101
|
Student Flow and Burnout: The Role of Teacher Autonomy Support and Student Autonomous Motivation. PSYCHOLOGICAL STUDIES 2020. [DOI: 10.1007/s12646-019-00539-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
102
|
Kind N, Bürgin D, Fegert JM, Schmid M. What Protects Youth Residential Caregivers from Burning Out? A Longitudinal Analysis of Individual Resilience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2212. [PMID: 32218385 PMCID: PMC7178075 DOI: 10.3390/ijerph17072212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 01/03/2023]
Abstract
Background: Professional caregivers are exposed to multiple stressors and have high burnout rates; however, not all individuals are equally susceptible. We investigated the association between resilience and burnout in a Swiss population of professional caregivers working in youth residential care. Methods: Using a prospective longitudinal study design, participants (n = 159; 57.9% women) reported on burnout symptoms and sense of coherence (SOC), self-efficacy and self-care at four annual sampling points. The associations of individual resilience measures and sociodemographic variables, work-related and personal stressors, and burnout symptoms were assessed. Cox proportional hazards regressions were calculated to compute hazard ratios over the course of three years. Results: Higher SOC, self-efficacy and self-care were related to lower burnout symptoms in work-related and personal domains. Higher SOC and self-efficacy were reported by older caregivers and by those with children. All three resilience measures were highly correlated. A combined model analysis weakened the protective effect of self-efficacy, leaving only SOC and self-care negatively associated with burnout. Conclusion: This longitudinal analysis suggests that SOC and self-caring behaviour in particular protect against burnout. Our findings could have implications for promoting self-care practices, as well as cultivating a meaningful, comprehensible and manageable professional climate in all facets of institutional care.
Collapse
Affiliation(s)
- Nina Kind
- Child and Adolescent Psychiatry, University Basel, Psychiatric University Hospital Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; (D.B.); (M.S.)
| | - David Bürgin
- Child and Adolescent Psychiatry, University Basel, Psychiatric University Hospital Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; (D.B.); (M.S.)
| | - Jörg M. Fegert
- University Hospital Ulm, Department for Child and Adolescent Psychiatry and Psychotherapy, Steinhövelstrasse 5, 89075 Ulm, Germany;
| | - Marc Schmid
- Child and Adolescent Psychiatry, University Basel, Psychiatric University Hospital Basel, Wilhelm Klein-Strasse 27, 4002 Basel, Switzerland; (D.B.); (M.S.)
| |
Collapse
|
103
|
Fontana MCP, Generoso IP, Sizilio A, Bivanco-Lima D. Burnout syndrome, extracurricular activities and social support among Brazilian internship medical students: a cross-sectional analysis. BMC MEDICAL EDUCATION 2020; 20:81. [PMID: 32188433 PMCID: PMC7081526 DOI: 10.1186/s12909-020-01998-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/10/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Burnout syndrome (BS) is highly prevalent among medical students and is associated with lower empathy and worsening of medical students ́ mental health. The aim of our study was to identify prevalence of BS during internship and its association with self-rated social support and participation in extracurricular activities in one medical school in Brazil. METHODS This was a cross-sectional study conducted in 2015, with 121 medical students on internship (56% response rate). They were evaluated using the Maslach Burnout Inventory - Human Services (MBI) and assessed about socio demographic data, social support and extracurricular activities. RESULTS The overall BS prevalence was 57.5% among medical interns. High emotional exhaustion was present in 33.1% (N = 38) of interns, high depersonalization was observed in 45.7% (N = 58) and 36.2% of participants (N = 46) had low personal accomplishment. Individuals with participation in community services had lower frequency of depersonalization (prevalence ratio 0.61 CI95% 0.42-0.88). BS was not associated with different types of extracurricular activities and no association was found among BS and the behaviour of seeking social support. CONCLUSIONS We found high prevalence of BS in medical interns, however the behaviour of seeking social support had no association with BS. The interns participating in community activities had lower frequency of high depersonalization.
