A Longitudinal Study Exploring Learning Environment Culture and Subsequent Risk of Burnout Among Resident Physicians Overall and by Gender

Dyrbye, Liselotte N.; West, Colin P.; Herrin, Jeph; Dovidio, John F.; Cunningham, Brooke A.; Yeazel, Mark W.; Lam, Veronica; Onyeador, Ivuoma N.; Wittlin, Natalie M.; Burke, Sara E.; Hayes, Sharonne N.; Phelan, Seán; Ryn, Michelle van

doi:10.1016/j.mayocp.2020.12.036

Cited by 12 publications

(20 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 12 , 20 , 45 , 46 , 47 Notably, in a prior study of surgical residents, female residents were more likely to have burnout, but this difference resolved after adjusting for mistreatment. 20 However, in a longitudinal multispecialty cohort of US resident physicians, 47 female residents were more likely to develop burnout and have worsening in the severity of their emotional exhaustion between the second and third year of training compared with male residents, even after controlling for various forms of mistreatment. Others have called for additional epidemiological research to better define risk factors for burnout among groups of learners, with special attention to sex and marginalized groups.…”

Section: Discussionmentioning

confidence: 96%

“…Other longitudinal studies exploring the prevalence of burnout by sex among medical students and residents have reported conflicting findings. 12,20,[45][46][47] Notably, in a prior study of surgical residents, female residents were more likely to have burnout, but this difference resolved after adjusting for mistreatment. 20 However, in a longitudinal multispecialty cohort of US resident physicians, 47 female residents were more likely to develop burnout and have worsening in the severity of their emotional exhaustion between the second and third year of training compared with male residents, even after controlling for various forms of mistreatment.…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Association of Characteristics of the Learning Environment and US Medical Student Burnout, Empathy, and Career Regret

2021

Self Cite

View full text Add to dashboard Cite

Key Points Question Is perceived mistreatment during medical school associated with burnout, empathy, and career regret at graduation? Findings In this cohort study of 14 126 medical students, mistreatment by the beginning of year 2 was associated with severity of burnout and career regret toward the end of medical school, whereas positive experiences within the learning environment by the beginning of year 2 of medical school were associated with lower burnout, higher empathy, and less career regret during year 4. Meaning These data imply that modifiable factors in the learning environment may contribute to burnout, empathetic orientation, and career satisfaction of medical students.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

Association of Characteristics of the Learning Environment and US Medical Student Burnout, Empathy, and Career Regret

2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…42 Third, while this study included an array of individual, interpersonal, program, and work-related factors of potential relevance to residents’ social support and social isolation scores, other unmeasured factors could contribute to resident perceptions. For example, personality traits, 100–102 emotional intelligence, 103,104 coping styles, 105 communication skills, 106 and/or exposure to contextual stressors (e.g., unfair treatment, negative interpersonal experiences, sexism/racism) 43,107,108 could affect residents’ ability to develop social connections and/or increase their vulnerability to burnout. Fourth, we did not measure the quality of marriage or partner relationships or examine other potential sources of support (e.g., family of origin, friends, allied health staff, fellow residents, online networks).…”

Section: Discussionmentioning

confidence: 99%

“…Examples include treating residents with respect, inclusion, and helpfulness (rather than disrespect, dismissal, or bias); getting to know residents as individuals; and promoting resident autonomy through careful titration of supervision and support. 1,2,4,43,75–78…”

Section: Discussionmentioning

confidence: 99%

Social Support, Social Isolation, and Burnout: Cross-Sectional Study of U.S. Residents Exploring Associations With Individual, Interpersonal, Program, and Work-Related Factors

