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Academic Psychiatry

, Volume 41, Issue 2, pp 189–194 | Cite as

Risk and Resilience Factors Associated with Resident Burnout

  • Deanna ChaukosEmail author
  • Emma Chad-Friedman
  • Darshan H. Mehta
  • Laura Byerly
  • Alper Celik
  • Thomas H. McCoyJr
  • John W. Denninger
In Brief Report

Abstract

Objective

We investigated hypothesized risk and resilience factors and their association with burnout in first year medicine and psychiatry residents at an urban teaching hospital in order to help guide the development of interventions targeted at reducing burnout.

Methods

We administered the Maslach Burnout Inventory (MBI), Perceived Stress Scale-10, Functional Assessment of Chronic Illness Therapy–Fatigue Scale, Penn State Worry Questionnaire, Patient Health Questionnaire-9 (depression symptoms), Revised Life Orientation Test (optimism), Self-Efficacy Questionnaire, Cognitive and Affective Mindfulness Scale, Interpersonal Reactivity Index Perspective-Taking Scale (empathy), and Measure of Current Status-Part A to first year medicine and psychiatry residents prior to initiation of clinical rotations in June.

Results

The response rate was 91 % (68 of 75 residents). Nineteen respondents (28 %) met criteria for burnout as measured by the MBI. Residents with burnout scored higher on self-report measures assessing perceived stress (Cohen’s d = 0.97; p = 0.004), fatigue (d = 0.79; p = 0.018), worry (d = 0.88; p = 0.0009), and depression symptoms (d = 0.84; p = 0.035) and scored lower on questionnaires assessing mindfulness (d = −0.63; p = 0.029) and coping ability (d = −0.79; p = 0.003).

Conclusions

In a cross-sectional assessment using self-report measures, we found that nearly a third of first year residents prior to starting their internships experience burnout. They exhibit lower levels of mindfulness and coping skills and higher levels of depression symptoms, fatigue, worry, and stress. These preliminary findings should encourage programs to initiate and study curricula that combine mindfulness and self-awareness coping strategies to enhance or protect against burnout as well as cognitive behavioral coaching strategies to offset symptoms of burnout when present.

Keywords

Residents: professional development Resiliency Resident burnout Resident wellness 

Notes

Acknowledgments

The authors would like to thank Dr. Hasan Bazari and Dr. Felicia Smith for their support of this research within the residency training programs in the departments of Medicine and Psychiatry, respectively, at the Massachusetts General Hospital.

Compliance with Ethical Standards

Disclosures

Dr. Denninger receives support for unrelated investigator-initiated studies from Onyx Pharmaceuticals. Dr. Denninger receives support from Basis Inc. for materials related to investigator-initiated studies. This does not alter the author’s adherence to Academic Psychiatry policies on sharing data and materials.

Funding/Support

This pilot project was supported by an APIRE Janssen Resident Award (award recipient is the corresponding author).