Collapse
Affiliation(s)
| | | | | | - Danielle Bivanco-Lima
- Public Health Department of Faculdade de Ciências Médicas da Santa Casa de São Paulo, Rua Doutor Cesario Mota Júnior, 61, 5° andar, sala 3, São Paulo, SP 01221-906 Brazil
| |
Collapse
|
104
|
Vidhukumar K, Hamza M. Prevalence and Correlates of Burnout among Undergraduate Medical Students - A Cross-sectional Survey. Indian J Psychol Med 2020; 42:122-127. [PMID: 32346252 PMCID: PMC7173651 DOI: 10.4103/ijpsym.ijpsym_192_19] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/31/2019] [Accepted: 09/16/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Burnout among medical students is important for its prevalence, consequences, and modifiable risk factors. Although there are studies on the topic across the globe, Indian studies are few in number. A prevalence estimate of burnout and its determinants among Indian medical graduates will keep us informed about the emotional and motivational factors hindering their professional growth. METHODS From a total of 500 students spanning 5 professional years, data could be collected from 375 students. The study used a questionnaire primarily consisting of "personal burnout" domain of the Copenhagen Burnout Inventory (CBI), which is a validated instrument to assess the burnout at a cutoff score of 50. The questionnaire also included a set of potential personal correlates of burnout. In addition to summary statistics, both univariate and multivariate analyses were used for discerning the relationship of these correlates with burnout. RESULTS The prevalence of burnout among medical students in the college under study was 48.5% (95% confidence interval 43.4-53.7). The proportions of moderate, higher, and severe burnout were 44.8%, 3.2%, and 0.5% respectively. Univariate and multivariate analyses revealed that female gender and perceived stress were associated with burnout. Choosing medicine by one's own choice and maintaining hobbies and interests were associated with less chance for burnout. CONCLUSION Burnout is a prevalent phenomenon among medical students. There are modifiable risk factors for burnout and addressing them will help in training a medical student with high motivation and professionalism.
Collapse
Affiliation(s)
- K. Vidhukumar
- Department of Psychiatry, Government Medical College, Ernakulam, Kerala, India
| | - Majida Hamza
- Department of Psychiatry, Government Medical College, Ernakulam, Kerala, India
| |
Collapse
|
105
|
Chaudhuri JD. Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach. ANATOMICAL SCIENCES EDUCATION 2020; 13:250-271. [PMID: 31021529 DOI: 10.1002/ase.1884] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 04/17/2019] [Accepted: 04/21/2019] [Indexed: 06/09/2023]
Abstract
There has been a fundamental change in health care pedagogy to address the demands and challenges posed by the present generation of millennial students. There is also a growing recognition of the role of intrinsic motivation as a catalyst in a positive learning experience. The term intrinsic motivation refers to energizing behavior that comes from within an individual and develops due to an inherent interest in the activity at hand. However, stimulating intrinsic motivation in the present generation of millennial health care students is a daunting task, considering their diverse and disparate nature. In addition, the inherent generational differences between educators and students, and an increasing emphasis on technological tools have resulted in a dichotomy in the educational environment leading to the development of a greater incidence of burnouts among students. Hence, numerous innovative techniques have been introduced in health care education to enhance the levels of intrinsic motivation in these students. Unfortunately, most of these approaches have only been moderately successful due to their limited ability to address the unique educational expectations of millennial students. The cumulative evidence suggests that specific approaches to stimulate intrinsic motivation should aim at nurturing the learning efforts of students, bridging the generational barriers between educators and students, and ameliorating the stress associated with health care education. Hence, the specific aim of this narrative review is to suggest empirically proven curricular strategies and institutional reforms to enhance intrinsic motivation in health care students belonging to the Millennial Generation.
Collapse
Affiliation(s)
- Joydeep Dutta Chaudhuri
- School of Occupational Therapy, College of Health Sciences, Husson University, Bangor, Maine
| |
Collapse
|
106
|
Verougstraete D, Hachimi Idrissi S. The impact of burn-out on emergency physicians and emergency medicine residents: a systematic review. Acta Clin Belg 2020; 75:57-79. [PMID: 31835964 DOI: 10.1080/17843286.2019.1699690] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: In this systematic review we explored the different aspects of burnout in emergency medicine physicians and residents. We also investigated the possible solutions for this frequent burden.Design: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance.Data sources: Search terms such as (Burnout OR Burn-out OR 'Burn out') AND ('physicians'[MeSH Terms] OR 'physicians' OR 'physician'*) were utilised to identify studies investigating burnout in emergency physicians and emergency medicine residents. We used four electronic databases (MEDLINE (via the PubMed interface), PsycINFO, Embase (via embas.com interface)), in combination with a manual search amongst reference lists of eligible articles.Results: A total of eleven eligible studies were reviewed. Out of these, 7 and 4 were, respectively, conducted among emergency physicians and emergency medicine residents. The prevalence of burnout varies between 25,4 and 71,4% and between 55,6% and 77,9% in, respectively, emergency physicians and emergency medicine residents. In 82% of the studies Maslach Burnout Inventory (MBI) was used to estimate this prevalence, while 18% used other methods. The trigger factors for developing burnout in emergency medicine physicians and residents are plural and divers.Conclusions: A wide variety in the burnout prevalence was found in emergency physicians and emergency medicine residents. A non-patient-related problem (such as large administrative tasks) as well as human relations issues were reported as a trigger factor for burnout. Tackling these issues could lead to a breakthrough in the prevention and treatment for burnout.
