A longitudinal and multicentre study of burnout and error in Irish junior doctors

O’Connor, Paul; Lydon, Sinéad; O’Dea, Angela; Hehir, Layla; Offiah, Gozie; Vellinga, Akke; Byrne, Dara

doi:10.1136/postgradmedj-2016-134626

Cited by 36 publications

(22 citation statements)

References 24 publications

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“…In the interviews, these factors were also identified as common contributors (in the YCFF they are classified as 'individual staff' and were identified in 57% of the interviews). In a previous study it was found that around 70% of Irish junior doctors were burned out, 6 and in another study with the same population approximately half of the respondents were determined to be experiencing psychological distress. 5 Although a diary study of Irish interns appeared to indicate that interns were obtaining sufficient hours of sleep, it was common for them to work longer than their shift, with the medical intern on nightshift reporting particularly high levels of workload.…”

Section: Discussionmentioning

confidence: 93%

“…The medical error survey was an adjunct survey completed as part of a larger study of burnout and error among Irish interns. 6 The medical error survey was only completed by those interns who reported making an error that 'played on your mind in the last 3 months'.…”

Section: Survey Developmentmentioning

confidence: 99%

“…4 These doctors have been found to struggle with knowledge transfer, dealing with uncertainty, understanding their role and working as a member of the medical team. 4 5 Although experience with error is common among junior doctors, 6 data on how junior doctors, view, and respond to error is limited. 7 It has been argued that junior doctors have a unique perspective on the delivery of healthcare, and possess a set of attributes that means they have valuable insights for how to improve patient safety.…”

Section: Introductionmentioning

confidence: 99%

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A mixed-methods examination of the nature and frequency of medical error among junior doctors

O’Connor

Lydon

Mongan

et al. 2019

Postgraduate Medical Journal

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Purpose of the studyTo examine junior doctors’ experience and perceptions of medical errors in which they had been involved.Study designA mixed-methods design, consisting of an error survey and critical incident technique (CIT) interviews, was used. The survey asked doctors in the first year of postgraduate training in Ireland whether they had made a medical error that had ‘played on (their) mind’, and if so, to identify factors that had contributed to the error. The participants in the CIT interviews were asked to describe a medical error in which they had been involved.ResultsA total of 201 out of 332 (60.5%) respondents to the survey reported making an error that ‘played on their mind’. 'Individual factors’ were the most commonly identified group of factors (188/201; 93.5%), with ‘high workload’ (145/201; 72.1%) the most commonly identified contributory factor. Of the 28 CIT interviews which met the criteria for analysis, ‘situational factors’ (team, staff, task characteristics, and service user factors) were the most commonly identified group of contributory factors (24/28; 85.7%). A total of eight of the interviews were judged by subject matter experts (n=8) to be of medium risk to patients, and 20 to be of high-risk to patients. A significantly larger proportion of high-risk scenarios were attributed to ‘local working conditions’ than the medium-risk scenarios.ConclusionsThere is a need to prepare junior doctors to manage, and cope with, medical error and to ensure that healthcare professionals are adequately supported throughout their careers.

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Section: Discussionmentioning

confidence: 93%

Section: Survey Developmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A mixed-methods examination of the nature and frequency of medical error among junior doctors

O’Connor

Lydon

Mongan

et al. 2019

Postgraduate Medical Journal

Self Cite

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“…The experiences of junior doctors vary greatly depending on the settings within which they are placed [7,8]. The quality of training and supervision trainees receive during their first year of practice varies between medical teams and hospitals, and likely contributes to the high level of stress and burnout in junior doctors in the Republic of Ireland [9,10], and internationally [11,12]. It is also important to acknowledge that junior doctors do not all necessarily acquire the requisite skills to care for patients at the same pace [13].…”

