International study of medical school learning environments and their relationship with student well-being and empathy

Tackett, Sean; Wright, Scott M.; Lubin, Robert; Li, Jianing; Pan, Hui

doi:10.1111/medu.13120

Cited by 59 publications

(76 citation statements)

References 62 publications

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“…Burnout does not discriminate based on gender or culture, and presents veritable dangers to medical students. Following the initial findings of Tackett et al . this commentary thus serves to continue the investigation into the effect of medical school learning environments on quality of life, burnout and empathy.…”

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confidence: 88%

“…This is coupled with the ever‐present stressors of examinations, rapidly amassing medical knowledge, competition for employment, debt and social sacrifices. It appears that a student's perception of their learning environment drives these stressors – a concept captured in this issue by Tackett et al . in an international survey of students across three diverse medical schools.…”

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confidence: 98%

“…Suboptimal learning environments significantly contribute to student distress and a decline in empathy . However, the same literature that has shed light on the brewing burnout epidemic within medical schools has been unable to pinpoint what needs to be done to develop and support resilience in health care providers …”

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confidence: 99%

“…without ‘boundaries’) can perpetuate personal distress, further decreasing empathetic concern . Unfortunately, developing favourable perceptions of one's learning environment was found to have, at best, a modest influence on empathy …”

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confidence: 99%

“…The findings of Tackett et al . highlight both the influence of positive learning environments on quality of life and the elusiveness of ameliorating empathy.…”

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confidence: 99%

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Standing in quicksand: the triad of ‘perspective-empathy-resiliency’ in medical education

Perrella¹

2017

Med Educ

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mentioning

confidence: 88%

mentioning

confidence: 98%

mentioning

confidence: 99%

mentioning

confidence: 99%

“…The findings of Tackett et al . highlight both the influence of positive learning environments on quality of life and the elusiveness of ameliorating empathy.…”

mentioning

confidence: 99%

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Standing in quicksand: the triad of ‘perspective-empathy-resiliency’ in medical education

Perrella¹

2017

Med Educ

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Hypothesis: the hospital learning environment impedes students’ acquisition of reflectivity and medical professionalism

Benbassat

2018

Adv in Health Sci Educ

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Undergraduate clinical education follows the "bedside" tradition that exposes students to inpatients. However, the hospital learning environment has two main limitations. First, most inpatients require acute care, and students may complete their training without seeing patients with frequent non-emergent and chronic diseases that are managed in outpatient settings. Second, students rarely cope with diagnostic problems, because most inpatients are diagnosed in the community or the emergency room. These limitations have led some medical schools to offer longitudinal integrated clerkships in community settings instead of hospital block clerkship rotations. In this paper, I propose the hypothesis that the hospital learning environment has a third limitation: it causes students' distress and delays their development of reflectivity and medical professionalism. This hypothesis is supported by evidence that (a) the clinical learning environment, rather than students' personality traits, is the major driver of students' distress, and (b) the development of attributes, such as moral reasoning, empathy, emotional intelligence and tolerance of uncertainty that are included in the definitions of both reflectivity and medical professionalism, is arrested during undergraduate medical training. Future research may test the proposed hypothesis by comparing students' development of these attributes during clerkships in hospital wards with that during longitudinal clerkships in community settings.

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Residents’ Perceptions of Faculty Behaviors and Resident Burnout: a Cross-Sectional Survey Study Across a Large Health Care Organization

et al. 2021

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BACKGROUND: Data suggests the learning environment factors influence resident well-being. The authors conducted an assessment of how residents' perceptions of faculty-resident relationships, faculty professional behaviors, and afforded autonomy related to resident burnout. METHODS: All residents at one organization were surveyed in 2019 using two items from the Maslach Burnout Inventory and the faculty relationship subscale of the Johns Hopkins Learning Environment Scale (JHLES, range 6 to 30). Residents were also asked about faculty professional behaviors (range 0 to 30), and satisfaction with autonomy across various clinical settings. RESULTS: A total of 762/1146 (66.5%) residents responded to the survey. After adjusting for age, gender, postgraduate year, and specialty, lower (less favorable) JHLES-faculty relationship subscale score (parameter estimate, − 3.08, 95% CI − 3.75, − 2.41, p < 0.0001), fewer observed faculty professional behaviors (parameter estimate, − 3.34, 95% CI − 4.02, − 2.67, p < 0.0001), and lower odds of satisfaction with autonomy in the intensive care settings (OR 0.46, 95% CI 0.30, 0.70, p = 0.001), but not other care settings, were reported by residents with burnout in comparison to those without. Similar relationships were observed when emotional exhaustion and depersonalization were analyzed separately as continuous variables. CONCLUSION: In this cohort, resident perceptions of faculty relationships, faculty professional behaviors, and satisfaction with autonomy in the intensive care unit were associated with resident burnout. Additional longitudinal studies are needed to elucidate the direction of these relationships and determine if faculty development can reduce resident burnout.

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International study of medical school learning environments and their relationship with student well-being and empathy

Cited by 59 publications

References 62 publications

Standing in quicksand: the triad of ‘perspective-empathy-resiliency’ in medical education

Standing in quicksand: the triad of ‘perspective-empathy-resiliency’ in medical education

Hypothesis: the hospital learning environment impedes students’ acquisition of reflectivity and medical professionalism

Residents’ Perceptions of Faculty Behaviors and Resident Burnout: a Cross-Sectional Survey Study Across a Large Health Care Organization

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