Collapse
Affiliation(s)
| | - Said Hachimi Idrissi
- Department of Emergency Medicine, Ghent University Hospital, Gent, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
107
|
Shadid A, Shadid AM, Shadid A, Almutairi FE, Almotairi KE, Aldarwish T, Alzamil O, Alkholaiwi F, Khan SUD. Stress, Burnout, and Associated Risk Factors in Medical Students. Cureus 2020; 12:e6633. [PMID: 31966946 PMCID: PMC6957047 DOI: 10.7759/cureus.6633] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives To determine the prevalence of and the risk factors associated with burnout and stress for medical students in Saudi Arabia. Methods A cross-sectional, survey-based study was distributed between January and February 2018 among all 500 medical students from the first to fifth years in a medical college; 356 of the students responded (71.2% response rate). Burnout was measured using the Maslach Burnout Inventory-Student Survey (MBI-SS) while the stress level was measured using the 12-item General Health Questionnaire (GHQ-12). Socio-demographics, professional characteristics, and participation in extracurricular activities were also included as possible predictors of burnout and stress. Results The study revealed that the stress level was (51.7%, n= 184) and the rate of high burnout was (38.2%, n= 136), expressing high exhaustion (77.8%, n=277), high cynicism (65.7%, n=234), and low academic efficiency (45.5%, n=162). Half of the students (50%, n=178) participated in extracurricular activities and were involved in one or more activities such as organizing activities and medical volunteering (n = 52, 14.6%), research (n = 59, 16.6%), and physical exercise (n = 71, 10.4%). There was a statistically significant positive correlation between overall burnout and a lower grade point average (GPA) (OR = 0.581, p 0.004, 95% CI = 0.400 to 0.843). A statistically significant positive correlation was found between stress and students with a lower GPA (OR = 0.737, P = 0.0.23, 95% CI = 0.566 to 0.959); stress was also higher in students who were not involved in any extracurricular activities (OR 1.893, P = 0.004, 95% CI = 1.22 to 2.918). Conclusion Our study shows high burnout rates among medical students. Low GPA students in this study showed a higher overall burnout. Stress was high in our study participants and was higher in students with a low GPA and in students who were not involved in any extracurricular activities.
Collapse
Affiliation(s)
- Asem Shadid
- Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | | | | | | | - Talal Aldarwish
- Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Omar Alzamil
- Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Feras Alkholaiwi
- Otorhinolaryngology - Head and Neck Surgery, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, USA
| | - Salah-Ud-Din Khan
- Biochemistry, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| |
Collapse
|
108
|
Bizri M, Geagea L, Kobeissy F, Talih F. Prevalence of Eating Disorders Among Medical Students in a Lebanese Medical School: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2020; 16:1879-1887. [PMID: 32801721 PMCID: PMC7414930 DOI: 10.2147/ndt.s266241] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/24/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Eating disorders are among the most severe psychiatric disorders. Medical students are subjected to high levels of stress and have a high risk of developing burnout and mental health problems, including eating disorders. Due to societal stigma and lack of awareness, it is plausible that disordered eating behaviors among students may go unrecognized and under-reported. The current study aimed to evaluate the prevalence and possible factors associated with eating disorders among medical students at the American University of Beirut in Lebanon (AUB). METHODS This cross-sectional descriptive study was conducted in 2017 at AUB. Electronic anonymous surveys were sent to all 412 medical students, with a mean age of 23, enrolled in our four-year medical school. In addition to demographic data, students were asked to complete two validated questionnaires, the SCOFF and EAT-26, to assess eating disorders risk. RESULTS Total responses were 156, out of which 124 completed the whole survey. A total of 131 participants completed the Eat-26 questionnaire and 124 participants completed the SCOFF questionnaire. Out of those, 17% on EAT-26 and 19% on SCOFF were found to be at high risk of developing eating disorders. CONCLUSION There seems to be a high level of underrecognized and under-treated disordered eating behaviors among female medical students at AUB. Raising awareness among medical students is important, as well as developing better prevention and treatment strategies.
