The Relationship Between Spirituality and Burnout in the Lives of Medical Students
- 83 Downloads
Abstract
This study addresses medical student burnout, the physical and emotional exhaustion experienced due to chronic stress, which is prevalent among medical students. The relationships between spirituality and personal well-being were assessed across the 4 years of a medical school in southeastern USA using the Maslach Burnout Inventory General Survey, World Health Organization Quality of Life-Spiritual, Religious, and Personal Beliefs Survey, and the narrative HOPE Spiritual Assessment Tool. The instruments measured exhaustion, cynicism, and professional efficacy pertaining to medical students’ work environment as well as levels of spirituality extracted from facets such as personal practices, sources of hope and strength, and meaning and connection in the world. A significant inverse relationship was found between spirituality and exhaustion as well as spirituality and cynicism. Conversely, spirituality shared a significantly positive relationship with professional efficacy. A significantly higher level of exhaustion and cynicism and lower reported professional efficacy were found in M2 students compared to M4 students. Important sources of student support identified in thematic analysis of narrative were family, friends, a connection to God or a higher power, being part of a religious or spiritual community, prayer/meditation, music, and time spent outdoors. The data suggest that spirituality may be a protective coping tool against burnout in medical students; students nearing the end of pre-clerkship training were in the most need of coping resources. The integration of spirituality into medical school wellness programs may prove beneficial to students specifically before the stressful second year curriculum and can serve students well into their medical profession.
Keywords
Burnout Spirituality Undergraduate medical education StressNotes
Acknowledgements
The authors wish to thank Bee Ben Khallouq, the University of Central Florida College of Medicine research coordinator, for her assistance with study logistics and statistical analysis.
Funding/Support
This study was funded by the Focused Inquiry and Research Experience program at the University of Central Florida College of Medicine.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
References
- 1.Dyrbye LN, Thomas MR, Massie FS, et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med. 2008;149(5):334–41.CrossRefGoogle Scholar
- 2.Shanafelt TD, Hasan O, Dyrbye LN, 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.CrossRefGoogle Scholar
- 3.Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA. Dec 2016;316(21):2214–36.CrossRefGoogle Scholar
- 4.West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296(9):1071–8.CrossRefGoogle Scholar
- 5.Dyrbye LN, Harper W, Durning SJ, et al. Patterns of distress in US medical students. Med Teach. 2011;33(10):834–9.CrossRefGoogle Scholar
- 6.Association of American Medical Colleges. Medical school year two questionnaire- 2016 all schools summary report. https://www.aamc.org/download/476994/data/y2q2016report.pdf. Published February, 2017. Accessed June 15, 2017.
- 7.Meredith P, Murray J, Wilson T, Mitchell G, Hutch R. Can spirituality be taught to health care professionals? J Relig Health. Sep 2012;51(3):879–89.CrossRefGoogle Scholar
- 8.Hsiao YC, Chiang HY, Lee HC, Chen SH. The effects of a spiritual learning program on improving spiritual health and clinical practice stress among nursing students. J Nurs Res. Dec 2012;20(4):281–90.CrossRefGoogle Scholar
- 9.Weiner EL, Swain GR, Wolf B, Gottlieb M. A qualitative study of physicians’ own wellness-promotion practices. West J Med. 2001;174(1):19–23.CrossRefGoogle Scholar
- 10.Zwack J, Schweitzer J. If every fifth physician is affected by burnout, what about the other four? Resilience strategies of experienced physicians. Acad Med. 2013;88(3):382–9.CrossRefGoogle Scholar
- 11.Holland JM, Neimeyer RA. Reducing the risk of burnout in end-of-life care settings: the role of daily spiritual experiences and training. Palliat Support Care. Sep 2005;3(3):173–81.CrossRefGoogle Scholar
