Physician Burnout: Resilience Training is Only Part of the Solution

Card, Alan J.

doi:10.1370/afm.2223

Cited by 89 publications

(93 citation statements)

References 33 publications

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“…Medical students are exposed to a number of organisational-level stressors, some of which are relatively embedded in medical training and may be difficult to modify in the short term, while others constitute preventable systems-level failures, such as the fostering of a competitive culture that rewards overwork and environments permissive of intimidation and bullying 43. Strategies that address these organisational stressors should therefore be prominent in any intervention aimed at reducing suicidal ideation and behaviour, and mental ill health more generally in this population 44.…”

Section: Conclusion and Clinical Implicationsmentioning

confidence: 99%

Effectiveness of universal programmes for the prevention of suicidal ideation, behaviour and mental ill health in medical students: a systematic review and meta-analysis

Witt

Boland

Lamblin

et al. 2019

Evid Based Mental Health

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QuestionA growing body of work suggests that medical students may be particularly at risk of mental ill health, suicidal ideation and behaviour, resulting in recent calls to develop interventions to prevent these outcomes. However, few reviews have synthesised the current evidence base regarding the effectiveness of these interventions and provided guidance to improve future intervention efforts.Study selection and analysisThe authors conducted a systematic review to identify studies of any design reporting the effectiveness of any universal intervention to address these outcomes in medical students. Embase, MEDLINE and PsycINFO databases were searched from their respective start dates until 1 December 2017.FindingsData from 39 studies were included. Most investigated the effectiveness of relatively brief interventions designed to reduce stress; most commonly using mindfulness-based or guided meditation approaches. Only one implemented an intervention specifically designed to address suicidal ideation; none investigated the effectiveness of an intervention specifically designed to address suicidal behaviour. Five investigated the effects of curriculum-level changes. Overall, there was limited evidence of an effect for these programmes at both the postintervention and longest follow-up assessment on depression, anxiety and stress.ConclusionsRelatively brief, individually focused, mindfulness-based interventions may be effective in reducing levels of anxiety, depression and stress in medical students in the short term. Effects on suicidal ideation and behaviour, however, remain to be determined. There has been a significant lack of attention on organisational-level stressors associated with medical education and training.

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Section: Conclusion and Clinical Implicationsmentioning

confidence: 99%

Effectiveness of universal programmes for the prevention of suicidal ideation, behaviour and mental ill health in medical students: a systematic review and meta-analysis

Witt

Boland

Lamblin

et al. 2019

Evid Based Mental Health

View full text Add to dashboard Cite

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“…A kiégésre hajlamosító személyiségtényezők közül a nemzetközi vizsgálatok kiemelik a neuroticizmust, a szorongást és a perfekcionizmust [34][35][36]. Ugyanakkor a vizsgálatok tanúsága szerint a reziliencia a kiégés egyik kulcsmotívuma: a megelőzés és az intervenció mind szervezeti, mind pedig egyéni szinten kiemelt fontosságú [37,38].…”

Section: A Reziliencia Alakulása a Vizsgált Mintábanunclassified

Kiégés és reziliencia (rugalmas ellenállás) a magyarországi orvosok körében

Győrffy

2019

Orvosi Hetilap

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Introduction: The burnout of healthcare workers is of outstanding significance in both national and international studies. Aim: Based on a representative, national physician survey (n = 5013), the aim of this study was to describe burnout indicators and the correspondence between them and working conditions. Moreover, we were aiming to compare the results with our 2013 physician survey and to analyze the potential relationship between burnout and resilience. Method: We analyzed the results of the online quantitative survey with multiple variables descriptively. The connection between the respective dimensions of burnout and resilience was studied with logistic regression. Results: In comparison with data from 2013, the medium and high level proportions of depersonalization and personal accomplishment were similar (49% versus 49.9% and 65.1% versus 68.9%). Since 2013 (49%), we experienced a decrease in depersonalization (40.2%). Those working in in-patient care, at multiple workplaces and shift hours regularly have a higher chance of burnout. Our multivariable analysis has shown that the lack of resilience is an important predictor for the medium and high levels of emotional exhaustion, depersonalization and personal accomplishment. Conclusion: Our results have shown that internal resources, coping strategies and resilience play a key role in burnout and its decrease. Orv Hetil. 2018; 160(3): 112–119.

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“…Card, in his criticism of resilience training, explains: ‘First, by giving the illusion of a simple solution, it may pre‐empt the hard work required to address systems failures. And second, it may send the message to affected doctors that they are the problem’ …”

Section: Taking the Wider Viewmentioning

confidence: 99%