Collapse
Affiliation(s)
- Maya Bizri
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Luna Geagea
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Firas Kobeissy
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Farid Talih
- American University of Beirut Medical Center, Beirut, Lebanon
| |
Collapse
|
109
|
Cheng J, Zhao YY, Wang J, Sun YH. Academic burnout and depression of Chinese medical students in the pre-clinical years: the buffering hypothesis of resilience and social support. PSYCHOL HEALTH MED 2019; 25:1094-1105. [DOI: 10.1080/13548506.2019.1709651] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- J. Cheng
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Y. Y. Zhao
- The Fifth Sanatorium for Retired Cadres, Anhui Provincial Military Region, Hefei, China
| | - J. Wang
- School of Public Health, Anhui Medical University, Hefei, China
| | - Y. H. Sun
- School of Public Health, Anhui Medical University, Hefei, China
| |
Collapse
|
110
|
Hicks M, Hanes D. Naturopathic medical student empathy and burnout: A preliminary study. ADVANCES IN INTEGRATIVE MEDICINE 2019; 6:151-158. [PMID: 39239459 PMCID: PMC11376202 DOI: 10.1016/j.aimed.2018.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Many studies have demonstrated empathy decline in medical students over the course of training. Burnout negatively affects academic or professional performance and has been negatively correlated with empathy. Neither empathy nor burnout has been previously studied in naturopathic medical students. Objective The aims of this cross-sectional study were to (1) compare empathy at different levels of training, (2) describe the prevalence of burnout, and (3) identify correlations between empathy and burnout, in naturopathic medical students. Methods This cross-sectional study used the Interpersonal Reactivity Index and Maslach Burnout Inventory to measure empathy and burnout, respectively, in an online survey of current naturopathic medical students at one institution. Results 1) There was no significant difference in empathy between any cohorts or between those in internship versus those not in internship. 2) Among burnout outcomes, 42% of participants met criteria for emotional exhaustion, 19% for depersonalization, and 64% for low sense of personal accomplishment. 3) Cognitive empathy was positively correlated with affective empathy and a higher sense of personal accomplishment and negatively correlated with emotional exhaustion and depersonalization. Conclusions While a longitudinal study would provide more definitive evidence, this study suggests that empathy in naturopathic medical students is relatively stable over the course of training. It also demonstrates that burnout is prevalent in this population and has an inverse relationship with empathy. Interventions to prevent burnout and increase empathy are discussed.
Collapse
Affiliation(s)
- Matthew Hicks
- National University of Natural Medicine, Portland, Oregon, United States
| | - Douglas Hanes
- National University of Natural Medicine, Portland, Oregon, United States
| |
Collapse
|
111
|
Sanchez DJ, Strauman TJ, Compton S. Impact of Student Perceptions of the Educational Program on Burnout in Medical School. MEDICAL SCIENCE EDUCATOR 2019; 29:1077-1087. [PMID: 34457586 PMCID: PMC8368313 DOI: 10.1007/s40670-019-00812-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Burnout is considered to be at the opposite end of the continuum from engagement. People who experience burnout first go through various intermediate patterns that lead to burnout, which in medical students is associated with reduced empathy, intention to leave school, and suicidal ideation. Thus, understanding how to mitigate burnout is of primary importance. In this study, we investigate if students' positive perceptions of the educational program's alignment with adult education principles decreased symptoms suggestive of typical patterns of intermediate burnout. METHODS We conducted a cross-sectional survey study of all currently enrolled Duke-NUS Medical School students in Singapore (n = 238). An electronic questionnaire contained demographic questions and additional measures for factors known to be associated with burnout, including depression, anxiety, social support, and workload. In addition, we measured students' perceptions of how well the educational program aligned with adult learning principles by using a modified version of the Andragogical Practices Inventory (API) to suit medical education. An intermediate pattern of burnout was measured using the Maslach Burnout Inventory (MBI). Using logistic regression, we then assessed the unique association between the presence of an intermediate pattern of burnout with students' perceptions of the educational program's alignment with adult learning principles. RESULTS The survey response rate was 52%. Overall, 76% (95% CI 67-84%) displayed symptoms suggestive of an intermediate pattern of burnout. Perceptions of the educational program's alignment with adult learning principles were found to be inversely related to the pattern of burnout after controlling for depression, anxiety, and subjective workload. DISCUSSION AND CONCLUSION Though adult learning theory is the subject of rich debate, the results of this study suggest that promoting educational activities that are aligned with adult learning principles may help to ultimately reduce the risk of burnout in medical school students.
