The Relationship between Burnout and Sense of School Belonging among the Resident Physicians in the Standardization Training in China

BACKGROUND

As an important part in medical training in graduate school, 33-month medical residency training could be a stressful period inducing burnout (i.e. emotional exhaustion, depersonalization, and low personal accomplishment). Despite that existing literature has found that sense of belonging may have merits for residents' well-being, it has remained unclear how sense of school belonging affects burnout and the potential moderators. To address this question, a cross-sectional survey has been conducted among the residents of the physicians standardized residency training program in China.

METHODS

Seven hundred (N = 700) resident physicians from different majors (i.e. clinical medicine, clinical Stomatology, and Chinese medicine) and grades have participated in the survey. Resident's sense of school belonging was assessed with the psychological sense of school membership scale (PSSM, mean = 45.12, SD = 11.14). Burnout was measured by the 22-item Maslach Burnout Inventory (MBI-HSS, mean = 65.80, SD = 15.89), including three subscales of emotional exhaustion, depersonalization, and personal accomplishment.

RESULTS

The results showed that over 80% of the residents reported moderate or high level of emotional exhaustion and reduced personal accomplishment during residency training. Meanwhile, higher level of sense of school belonging was associated with lower overall burnout (B = -0.722, p < 0.001), less emotional exhaustion, reduced depersonalization, and higher personal accomplishment. In particular, the benefits of sense of belonging seem more pronounced among female and those at earlier stage of residency. No interaction effect was found between sense of belonging and major, while those from Chinese medicine reported lower scores in overall burnout and the three dimensions.

CONCLUSIONS

Burnout was a prevalent issue among the resident physicians, and our findings confirmed the protective effects of sense of school belonging against burnout. Therefore, support service should be developed to cultivate resident's sense of school belonging and social connections, particularly for female and those at earlier stage of residency.

From classroom to life: Gender differences in the persistent effect of learning disabilities on adult depressive symptoms

Despite the well-established link between adolescent learning disabilities (LD) and mental health, little is known about its long-term consequences. This study examines the relationship between adolescent LD and adult depressive symptoms, with a focus on gender differences and underlying mechanisms. Using a sibling sample from the National Longitudinal Study of Adolescent to Adult Health (N = 3,414), this study estimated sibling fixed effects models to account for unobserved family-level characteristics such as genes and early childhood family and social context. Sobel mediation analyses were conducted to examine social-psychological mechanisms, including the student-teacher relationship, the student-student relationship, and a sense of school belonging. LD in adolescence was positively associated with depressive symptoms in adulthood (b = 0.823, p < 0.05). This association remained robust when controlling for unobserved family-level confounders as well as educational attainment in adulthood. Gender-stratified models showed that only the association for women is statistically significant (b = 1.935, p < 0.05), and its magnitude is nearly three times that of the association for men. Sobel mediation tests indicate that a decline in a sense of school belonging mediates approximately 17% of the association between adolescent LD and adult depressive symptoms. This study's findings suggest that LD in adolescence is associated with an increase in depressive symptoms in adulthood, particularly in women, and a low sense of school belonging may be a potential mediator. Implementing interventions to improve the school integration of girls with LD could be an effective means of improving their long-term mental health.

The relationship between school burnout, sense of school belonging and academic achievement in preclinical medical students

The purpose of the study was to evaluate the relationship between school burnout, sense of school belonging, and academic achievement in medical students. This cross-sectional study was performed with students at the Ondokuz Mayıs University Medical Faculty (Samsun, Turkey) between 1 and 31 May 2019. Six hundred one (71.0%) first, second, and third-year students were included in the study. A questionnaire was employed as the data collection method. The questionnaire consisted of two parts. The first part consisted of questions investigating sociodemographic information produced by the authors by scanning the literature. The second part consisted of the School Burnout Inventory and the Psychological Sense of School Membership Scale. The relationship between the sense of school belonging, school burnout, and academic achievement was evaluated using structural equation modeling. The structural equation modeling analysis determined that school burnout played a mediating role in the relationship between the sense of school belonging and academic achievement in preclinical medical students. As the sense of belonging to the school increases in preclinical medical students, academic achievement increases. School burnout in preclinical medical students increases as a sense of school belonging decreases. Academic achievement among preclinical medical students decreases as school burnout levels increase. Increasing the sense of school belonging can be effective in preventing school burnout and increasing academic achievement.

The relations between students' sense of school belonging, perceptions of school kindness and character strength of kindness

This study explored the associations between secondary school students' sense of school belonging, their perceptions of school kindness, and character strength of kindness, and examined possible differences in these constructs across gender groups. The study, which included 1973 Hong Kong secondary school students, revealed that students' sense of school belonging was positively correlated with their perceptions of school kindness at the school and student levels (0.021 and 0.185, respectively). Furthermore, students' sense of school belonging was positively linked to character strength of kindness at the student level, although this relationship was found to be non-significant at the school level. At both levels of analysis, the positive relationships between students' perceptions of school kindness and character strength of kindness were significant. In addition, girls reported higher levels of character strength of kindness than boys. The findings of this study provide a better understanding of the relationships between sense of school belonging, school kindness, and character strength of kindness. Implications for research are also discussed.