Relationship of Grit and Resilience to Burnout Among U.S. Neurosurgery Residents

Shakir, Hakeem J; Cappuzzo, Justin M; Shallwani, Hussain; Kwasnicki, Amanda; Bullis, Carli; Wang, Jiefei; Hess, Ryan M.; Levy, Elad I.

doi:10.1016/j.wneu.2019.10.043

Cited by 71 publications

(82 citation statements)

References 22 publications

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“… 11 2017 US Residents 21% 255 93 (36.5) 205 50 NA Shakir et al. 12 2019 US Residents 31% 427 141 (33) 324 99 NA Yu et al. 13 2019 China Neurosurgeons and residents 16% 1202 535 (44.5) 1117 85 34.32 …”

Section: Resultsmentioning

confidence: 99%

“…The results are summarized in Table 1 . Five of the studies included obtained 6 stars, 5 , 9 , 10 , 11 , 12 whereas 1 study gathered 5 stars. 13 …”

Section: Resultsmentioning

confidence: 99%

“…These limitations are further confounded at the meta-analysis level, because the included studies are not independent samples. For example, the 3 studies of US neurosurgery residents 9 , 11 , 12 included 1028 subjects. There are approximately 1200 neurosurgery residents in the US 11 ; therefore, it is almost certain that the meta-analysis includes the at least most of the residents in the 3 studies.…”

Section: Discussionmentioning

confidence: 99%

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Burnout Among Neurosurgeons and Residents in Neurosurgery: A Systematic Review and Meta-Analysis of the Literature

et al. 2020

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Background Burnout syndrome (BS) is a common condition among medical professionals. It is composed of 3 different subdimensions: emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). In the last years, interest in BS in the neurosurgical community has increased. Here we investigated burnout among neurosurgeons and residents in neurosurgery. Methods A systematic review with meta-analysis was performed following PRISMA guidelines. A search of bibliographic databases was conducted from study inception to February 2020. A total of 16,377 studies were found. Six articles were included in our final analysis. Their references were checked for additional studies, but none were found. Results From the initial 16,377 studies identified, only 6 met our inclusion criteria. These studies included a total of 3310 physicians. The general prevalence of BS was 48%. The prevalence in neurosurgeons was 51.1%, higher than that recorded in neurosurgical residents (45.4%). Regarding subdimensions, personal accomplishment seemed to be the most influential factor for burnout development among neurosurgeons (42.57%) and residents (51.56%) alike. Conclusions Neurosurgery is a rewarding career choice, but numerous challenges and stressors can lead to lower levels of satisfaction and dangerously increased levels of burnout. We hope that our results will generate discussion, raise awareness, stimulate further studies, and lead to programs designed to mitigate excessive stress and burnout in neurosurgeons.

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Section: Resultsmentioning

confidence: 99%

“…The results are summarized in Table 1 . Five of the studies included obtained 6 stars, 5 , 9 , 10 , 11 , 12 whereas 1 study gathered 5 stars. 13 …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Burnout Among Neurosurgeons and Residents in Neurosurgery: A Systematic Review and Meta-Analysis of the Literature

et al. 2020

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“…A recent survey-based study examining grit (defined as continued fortitude in the face of hardship) and resilience (ability to recovery from a setback) and their relationship to burnout in neurosurgery residents reported an inverse relationship between self-reported grit/resilience and burnout [18]. When evaluating this conclusion with the lower reported rates of burnout in neurosurgery residents, it can be determined that neurosurgery residents possess, if subjectively, at least a statistically higher level of perseverance and fortitude when compared to other medical specialty physicians.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to our reported gender-pay equity, several aspects of the field of neurosurgery appear to be unique when compared to other surgical subspecialties. Despite having one of the longest and most rigorous training periods, neurosurgery residents consistently have lower rates of burnout and higher personal accomplishment scores than residents and fellows of other specialties [ 18 - 21 ]. When compared with residents of 13 other surgical specialties, neurosurgery residents ranked 12/14 in rates of depression, 12/14 in rates of low mental quality of life, 13/14 in rates of work/home conflict, and 8/14 in overall rates of burnout [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Gender-Pay Equity in Academic Neurosurgery at United States Public Universities