Collapse
Affiliation(s)
- Daniel J. Sanchez
- Office of Education, Duke-NUS Medical School, 8 College Rd, Singapore, 169857 Singapore
| | - Timothy J. Strauman
- Office of Education, Duke-NUS Medical School, 8 College Rd, Singapore, 169857 Singapore
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Dr, Durham, NC 27708 USA
| | - Scott Compton
- Office of Education, Duke-NUS Medical School, 8 College Rd, Singapore, 169857 Singapore
| |
Collapse
|
112
|
Scudder DR, Sherry AD, Jarrett RT, Fernando S, Kuhn AW, Fleming AE. Fundamental Curriculum Change with 1-Year Pre-Clerkship Phase and Effect on Stress Associated with Residency Specialty Selection. MEDICAL SCIENCE EDUCATOR 2019; 29:1033-1042. [PMID: 34457581 PMCID: PMC8368347 DOI: 10.1007/s40670-019-00800-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Vanderbilt University School of Medicine recently changed from 2 pre-clerkship years (Traditional curriculum) to a 1.5-year pre-clerkship phase for one class (Hybrid curriculum) to a 1-year pre-clerkship phase (Curriculum 2.0). This study investigated the relationship between shortened pre-clerkship training and stress associated with selecting a residency field. The surveyed graduating medical student population included one cohort from the Traditional and Hybrid curricula, and the first two cohorts from Curriculum 2.0. The authors modeled recollected stress levels using a Zero-Inflated Linear Mixed Model with additional covariate and random effects adjustments. Specialty decision-related stress levels increased in the Hybrid curriculum by 10.208 points [p = 0.0115, 95% CI 2.293, 18.122] on a 0-100 point scale. Curriculum 2.0 students had an insignificant increase in stress of 4.062 points [p = 0.304, 95% CI - 3.690, 11.814] relative to the Traditional curriculum. Time since starting medical school and time when a specialty was chosen were the largest factors associated with stress. While this study only evaluated a single facet of the potential downstream effects of curricular change, these data should inspire confidence for reform efforts as a significant increase in specialty decision-related stress present in Hybrid curriculum resolved in both cohorts of Curriculum 2.0.
Collapse
Affiliation(s)
- David R. Scudder
- Vanderbilt University School of Medicine, Nashville, TN USA
- Departments of Internal Medicine and Pediatrics, University of Colorado School of Medicine, Aurora, CO USA
| | | | - Ryan T. Jarrett
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN USA
| | - Shanik Fernando
- Department of Otolaryngology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Andrew W. Kuhn
- Vanderbilt University School of Medicine, Nashville, TN USA
| | - Amy E. Fleming
- Vanderbilt University School of Medicine, Nashville, TN USA
| |
Collapse
|
113
|
Fallar R, Leikauf J, Dokun O, Anand S, Gliatto P, Mellman L, Autenrieth S, Katz C. Medical Students' Experiences of Unplanned Leaves of Absence. MEDICAL SCIENCE EDUCATOR 2019; 29:1003-1011. [PMID: 34457577 PMCID: PMC8368954 DOI: 10.1007/s40670-019-00792-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CONTEXT Many medical students take leaves of absence (LOA), both planned and unplanned. Unplanned LOA relate to personal or academic situations which arise and create the need for a student to temporarily suspend their medical education. This can be a high-stakes decision for the student and the school. However, there is a dearth of published literature regarding the experience of students who take a LOA to guide decision-makers. The aim of this study is to examine the experiences of medical students who took an unplanned LOA and subsequently returned to school. METHODS A phenomenological analysis of semi-structured interviews of eight medical students returning from unplanned LOAs at two urban, academic medical centers was conducted. Transcripts were analyzed and themes were coded, and consensus regarding all themes was reached through an iterative process. RESULTS Eight themes were identified. Some important concerns included having a sense of choice to take a LOA, the burden of logistical issues, clear communication from administrators, and worries about stigma upon return. The students retrospectively viewed their LOA as helpful and their subsequent return as less stressful than feared. DISCUSSION The experiences of these students indicate several primary concerns that medical schools can anticipate in order to support students considering or taking an unplanned LOA. The more information a school is able to share with these students, the greater the potential to reduce anxiety at this vulnerable stage. Future research should attempt to explore these findings in a larger sample and correlate them with academic and other outcomes.
