Work Environment Evaluation Instrument (WEEI): development, validation, and association with burnout

Abstract

Introduction: Physician burnout is considered an epidemic. In 2019, 44% of U.S. physicians reported feeling burned out. The work environment is a central risk factor for this. The aim of this study is to develop and test an instrument to evaluate work environment factors in medical training courses. Method: After focus groups, an initial pool of 14 items was generated and tested in a pilot study (n = 66). Face validity was verified, and small adjustments were made. The resulting version was administered to a sample of 115 psychiatry residents. Eleven items were selected based on the correlations between them, principal component analysis, and theoretical reasons, and then tested for internal and construct validity. Results: The final version had high reliability (Cronbach's alpha = 0.898) and comprised three dimensions: relations with the institution; with colleagues; and with preceptors. Both total scores and dimensions correlated significantly with burnout scores (p < 0.01). Cutoffs defining the environment as healthy (>32 points); risky (23-31 points); or toxic (<22 points) were suggested and related to the risk of burnout. Conclusion: Several authors have emphasized the importance of approaching institutional factors as an effective strategy for coping with the increased prevalence of burnout. This instrument should contribute to these efforts.

Factor Structure, Reliability and Validity of the Institutional Culture Assessment Scale (ICAS)

“…The items evaluated have been proven to be related to burnout symptoms in previous studies with medical residents as well in this national sample of medical studies and physicians. 16,19 As the aspects evaluated are related to leadership style (e.g. fostering collaboration, emphatic listening and attitudes towards employees), and to the perception of the institution (e.g., collaborative climate, shared values), the ICAS is expected to be associated with employee mental health in populations other than health professionals and should be tested in different settings.…”

“…Both total scores and dimensions correlated significantly with Burnout scores (p<0.01). 16 For the current study the items were adapted to be suitable for all phases of medical career and tested in a national sample of physicians and medical students with the aim of developing the ICAS.…”

“…With the intention of identifying these aspects Carneiro Monteiro et al 16 developed the Work Environment Evaluation Instrument (WEEI), to evaluate the work environment in medical training settings. The WEEI was developed and tested in a specific population, i.e., residents in training.…”

Workplace Environment Microaggressions in Otolaryngology–Head and Neck Surgery: An International Survey

“…Our adapted questionnaire aligned with theoretical constructs that have been validated and published specifically regarding perceptions of work environment, burnout, and a sense of inclusion and belonging. [40][41][42] The survey included 10 demographic and 4 general questions investigating the following outcomes: age, biological sex, disability, gender identity, language proficiency, military experience, citizenship, ethnicity/race, political belief, sexual orientation, and socioeconomic status (Supplemental Appendix S1, available online). For the 4 questions dedicated to personal or observed experiences, participants were invited to rate each item with a 6-point scale ranging from "I observed this one daily" to "I have not witnessed an experience like this at my institution" (Supplemental Appendix S1, available online).…”

“…The survey also asked questions about their general experience in the work environment. Our adapted questionnaire aligned with theoretical constructs that have been validated and published specifically regarding perceptions of work environment, burnout, and a sense of inclusion and belonging 40‐42 …”