Kearns

Chen

Jane

et al. 2020

Cureus

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Background Compensation has historically been unequal for men versus women in medical fields, particularly in surgical subspecialties. Objective We analyzed associations between gender and compensation and identified factors associated with compensation among male and female academic neurosurgeons in the United States (US) public institutions. Methods This is a cross-sectional study of available data for the 2016-2017 fiscal years associated with male and female neurosurgical faculty from public, academic institutions within the US. The data used for analysis included total annual salary, which consisted of the base salary and additional compensation. Other gleaned data included faculty demographics, training, and academic appointments. The male and female neurosurgeons' data were separated into two respective gender groups and then were compared. Predictors of compensation were identified using univariable and non-imputed and multiply-imputed multivariable statistical models. Results The cohort was comprised of 460 neurosurgery faculty members (female n=34; male n=426). Total annual salaries were comparable between the genders. Females were more likely to be younger (p=0.001), to have completed neurosurgery training recently (p=0.003), to have had fellowship training (p=0.011), and to have lower h-indices (p=0.003) compared to males. Males and females differed in academic ranks (p=0.035) and neurosurgical subspecialties (p=0.038).

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National Evaluation of Surgical Resident Grit and the Association With Wellness Outcomes

et al. 2021

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IMPORTANCE Grit, defined as perseverance and passion for long-term goals, is predictive of success and performance even among high-achieving individuals. Previous studies examining the effect of grit on attrition and wellness during surgical residency are limited by low response rates or single-institution analyses.OBJECTIVES To characterize grit among US general surgery residents and examine the association between resident grit and wellness outcomes. DESIGN, SETTING, AND PARTICIPANTSA cross-sectional national survey study of 7464 clinically active general surgery residents in the US was administered in conjunction with the 2018 American Board of Surgery In-Training Examination and assessed grit, burnout, thoughts of attrition, and suicidal thoughts during the previous year. Multivariable logistic regression models were constructed to assess the association of grit with resident burnout, thoughts of attrition, and suicidal thoughts. Statistical analyses were performed from June 1 to August 15, 2019.EXPOSURES Grit was measured using the 8-item Short Grit Scale (scores range from 1 [not at all gritty] to 5 [extremely gritty]). MAIN OUTCOMES AND MEASURESThe primary outcome was burnout. Secondary outcomes were thoughts of attrition and suicidal thoughts within the past year. RESULTS Among 7464 residents (7413 [99.3%] responded; 4469 men [60.2%]) from 262 general surgery residency programs, individual grit scores ranged from 1.13 to 5.00 points (mean [SD], 3.69 [0.58] points). Mean (SD) grit scores were significantly higher in women (3.72 [0.56] points), in residents in postgraduate training year 4 or 5 (3.72 [0.58] points), and in residents who were married (3.72 [0.57] points; all P Յ .001), although the absolute magnitude of the differences was small. In adjusted analyses, residents with higher grit scores were significantly less likely to report duty hour violations (odds ratio [OR], 0.85; 95% CI, 0.77-0.93), dissatisfaction with becoming a surgeon (OR, 0.53; 95% CI, 0.48-0.59), burnout (OR, 0.53; 95% CI, 0.49-0.58), thoughts of attrition (OR, 0.61; 95% CI, 0.55-0.67), and suicidal thoughts (OR, 0.58; 95% CI, 0.47-0.71). Grit scores were not associated with American Board of Surgery In-Training Examination performance. For individual residency programs, mean program-level grit scores ranged from 3.18 to 4.09 points (mean [SD], 3.69 [0.13] points). CONCLUSIONS AND RELEVANCEIn this national survey evaluation, higher grit scores were associated with a lower likelihood of burnout, thoughts of attrition, and suicidal thoughts among general surgery residents. Given that surgical resident grit scores are generally high and much remains unknown about how to employ grit measurement, grit is likely not an effective screening instrument to select residents; instead, institutions should ensure an organizational culture that promotes and supports trainees across this elevated range of grit scores.

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Relationship of Grit and Resilience to Burnout Among U.S. Neurosurgery Residents

Cited by 71 publications

References 22 publications

Burnout Among Neurosurgeons and Residents in Neurosurgery: A Systematic Review and Meta-Analysis of the Literature

Burnout Among Neurosurgeons and Residents in Neurosurgery: A Systematic Review and Meta-Analysis of the Literature

Gender-Pay Equity in Academic Neurosurgery at United States Public Universities

National Evaluation of Surgical Resident Grit and the Association With Wellness Outcomes

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