Collapse
Affiliation(s)
- Robert Fallar
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, #1255, New York, NY 10029 USA
| | - John Leikauf
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94304 USA
| | - Olanrewaju Dokun
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, #1255, New York, NY 10029 USA
| | - Shashi Anand
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, #1255, New York, NY 10029 USA
| | - Peter Gliatto
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, #1255, New York, NY 10029 USA
| | - Lisa Mellman
- Columbia University Vagelos College of Physicians & Surgeons, 710 West 168th Street, New York, NY 10032 USA
| | - Stephanie Autenrieth
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, #1255, New York, NY 10029 USA
| | - Craig Katz
- Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, #1255, New York, NY 10029 USA
| |
Collapse
|
114
|
Hariharan TS, Griffin B. A review of the factors related to burnout at the early-career stage of medicine. MEDICAL TEACHER 2019; 41:1380-1391. [PMID: 31345077 DOI: 10.1080/0142159x.2019.1641189] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Background: Globally, burnout is an increasingly prevalent problem amongst young medical professionals. This review aims to understand the factors related to burnout in the early-career stage of medicine. Drawing on the widely used Job Demands-Resources Model, the antecedents of burnout were distinguished from its outcomes.Methods: The review adopted the PRISMA guidelines. Using specific search terms, peer-reviewed articles were obtained from a range of databases and assessed against selection criteria. To meet inclusion requirements, the study had to be published between 2000 and 2018, include a validated measure of burnout, and undertake empirical assessment of factors related to burnout in medical students and/or junior medical officers/residents. Additional studies were obtained and reviewed from the reference lists of selected articles.Results: Out of the 3796 studies that were initially found, 585 were assessed against the eligibility criteria leaving 113 studies for review. These studies highlighted the negative consequences of burnout in the early medical career. Also identified were work-specific and person-specific demands that likely lead to burnout and, work and person resources that appear to reduce burnout.Conclusion: This review provides a framework to explain the growing problem of burnout amongst early-career medical professionals. However, further research is necessary to overcome the current reliance on cross-sectional designs and small sample sizes.
Collapse
Affiliation(s)
| | - Barbara Griffin
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| |
Collapse
|
115
|
Puranitee P, Saetang S, Sumrithe S, Busari JO, van Mook WN, Heeneman S. Exploring burnout and depression of Thai medical students: the psychometric properties of the Maslach Burnout Inventory. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2019; 10:223-229. [PMID: 31786565 PMCID: PMC7252444 DOI: 10.5116/ijme.5dc6.8228] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 11/09/2019] [Indexed: 05/16/2023]
Abstract
OBJECTIVES To examine the psychometric properties of the Maslach Burnout Inventory-Student Survey (MBI-SS) Thai version and to determine the frequency of burnout and correlation between burnout and associated factors. METHODS A cross-sectional study was conducted among undergraduate medical students using convenience sampling (n=545, 76.1% response rate, female 52.1%). Data were collected by a self-report survey. The MBI-SS was translated in Thai and tested for internal consistency using Cronbach's coefficient alpha. A confirmatory factor analysis was performed using as fit indices of the chi-square and degree of freedom ratio (χ2/df), Comparative Fit Index (CFI), the Goodness of Fit Index (GFI), the Non-normed Fit Index (NNFI), Akaike information criterion (AIC) and the Root Mean Square Error of Approximation (RMSEA). Spearman and Kendall's tau-b were used to identify correlations between burnout, depression and other factors. RESULTS Interrater reliability was acceptable with Kappa of 0.83. Confirmatory factor analysis demonstrated good fit indices (χ2/df=197.62/83, CFI=0.97, GFI=0.95, NNFI=0.96, AIC=271.62 and RMSEA=0.06). Burnout had a weak, positive association with the PHQ-9 (r=0.294, df=2, p< 0.001). The screening depression score had a significant, modest positive association with emotional exhaustion (r=0.469, df=4, p<0.001) and cynicism (r=0.411, df=4, p< 0.001), and a weak inverse association with professional efficacy (r=-0.273, df=4, p< 0.001). CONCLUSIONS The Thai version of the MBI-SS had adequate psychometric properties among Thai medical students and can be used to assess burnout among undergraduate medical students in Thailand. Burnout was associated with risk for depression. Further studies on other associated factors contributing to depression are suggested.