Section: Introductionmentioning

confidence: 99%

The development of a framework of entrustable professional activities for the intern year in Ireland

et al. 2020

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Background: Entrustable Professional Activities (EPAs) are units of professional practice that capture essential competencies in which trainees must become proficient before undertaking them independently. EPAs provide supervisors with a solid justification for delegating an activity to trainees. This study aimed to develop and ensure face validity of a set of EPAs for junior doctors in the first year of clinical practice in the Republic of Ireland. Methods: An iterative eight stage consensus building process was used to develop the set of EPAs. This process was based on international best practice recommendations for EPA development. A series of surveys and workshops with stakeholders was used to develop a framework of EPAs and associated competencies. An external stakeholder consultation survey was then conducted by the Irish Medical Council. The framework of EPAs was then benchmarked against the 13 core EPAs developed by the Association of American Medical Colleges (AAMC). Results: A framework of seven EPAs, and associated competencies resulted from this study. These EPAs address all core activities that junior doctors should be readily entrusted with at the end of the intern year, which is the first year of clinical practice in the Republic of Ireland. Each EPA contains a series of defined competencies. The final EPAs were found to be comparable to the AAMC core EPAs for entering residency. Conclusions: A framework of EPAs for interns in Ireland that are appropriate for the intern year has been developed by key stakeholders. The implementation of the EPAs in practice is the next step, and is likely to result in an improved intern training process and increased patient safety.

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“…Stress, burnout and impairment are substantial mental problems of doctors that have attracted increasing attention in recent years [2,3] . Burnout is an important factor affecting the QOL of young doctors and college students [4,5] . Anxiety, depression and other mental problems are also commonly reported in doctors [6] .…”

Section: Introductionmentioning

confidence: 99%

Assessing Mental Health and Physical Fitness in Young Chinese Doctors Using the Short-Form 36 Health Survey (SF-36)

Wang

Liu

Yang

et al. 2020

Preprint

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Background Psychological and physical problems regarding the quality of life (QOL) of doctors have attracted increasing attention in recent years, especially in China. The objective of this study was to measure the mental health and physical fitness of young clinical doctors with the SF-36 and to evaluate related psychometric properties and factors.Subjects and methods Young doctors from Guizhou Provincial People’s Hospital completed the SF-36 between November 1, 2017, and February 28, 2018. The Physical Component Summary (PCS) and Mental Component Summary (MCS) were measured to represent physical and mental health conditions.Results A total of 444 doctors aged 20–40 years, with 138 (31.08%) surgeons, 110 (24.77%) physicians, 26 (5.86%) pediatricians, 28 (6.31%) obstetricians/gynecologists and 142 (31.98%) doctors from other departments were enrolled in this study, and their data were analyzed. The mean PCS scores (71.30 ± 16.54 vs. 77.54 ± 15.96, p < 0.0001) and MCS scores (63.72 ± 18.91 vs. 71.29 ± 17.86, p < 0.0001) were significantly lower than the normative values of Chinese respondents. Pediatricians and obstetricians/gynecologists reported the lowest PCS and MCS scores. Young doctors with master’s degrees and above (OR = 1.68, 95%CI: 1.03–2.75, p < 0.05), those who were unmarried (OR = 2.40, 95%CI: 1.40–4.08, p < 0.01), and those who had low family incomes (OR = 2.45, 95%CI: 1.00-6.01, p < 0.05) had increased odds of poor MCS scores.Conclusions Poor mental and physical health were common in young doctors in China. Pediatricians and obstetricians/gynecologists had the poorest physical and mental health status. Having a high education level, being unmarried and having a low family income were negatively associated with mental health.

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A longitudinal and multicentre study of burnout and error in Irish junior doctors

Abstract: Current levels of burnout are unsustainable and place the health of both junior doctors and their patients at risk.

Cited by 36 publications

References 24 publications

A mixed-methods examination of the nature and frequency of medical error among junior doctors

A mixed-methods examination of the nature and frequency of medical error among junior doctors

The development of a framework of entrustable professional activities for the intern year in Ireland

Assessing Mental Health and Physical Fitness in Young Chinese Doctors Using the Short-Form 36 Health Survey (SF-36)

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