines, high-quality evidence for KSD management in Canada is lacking. We aimed to assess Canadian urologists' practice patterns, preferences, and barriers in managing KSD.

METHODS

A cross-sectional survey was distributed to Canadian urologists via the Canadian Urological Association (CUA), Quebec Urological Association (QUA), and Canadian Endourology Group (CEG), as well as directly to urology departments nationwide. Descriptive statistics were used to analyze the results.

RESULTS

Of 93 respondents, 47% were from academic centers, 43% from community hospitals, and 10% from mixed/private settings. Most performed over 75 ureteroscopies and fewer than 25 percutaneous nephrolithotomies (PCNLs) annually (67% and 58%, respectively). Holmium:YAG (Ho:YAG) lasers were available in 85% of hospitals, thulium fiber laser (TFL) in 70%, and Ho:YAG with Moses effect lasers in 28%. Preferred surgical devices included the TFL (74.5%), followed by the Ho:YAG laser (24.2%) and Ho:YAG with Moses effect laser (21.7%). Endourology fellowship-trained urologists (53%) were more likely to perform their own PCNL access (90% vs. 23%, p<0.001), metabolic workup (73% vs. 48%, p=0.02), and felt more comfortable prescribing prophylactic and medical treatment for KSD (86% vs. 50%, p<0.01) compared to non-endourology fellowship-trained colleagues. Metabolic workup was delegated to nephrologists or specialized clinics by 38%, mainly due to lack of time (25%) and expertise (25%). Additionally, 71% lacked access to multidisciplinary KSD clinics, with 76% believing such clinics would be beneficial.

CONCLUSIONS

The study highlights variability in KSD management practices and barriers. Addressing these issues could improve KSD care in Canada and inform future guidelines.

Trends in Surgeon Burnout in the US and Canada: Systematic Review and Meta-Regression Analysis

BACKGROUND

Burnout among surgeons is increasingly recognized as a crisis. However, little is known about changes in burnout prevalence over time. We evaluated temporal trends in burnout among surgeons and surgical trainees of all specialties in the US and Canada.

STUDY DESIGN

We systematically reviewed MEDLINE, Embase, and PsycINFO for studies assessing surgeon burnout from January 1981 through September 2021. Changes in dichotomized Maslach Burnout Inventory scores and mean subscale scores over time were assessed using multivariable random-effects meta-regression.

RESULTS

Of 3,575 studies screened, 103 studies representing 63,587 individuals met inclusion criteria. Publication dates ranged from 1996 through 2021. Overall, 41% of surgeons met criteria for burnout. Trainees were more affected than attending surgeons (46% vs 36%, p = 0.012). Prevalence remained stable over the study period (-4.8% per decade, 95% CI -13.2% to 3.5%). Mean scores for emotional exhaustion declined and depersonalization declined over time (-4.1 per decade, 95% CI -7.4 to -0.8 and -1.4 per decade, 95% CI -3.0 to -0.2). Personal accomplishment scores remained unchanged. A high degree of heterogeneity was noted in all analyses despite adjustment for training status, specialty, practice setting, and study quality.

CONCLUSIONS

Contrary to popular perceptions, we found no evidence of rising surgeon burnout in published literature. Rather, emotional exhaustion and depersonalization may be decreasing. Nonetheless, burnout levels remain unacceptably high, indicating a need for meaningful interventions across training levels and specialties. Future research should be deliberately designed to support longitudinal integration through prospective meta-regression to facilitate monitoring of trends in surgeon burnout.

An organizational approach to improve staff resiliency and wellness during the COVID-19 pandemic

Healthcare worker burnout is a well-established phenomenon known to affect an individual's mental state, and has been shown to be diminished amongst individuals with higher levels of resilience. From a leadership perspective, practices that drive and inspire others to demonstrate resilience and surpass their own expectations fosters a resilient culture and allows employees to view adversity as an opportunity while knowing that support is omnipresent. In this paper, we describe and evaluate the outcomes of a virtual organizational intervention during the COVID-19 pandemic aimed to reduce healthcare staff burnout, and improve their levels of resilience, well-being, and self-compassion. Participants reported the workshops were relevant and provided strategies for wellness that were easy to incorporate into their daily routine. By nurturing one's own personal well-being through resiliency strategies learned in this educational series, staff can enact strategies to care for themselves, which in turn can contribute to organizational wide healthy work environments, improved health system outcomes, and enhanced patient care.

Burnout among surgeons and surgical trainees: A systematic review and meta-analysis of the prevalence and associated factors

Introduction

The more effort is put into work, the greater the chances of burnout. This is common among surgical personnel. We carried out this review study to determine the overall and per-specialty prevalence of burnout, and to identify the factors that affect burnout positively and negatively.

Methods

All full-text articles reporting data related to burnout in surgery and surgical subspecialties using the Maslach Burnout Inventory (MBI) were included. The following bibliographic databases were searched PubMed, Embase and Google Scholar (First 500 pages). We extracted data on the characteristics of the articles including the burnout prevalence and factors.

Results

27 articles met the criteria. The studies involved 8617 surgeons cutting acrossvarious surgical specialties. The overall prevalence was 47%. The rate per specialty ranged between 15% and 77% with Ear, Nose and Throat (ENT) surgeons having the highest rates. Associated factors included work-related issues and poor work/life balance while protective factors included career advancement, increase in postgraduate years, and having good relationships with co-residents. Our findings are similar to findings from other studies; ENT is seen to have the highest burnout rate while pediatric surgery the lowest.

Conclusion

The high prevalence of burnout among surgeons is concerning and the identified factors responsible should be explored by surgeons, hospital management boards, training colleges, and all bodies concerned to see how it can be reduced.