- 12.Kash KM, Holland JC, Breitbart W, et al. Stress and burnout in oncology. Oncology. 2000;14(11):1621–33. discussion 1633–1624, 1636-1627Google Scholar
- 13.Addiss DG. Spiritual themes and challenges in global health. J Med Humanit. 2015:30.Google Scholar
- 14.Bennett V, Thompson ML. Teaching spirituality to student nurses. J Nurs Educ Pract. 2015;5(2):26–33.Google Scholar
- 15.Best M, Butow P, Olver I. Do patients want doctors to talk about spirituality? A systematic literature review. Patient Educ Couns. 2015;98(11):1320–8.CrossRefGoogle Scholar
- 16.Delgado-Guay MO, Parsons HA, Hui D, De la Cruz MG, Thorney S, Bruera E. Spirituality, religiosity, and spiritual pain among caregivers of patients with advanced cancer. Am J Hosp Palliat Care. 2013;30(5):455–61.CrossRefGoogle Scholar
- 17.Peteet JR. Spiritually integrated treatment of depression: a conceptual framework. Depress Res Treat. 2012;2012:124370.Google Scholar
- 18.Puchalski C, Ferrell B, Virani R, et al. Improving the quality of spiritual care as a dimension of palliative care: the report of the consensus conference. J Palliat Med. 2009;12:885–904.CrossRefGoogle Scholar
- 19.Puchalski CM, Larson DB. Developing curricula in spirituality and medicine. Acad Med. 1998;73(9):970–4.CrossRefGoogle Scholar
- 20.Puchalski CM. Spirituality and medicine: curricula in medical education. J Cancer Educ. 2006;21(1):14–8.CrossRefGoogle Scholar
- 21.Maslach C, Jackson S, Leiter M. Maslach burnout inventory manual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996.Google Scholar
- 22.World Health Organization WHOQOL-SRPB User Manual. Geneva, Switzerland: World Health Organization; 2002.Google Scholar
- 23.Anandarajah G, Hight E. Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment. Am Fam Physician. 2001;63(1):81–9.Google Scholar
- 24.IBM Corp. SPSS computer program, version 23.0. Armonk, NY: IBM Inc; 2015.Google Scholar
- 25.Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81(4):354–73.CrossRefGoogle Scholar
- 26.Dyrbye LN, West CP, Satele D, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89(3):443–51.CrossRefGoogle Scholar
- 27.Riley GJ. Understanding the stresses and strains of being a doctor. Med J Aust. 2004;181(7):350–3.Google Scholar
- 28.Tyssen R, Dolatowski FC, Rovik JO, et al. Personality traits and types predict medical school stress: a six-year longitudinal and nationwide study. Med Educ. 2007;41(8):781–7.CrossRefGoogle Scholar
- 29.Wachholtz A, Rogoff M. The relationship between spirituality and burnout among medical students. J Contemp Med Edu. 2013;1(2):83–91.CrossRefGoogle Scholar
- 30.Ho RT, Sing CY, Fong TC, et al. Underlying spirituality and mental health: the role of burnout. J Occup Health. 2016;58(1):66–71.CrossRefGoogle Scholar
- 31.Adegbola M. Spirituality, self-efficacy, and quality of life among adults with sickle cell disease. South Online J Nurs. 2011;11(1).Google Scholar
- 32.Thompson SC. The role of personal control in adaptive functioning. In: Lopez SJ, Synder DR, editors. Oxford handbook of positive psychology. 2nd ed. New York, NY: Oxford University Press; 2009.Google Scholar
- 33.Sandars J, Cleary TJAMEE. Guide 58: self-regulation theory: applications to medical education. Med Teach. 2011;33(11):875–86.CrossRefGoogle Scholar
- 34.Mazurkiewicz R, Korenstein D, Fallar R, Ripp J. The prevalence and correlations of medical student burnout in the pre-clinical years: a cross-sectional study. Psychol Health Med. 2012;17(2):188–95.CrossRefGoogle Scholar
- 35.Brazeau CM, Schroeder R, Rovi S, Boyd L. Relationships between medical student burnout, empathy, and professionalism climate. Acad Med. 2010;85:S33–6.CrossRefGoogle Scholar
- 36.Hojat M, Vergare M, Isenberg G, Cohen M, Spandorfer J. Underlying construct of empathy, optimism, and burnout in medical students. Int J Med Edu. 2015;6:12–6.CrossRefGoogle Scholar
- 37.Krageloh CU, Henning MA, Billington R, Hawken SJ. The relationship between quality of life and spirituality, religiousness, and personal beliefs of medical students. Acad Psychiatry. 2015;39(1):85–9.CrossRefGoogle Scholar
- 38.Kreitzer MJ, Klatt M. Educational innovations to foster resilience in the health professions. Med Teach. 2017;39(2):153–9.CrossRefGoogle Scholar
- 39.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.CrossRefGoogle Scholar