A cross-sectional study of burnout and its associations with learning environment and learner factors among psychiatry residents within a National Psychiatry Residency Programme

Abstract

BackgroundMultiple studies have reported high burnout rates among residents, including psychiatry. There is a paucity of studies examining the relationship between burnout and learning context, stress levels, resilience, stigma in healthcare providers and coping methods concurrently within the same cohort.ObjectiveWe examined the rate of burnout among our psychiatry residents in a cross-sectional study and hypothesised that burnout is associated with poorer perception of learning environment, greater perceived stress, stigma levels, lower resilience and specific coping strategies during training.MethodsNinety-three out of 104 psychiatry residents (89.4%) within our National Psychiatry Residency Programme participated in the study from June 2016 to June 2018. Relevant scales were administered to assess the perception of learning environment, burnout, stress, resilience, stigma levels and coping methods, respectively. We performed comparisons of the above measures between groups (burnout vs no burnout) and within-group correlations for these same measures.ResultsOverall, 54.8% of the sample met criteria for burnout. Residents with burnout had poorer perception of the learning environment, greater stress levels (both p<0.001), were less willing to disclose/seek help and employed greater active-avoidance coping strategies. Within the burnout group, greater perceived stress was correlated with poorer perception of learning environment (rs=−0.549) and greater use of active-avoidance coping (rs=0.450) versus additional use of problem-focussed coping within the non-burnout group.ConclusionsBurnout was related to both environment and learner factors. These findings viewed within the transactional, sequential and imbalance models of burnout suggest the need to address stressors, beef up coping, provide continual support and develop resilience among our learners.

Wellness Review 2019, Part 2

“…Residents with burnout had greater stress levels and worse perception of the learning environment (p < 0.001) [7]. Consistent with anticipated personal effects of shame, the burnout group was less willing to disclose or seek help, employing greater active-avoidance coping mechanisms [7]. This avoidance of help and introversion in the setting of burnout could be more troublesome than previously described-a positive culture and learning environment can mitigate these concerns.…”

“…The importance of workplace culture is also addressed in a cross-sectional study of burnout and its associations with the learning environment of 93 psychiatry residents-55% of whom met Oldenburg Burnout Inventory burnout criteria [7]. Residents with burnout had greater stress levels and worse perception of the learning environment (p < 0.001) [7].…”

“…The importance of workplace culture is also addressed in a cross-sectional study of burnout and its associations with the learning environment of 93 psychiatry residents-55% of whom met Oldenburg Burnout Inventory burnout criteria [7]. Residents with burnout had greater stress levels and worse perception of the learning environment (p < 0.001) [7]. Consistent with anticipated personal effects of shame, the burnout group was less willing to disclose or seek help, employing greater active-avoidance coping mechanisms [7].…”

Psychological wellbeing among psychiatry residents: dealing with stigma starts from our home

“…Studies have shown that the failure of the system contributed to 80% of burnout factors (Moffic, 2019). Furthermore, in a cross-sectional study in Singapore, burnout had also been associated with higher stigma in residents' help-seeking behaviour and was related to environment and learner factors including stigma, resilience, and coping mechanism (Chew et al, 2019).…”

The Effect of the Educational Environment on the rate of Burnout among Postgraduate Medical Trainees – A Narrative Literature Review

“…32 Trainees in the first 5 years after graduation are at a greater risk of burnout if they possess the aforementioned characteristics. 33 Patient factors that can also lead to burnout among doctors. Examples would include patients and relatives with unrealistic expectations, deterioration in the patient's health and aggressive patients.…”