Multifaceted Longitudinal Study of Surgical Resident Education, Quality of Life, and Patient Care Before and After July 2011

Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review

“…Most studies were from the United States (n ¼ 16), and 1 study each was from Canada, 7 Belgium, 8 and Israel. 9 Internal medicine residents were the subject 4 studies 3,12,13,18 ; 1 study of orthopedic residents 10 ; 2 studies of pediatrics residents 19,20 ; 1 study of family medicine residents 21 ; 1 study of obstetrics and gynecology residents 22 ; 3 studies of surgical specialty residents 11,14,15 ; 2 studies of oncology residents 8,9 ; and 5 studies enrolled residents from a combination of residency programs. 7,16,17,23,24 The studies included enrolled 2030 residents, and examined the effect of 12 different strategies on resident burnout (TABLE 1).…”

“…Of the 14 observational studies that were assessed using the NOS (provided as online supplemental material), 2 were rated high quality, 12,13 and 7 were rated as being of moderate quality. 3,9,14,15,17,21,24 Of the 5 RCTs that were assessed using the Jadad scale (TABLE 1), 3 were rated high quality 8,18,19 (score ! 3), and the remaining 2 were rated to be of moderate quality.…”

“…9 We pooled data from the 9 studies that examined the effect of work hour limits on burnout rates using random effects meta-analysis that accounted for between-study heterogeneity. 7,[10][11][12][13][14][15][16][17] The studies reported data in different forms; when studies reported data on the number (or percentage) of residents with high levels of burnout, we pooled their odds ratios (ORs), and when studies reported mean burnout scores, we pooled their mean differences. Six of the 9 studies reported data on all or some components of the Maslach Burnout Inventory (MBI; Mind Garden, Menlo Park, CA), and data were pooled within those components.…”

“…7 Seven studies reported on emotional exhaustion and depersonalization, 7,10-14,17 6 on personal accomplishment, 7,10-14 and 2 on overall burnout. 15,16 Several studies reported on more than 1 dimension of the MBI. Improvement in emotional exhaustion was reported in 4 studies, [12][13][14]21 improvement in depersonalization was reported in 1 study, 19 and improvements in personal achievement was reported in 1 study.…”

Exploring the relative importance of work-organizational burnout risk factors in Belgian residents

“…Working-time restriction is mainly investigated in US residents. In most studies, burnout scores decreased significantly with reduced working-time [21–23]. Literature is inconclusive whether this decrease is a consequence of weekly working-time restrictions or a restriction in shift length.…”