Exploring the relationship between burnout and grit during general surgery residency: A longitudinal, single-institution analysis

Cortez, Alexander R.; Winer, Leah K.; Kassam, Al‐Faraaz; Hanseman, Dennis J.; Kuethe, Joshua W.; Sussman, Jeffrey J.; Quillin, Ralph C.

doi:10.1016/j.amjsurg.2019.09.041

Cited by 37 publications

(36 citation statements)

References 28 publications

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“…Burnout was assessed using the Maslach Burnout Inventory Human Services Survey, which gauges the frequency one feels specific emotions to determine levels of EE, DP, and PA. A 7‐point Likert scale is used, ranging from 0 (never) to 6 (every day), and the subscale scores are converted to ordinal categories of low, moderate, or high. For the purposes of our study, “burnout” criteria were determined by having 2 of the following 3 based on previously published work: high EE (≥27), high DP (≥13), or low PA (≤31) 1,16,17 …”

Section: Methodsmentioning

confidence: 99%

“…Burnout, characterized by the constellation of emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA), has been extensively studied in recent years in the surgical literature 1,2 . A common theme that emerges among surgeons is the association of burnout with increased workload accompanied by reduced autonomy 3‐5 .…”

Section: Introductionmentioning

confidence: 99%

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Extinguishing burnout: National analysis of predictors and effects of burnout in abdominal transplant surgery fellows

Kassam

Cortez

Winer

et al. 2021

American Journal of Transplantation

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Burnout among surgeons has been attributed to increased workload and decreased autonomy. Although prior studies have examined burnout among transplant surgeons, no studies have evaluated burnout in abdominal transplant surgery fellows. The objective of our study was to identify predictors of burnout and understand its impact on personal and patient care during fellowship. A survey was sent to all abdominal transplant surgery fellows in an American Society of Transplant Surgeons–accredited fellowship. The response rate was 59.2% (n = 77) and 22.7% (n = 17) of fellows met criteria for burnout. Fellows with lower grit scores were more likely to exhibit burnout compared with fellows with higher scores (3.6 vs 4.0, P = .026). Those with burnout were more likely to work >100 hours per week (58.8% vs 27.6%, P = .023), have severe work‐related stress (58.8% vs 22.4%, P = .010), consider quitting fellowship (94.1% vs 20.7%, P < .001), or make a medical error (35.3% vs 5.2%, P = .003). This national analysis of abdominal transplant fellows found that burnout rates are relatively low, but few fellows engage in self‐care. Personal and program‐related factors attribute to burnout and it has unacceptable effects on patient care. Transplant societies and fellowship programs should develop interventions to give fellows tools to prevent and combat burnout.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Extinguishing burnout: National analysis of predictors and effects of burnout in abdominal transplant surgery fellows

Kassam

Cortez

Winer

et al. 2021

American Journal of Transplantation

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“…In general surgery, the earlier years of training are associated with greater emotional exhaustion and feelings of depersonalization. 49 Golub et al 4 described a trend of increased self-efficacy and reduction of stressors such as excessive call, lack of sleep, and excessive work hours from the second to the fifth year of otolaryngology residency. PGY-4 residents in our study had consistently better measures of wellness compared to their colleagues.…”

Section: Discussionmentioning

confidence: 99%

Otolaryngology Resident Wellness, Training, and Education in the Early Phase of the COVID-19 Pandemic

Chou

Staltari

Mullen

et al. 2021

Ann Otol Rhinol Laryngol

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Objective: To determine changes in the residency experience early in the COVID-19 pandemic and evaluate wellness measures among otolaryngology residents. Methods: A web-based survey was administered to U.S. otolaryngology residents. Responses to the Shirom-Melamed Burnout Measure (SMBM) and the Generalized Anxiety Disorder-7 scale were recorded along with data on burnout, demographics, wellness, sleep, training, and education. Results: 119 U.S. otolaryngology residents representing 27 of 42 states with otolaryngology residency programs responded to the survey. 24.4% (95% CI 17.0-31.8%) self-reported some level of burnout, while 10.9% met SMBM criteria for “clinically relevant” burnout. 51.3% experienced more stress, and 58.8% reported more anxiety during the COVID-19 pandemic. Compared to males, females had a higher prevalence of burnout (38.9% vs 12.3%, P = .001) and anxiety (75.9% vs 43.8%, P < .001). PGY-2s had a greater mean SMBM index (3.64) and higher rates of self-reported burnout (54.2%) than their counterparts at other levels of training. Residents reported less time spent in the hospital, lower surgical volume, and less procedural independence. Educational didactics, primarily via videoconference, were more frequent for 63.9% of respondents. Conclusion: While burnout among otolaryngology residents was low early in the COVID-19 pandemic, likely due to separation from the workplace environment, trainees had higher levels of anxiety and stress. The surgical experience was negatively impacted by the pandemic, but remote didactics and educational opportunities increased. These findings may inform otolaryngology residency programs on the need to promote resident wellness and aid in devising strategies to improve the educational experience during this unique global health crisis as well as in the long term.

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“…For example, some have referred to this trait as "grit" -the previously undesignated characteristic that makes an individual both less likely to experience burnout and better equipped at managing demands of graduate medical training. It is specifically defined as perseverance and passion for long term goals; clearly a valuable quality in GME trainees across all specialties [84]. Higher levels of "grit" have been shown to result in decreased feelings of burnout, depersonalization and emotional exhaustion.…”

Section: Coping Intelligence In the Context Of Resiliencymentioning

confidence: 99%

Facing Adversity during Graduate Medical Training: The Concept of ‘Coping Intelligence’

Taylor¹,

Kelley²,

Firstenberg³

et al. 2022

Contemporary Topics in Graduate Medical Education - Volume 2

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Effective coping strategies are of great importance for trainees actively navigating the challenges and stresses of graduate medical education (GME). Although there is increasing emphasis on the concept of emotional intelligence (EI) in medical curricula, the range of behavioral skills learned in typical EI training may not be sufficient when dealing with extreme stress – something that healthcare students in general, and GME trainees as a subset, continue to struggle with. Under the conditions of extreme stress, multiple competing priorities and high cognitive load, even those with excellent command of EI skills may not be able to universally maintain sufficient emotional control. This, in turn, exposes a significant opportunity for further understanding and development in this dynamically evolving area of investigation. Increasing amount of research suggests that a unique skill set exists, known as ‘coping intelligence’ (CI), that may help fill the gap under the conditions of extreme stress and significantly elevated cognitive load. This chapter will discuss CI as a unique and novel concept, further exploring the possibility of introducing this new construct into the realm of GME.

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Exploring the relationship between burnout and grit during general surgery residency: A longitudinal, single-institution analysis

Cited by 37 publications

References 28 publications

Extinguishing burnout: National analysis of predictors and effects of burnout in abdominal transplant surgery fellows

Extinguishing burnout: National analysis of predictors and effects of burnout in abdominal transplant surgery fellows

Otolaryngology Resident Wellness, Training, and Education in the Early Phase of the COVID-19 Pandemic

Facing Adversity during Graduate Medical Training: The Concept of ‘Coping Intelligence’

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