Ethical Approval

Partners Healthcare IRB review

References

  1. 1.
    Schaufeli WB, Bakker AB, Hoogduin K, Schaap C, Kladler A. On the clinical validity of the Maslach burnout inventory and the burnout measure. Psychol Health. 2001;16(5):565–82.CrossRefPubMedGoogle Scholar
  2. 2.
    Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, et al. Burnout among US medical students, residents, and early career physicians relative to the general US population. Acad Med J Assoc Am Med Coll. 2014;89(3):443–51.CrossRefGoogle Scholar
  3. 3.
    Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600–13.CrossRefPubMedGoogle Scholar
  4. 4.
    West CP, Huschka MM, Novotny PJ, Sloan JA, Kolars JC, Habermann TM, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296(9):1071–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Daskivich TJ, Jardine DA, Tseng J, Correa R, Stagg BC, Jacob KM, et al. Promotion of wellness and mental health awareness among physicians in training: perspective of a national, multispecialty panel of residents and fellows. J Grad Med Educ. 2015;7(1):143–7.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Dyrbye LN, Thomas MR, Massie FS, Power DV, Eacker A, Harper W, et al. Burnout and suicidal ideation among US medical students. Ann Intern Med. 2008;149(5):334–41.CrossRefPubMedGoogle Scholar
  7. 7.
    Dyrbye LN, Power DV, Massie F, Eacker A, Harper W, Thomas MR, et al. Factors associated with resilience to and recovery from burnout: a prospective, multi‐institutional study of US medical students. Med Educ. 2010;44(10):1016–26.CrossRefPubMedGoogle Scholar
  8. 8.
    Ripp J, Babyatsky M, Fallar R, Bazari H, Bellini L, Kapadia C, et al. The incidence and predictors of job burnout in first-year internal medicine residents: a five-institution study. Acad Med. 2011;86(10):1304–10.CrossRefPubMedGoogle Scholar
  9. 9.
    Goldhagen BE, Kingsolver K, Stinnett SS, Rosdahl JA. Stress and burnout in residents: impact of mindfulness-based resilience training. Adv Med Educ Pract. 2015;6:525.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Stern TA, Prager LM, Cremens MC. Autognosis rounds for medical house staff. Psychosomatics. 1993;34(1):1–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Ripp JA, Fallar R, Korenstein D. A randomized controlled trial to decrease job burnout in first-year internal medicine residents using a facilitated discussion group intervention. J Grad Med Educ. 2016;8(2):256–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Riess H, Kelley JM, Bailey R, Konowitz PM, Gray ST. Improving empathy and relational skills in otolaryngology residents a pilot study. Otolaryngol Head Neck Surg. 2011;144(1):120–2.CrossRefPubMedGoogle Scholar
  13. 13.
    Firth-Cozens J. Doctors, their wellbeing, and their stress. BMJ. 2003;326(7391):670.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Mata DA, Ramos MA, Bansal N, Khan R, Guille C, Di Angelantonio E, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314(22):2373–83.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Dyrbye LN, Harper W, Durning SJ, Moutier C, Thomas MR, Massie Jr FS, et al. Patterns of distress in US medical students. Med Teach. 2011;33(10):834–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med J Assoc Am Med Coll. 2006;81(4):354–73.CrossRefGoogle Scholar
  17. 17.
    Krasner MS, Epstein RM, Beckman H, Suchman AL, Chapman B, Mooney CJ, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009;302(12):1284–93.CrossRefPubMedGoogle Scholar
  18. 18.
    Brennan J, McGrady A. Designing and implementing a resiliency program for family medicine residents. Int J Psychiatry Med. 2015;50(1):104–14.CrossRefPubMedGoogle Scholar
  19. 19.
    Rogala A, Shoji K, Luszczynska A, Kuna A, Yeager C, Benight CC, et al. From exhaustion to disengagement via self-efficacy change: findings from two longitudinal studies among human services workers. Front Psychol. 2015;6:2032.PubMedGoogle Scholar
  20. 20.
    Bore M, Kelly B, Nair B. Potential predictors of psychological distress and well-being in medical students: a cross-sectional pilot study. Adv Med Educ Pract. 2016;7:125.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81.CrossRefPubMedGoogle Scholar
  22. 22.
    Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory. 3rd ed. Palo Alto: Consulting Psychologists Press; 1996.Google Scholar
  23. 23.
    Thomas NK. Resident burnout. JAMA. 2004;292(23):2880–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ. 2016;50(1):132–49.CrossRefPubMedGoogle Scholar
  25. 25.
    Bellini LM, Baime M, Shea JA. Variation of mood and empathy during internship. JAMA. 2002;287(23):3143–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Rosenzweig S, Reibel DK, Greeson JM, Brainard GC, Hojat M. Mindfulness-based stress reduction lowers psychological distress in medical students. Teach Learn Med. 2003;15(2):88–92.CrossRefPubMedGoogle Scholar
  27. 27.
    Physician Well-Being Initiative. In: The Accreditation Council for Graduate Medical Education. 2016.http://www.acgme.org/What-We-Do/Initiatives/Physician-Well-Being. Accessed 20 Aug 2016.

Copyright information

© Academic Psychiatry 2016

Authors and Affiliations

  1. 1.Massachusetts General HospitalBostonUSA
  2. 2.University of California San FranciscoSan FranciscoUSA
  3. 3.University of Massachusetts Medical SchoolWorcesterUSA

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