et al. 2022

Self Cite

View full text Add to dashboard Cite

Purpose To examine associations of social support and social isolation with burnout, program satisfaction, and organization satisfaction among a large population of U.S. residents and fellows and to identify correlates of social support and social isolation. Method All residents and fellows enrolled in graduate medical education programs at Mayo Clinic sites were surveyed in February 2019. Survey items measured social support (emotional and tangible), social isolation, burnout, program satisfaction, and organization satisfaction. Factors of potential relevance to social support were collected (via the survey, institutional administrative records, and interviews with program coordinators and/or program directors) and categorized as individual, interpersonal, program, or work-related factors (duty hours, call burden, elective time, vacation days used before survey administration, required away rotations, etc.). Multivariable regression analyses were conducted to examine relationships between variables. Results Of 1,146 residents surveyed, 762 (66%) from 58 programs responded. In adjusted models, higher emotional and tangible support were associated with lower odds of burnout and higher odds of program and organization satisfaction, while higher social isolation scores were associated with higher odds of burnout and lower odds of program satisfaction and organization satisfaction. Independent predictors of social support and/or social isolation included age, gender, relationship status, parental status, postgraduate year, site, ratings of the program leadership team, ratings of faculty relationships and faculty professional behaviors, satisfaction with autonomy, and vacation days used before survey administration. Conclusions This study demonstrates that social support and social isolation are strongly related to burnout and satisfaction among residents and fellows. Personal and professional relationships, satisfaction with autonomy, and vacation days are independently associated with social support and/or social isolation, whereas most program and work-related factors are not. Additional studies are needed to determine if social support interventions targeting these factors can improve well-being and enhance satisfaction with training.

show abstract

“…These ideas have been explored in a number of recent cross-sectional studies by Dyrbye et al looking at resident perceptions of faculty professional behavior and relationships with trainees, program leadership qualities, level of trainee autonomy, and the relationship to burnout ( 12 , 13 ). At least one longitudinal study found that burnout in the third year of residency was higher among women residents compared to men, with women reporting higher levels of negative interpersonal experiences and unfair treatment in prior years ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Burnout in Pediatric Nephrology Fellows and Faculty: Lessons From the Sustainable Pediatric Nephrology Workforce Project (SUPERPOWER)

et al. 2022

View full text Add to dashboard Cite

Physician well-being is an important contributor to both job satisfaction and patient outcomes. Rates of burnout among physicians vary by specialty, ranging from 35 to 70%. Among pediatric residents, longitudinal data demonstrates consistent rates of burnout around 50-60%, although little is known about burnout among pediatric subspecialty fellows. Specifically, the degree of burnout among pediatric nephrologists remains unknown, as does the impact faculty burnout may have on trainee burnout. We sought to evaluate prevalence and predictors of burnout among US pediatric nephrology fellows and faculty, and assess for interactions between groups. In this multi-center pilot survey of all United States pediatric nephrology training programs from February to April 2020, burnout was assessed through abbreviated Maslach Burnout Inventory and predictors were explored through survey items devoted to demographic, personal characteristics, and job and career satisfaction questions. A total of 30/34 available fellows and 86/102 faculty from 11 institutions completed the survey (overall response rate 85%). The prevalence of burnout was 13% among fellows and 16% among faculty. Demographic (age, gender, year of training, faculty rank, marital status) and program factors (fellowship size, faculty size, current block/rotation, vacation or weekend off timing) were not significantly associated with burnout. Faculty and fellows with burnout reported significantly lower quality of life (5.3 vs. 7.9, p < 0.05), higher perceived stress (2.4 vs. 1.4, p < 0.05) and lower satisfaction with career choice (66 vs. 22%) and work life balance (28 vs. 0%), compared to those without burnout (p < 0.05 for all). Other important factors positively associated with burnout included lower institutional support for wellness programs and lower satisfaction with both colleague and faculty support. Larger studies are needed to explore if burnout is truly less prevalent among pediatric nephrology fellows and faculty compared to pediatric residents and graduate physicians. A larger sample size is also necessary to determine whether any interactions exist between the faculty and trainee roles in the developments of burnout. Future studies should also explore how to promote well-being through addressing key factors such as overall learning/working environment, stress reduction, and building personal resilience.

show abstract

A Longitudinal Study Exploring Learning Environment Culture and Subsequent Risk of Burnout Among Resident Physicians Overall and by Gender

Cited by 12 publications

References 47 publications

Association of Characteristics of the Learning Environment and US Medical Student Burnout, Empathy, and Career Regret

Association of Characteristics of the Learning Environment and US Medical Student Burnout, Empathy, and Career Regret

Social Support, Social Isolation, and Burnout: Cross-Sectional Study of U.S. Residents Exploring Associations With Individual, Interpersonal, Program, and Work-Related Factors

Burnout in Pediatric Nephrology Fellows and Faculty: Lessons From the Sustainable Pediatric Nephrology Workforce Project (SUPERPOWER)

Contact Info

Product

Resources

About