Collapse
Affiliation(s)
- Pongtong Puranitee
- Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Siam Saetang
- Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Sutida Sumrithe
- Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Jamiu O. Busari
- Department of Educational Development & Research, Faculty of Health, Medicine & Life Sciences (FHML), Maastricht University (UM), The Netherlands
| | - Walther N.K.A. van Mook
- School of Health Profession Education, Maastricht University (UM), Department of Intensive Care Medicine, The Netherlands
| | - Sylvia Heeneman
- Department of Pathology, Faculty of Health, Medicine & Life Sciences (FHML), School of Health Profession Education, Maastricht University (UM), The Netherlands
| |
Collapse
|
116
|
Swendiman RA, Edmondson AC, Mahmoud NN. Burnout in Surgery Viewed Through the Lens of Psychological Safety. Ann Surg 2019; 269:234-235. [PMID: 30169397 DOI: 10.1097/sla.0000000000003019] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Robert A Swendiman
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| | | | - Najjia N Mahmoud
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
117
|
Haile YG, Senkute AL, Alemu BT, Bedane DM, Kebede KB. Prevalence and associated factors of burnout among Debre Berhan University medical students: a cross-sectional study. BMC MEDICAL EDUCATION 2019; 19:413. [PMID: 31703674 PMCID: PMC6842173 DOI: 10.1186/s12909-019-1864-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 10/31/2019] [Indexed: 06/02/2023]
Abstract
BACKGROUND Burnout, a measure of professional distress, is more common among medical professionals. About half of medical students have this problem. However, little is known about the burnout status of medical students in Ethiopia. Therefore, the aim of this study was to assess the prevalence and associated factors of burnout among medical students of Debre Berhan University (DBU). METHODS A cross-sectional study was conducted on randomly selected 151 medical students of DBU. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Participants were reported as having burnout if they scored ≥27 on Emotional Exhaustion (EE), ≥13 on Depersonalization (DP) sub-scales, and ≤ 31 on Personal Accomplishment (PA) sub-scale of the MBI-HSS. EpiData version 3.1 was used for data entry while SPSS version 20 and STATA version 13 for windows were used for data analysis. Both univariable and multivariable binary logistic regression analyses were conducted. The degree of association between variables was assessed using odds ratio (OR) with 95% confidence interval (CI) at two-tailed p-value of < 0.05. RESULT Of 144 medical students took part, 34.0% had symptoms of burnout. Regarding domains of burnout, 61.8% scored high on EE, 47.9% scored high on DP and 59.7% scored low on PA. Dissatisfaction with practice lecturer (AOR = 3.8, 95% CI (1.3, 11.6)), moderate social support (AOR = 0.2, 95% CI (0.1, 0.8)), and satisfaction with their education (AOR = 0.1 95% CI (0.0, 0.7)) were associated with burnout. CONCLUSION More than one-third of medical students at DBU had burnout. Individual and organizational level interventions targeting students who had poor social support, dissatisfied by their lecturer at the hospitals and their education are recommended.
Collapse
Affiliation(s)
| | | | | | - Dawit Mamo Bedane
- Department of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | | |
Collapse
|
118
|
Maser B, Danilewitz M, Guérin E, Findlay L, Frank E. Medical Student Psychological Distress and Mental Illness Relative to the General Population: A Canadian Cross-Sectional Survey. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1781-1791. [PMID: 31436626 DOI: 10.1097/acm.0000000000002958] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE To provide national data on Canadian medical students' mental health and show how their mental health compares with that of similarly aged postsecondary graduates from the general population. METHOD In 2015-2016, the authors conducted a survey of medical students in all years of study at all 17 Canadian medical schools. The surveys included validated items and instruments to assess for psychological distress, suicidal ideation, and diagnosed mood and anxiety disorders. Comparative analyses were performed between medical students and similarly aged postsecondary graduates using data from the Canadian Community Health Survey-Mental Health 2012. RESULTS The participation rate across all medical students was 40.2% (4,613/11,469). Relative to the general population of postsecondary graduates aged 20-34, medical students aged 20-34 had significantly higher rates of diagnosed mood disorders, diagnosed anxiety disorders, suicidal ideation, and psychological distress. Among medical students, being female was associated with having a mood or anxiety disorder, lifetime suicidal ideation, moderate or severe psychological distress, and higher mean Kessler Psychological Distress Scale 6-item summative scores. Being in clinical training was associated with having suicidal ideation, moderate or severe psychological distress, and mood and anxiety disorders. CONCLUSIONS Compared with postsecondary graduates from the general population, medical student respondents had significantly higher rates of psychological distress, suicidal ideation, and mood and anxiety disorders. Further research is needed to understand the factors that are contributing to these higher rates.
Collapse
Affiliation(s)
- Brandon Maser
- B. Maser is resident physician and PhD student, Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. M. Danilewitz is resident physician, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada. E. Guérin is biostatistician, Hôpital Montfort, Ottawa, Ontario, Canada. L. Findlay is senior research analyst, Health Analysis Division, Analytical Studies, Methodology and Statistical Infrastructure Field, Statistics Canada, Government of Canada, Ottawa, Ontario, Canada. E. Frank is professor, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, and Canada Research Chair in Preventive Medicine and Population Health, Government of Canada, Ottawa, Ontario, Canada
| | | | | | | | | |
Collapse
|
119
|
Mohebbi SZ, Yazdani R, Talebi M, Pakdaman A, Heft MW, Bahramian H. Burn out among Iranian dental students: psychometric properties of burnout clinical subtype questionnaire (BCSQ-12-SS) and its correlates. BMC MEDICAL EDUCATION 2019; 19:388. [PMID: 31640682 PMCID: PMC6805565 DOI: 10.1186/s12909-019-1808-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 09/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Burnout Clinical Subtype Questionnaire (BCSQ-12-SS) is a short valid questionnaire for assessment of burnout in students. The aim of the present study was to evaluate the psychometric properties of Persian-translated version of the BCSQ-12-SS and assess the burn out clinical subtypes and their correlates in dental students. METHODS In this psychometry study, the BCSQ-12-SS questionnaire in domains of overload (4 questions), lack of development (4 questions), and neglect (4 questions) was translated to Persian and back-translated. Six experts determined the content and face validity of the Persian version. The questionnaire was then piloted on 167 dental students of Tehran University of Medical Sciences in 2016. Data were analyzed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) for construct validity and Linear Regression modeling in IBM SPSS and AMOS SPSS. To assess reliability, the questionnaire was filled out by 15 students twice and Kappa coefficient and Composite Reliability (CR) were calculated. RESULTS Content validity Ratio (CVR) and Content Validity Index (CVI) values and Cronbach's alphas were all over 0.8. Kappa coefficient ranged from 65 to 82.5%. The average burnout score was 29.6 out of maximum score of 60. There were no significant differences in burnout scores across the different semesters (8,10 and 12). Financial support by the family significantly affected the total score of burnout and lack of development. In addition, gender, mother's education, residential status of student, preparing for post graduate exam and financial support by the family affected the overload. CONCLUSION The BCSQ-12-SS has good psychometric properties and therefore can be used to assess burnout in IRANIAN dental students. The BCSQ-12-SS may provide an opportunity to identify individuals at risk for burn out and provide counseling to assist in dental student development.
Collapse
Affiliation(s)
- Simin Z. Mohebbi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Yazdani
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Musa Talebi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Pakdaman
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Marc W. Heft
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Florida, Gainesville, USA
| | - Hoda Bahramian
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
120
|
Zhang N, Henderson CNR. Predicting stress and test anxiety among 1st-year chiropractic students. THE JOURNAL OF CHIROPRACTIC EDUCATION 2019; 33:133-139. [PMID: 30830795 PMCID: PMC6759007 DOI: 10.7899/jce-18-11] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE We evaluated perceived stress in 1st-year chiropractic students and the relationship between perceived stress and test anxiety. Moreover, we sought student-identified stressors that complicate chiropractic education. METHODS We tested 3 hypotheses in a longitudinal descriptive study: (1) student-perceived stress would increase over 6 months of chiropractic training, (2) depression level and grade-point average (GPA) at matriculation would predict student-perceived stress 6 months into the program, and (3) perceived stress would correlate with cognitive and emotional test anxiety levels. Assessments used were prematriculation GPA, perceived chiropractic college stress (PCCS), the Center for Epidemiologic Studies Depression Scale, and the Test Anxiety Inventory. RESULTS Four hundred and seven students participated during 2014 and 2015. PCCS increased 18% after 6 months (t(406) = 6.32, p < .001, d = .33). Prematriculation GPA was not a significant predictor of PCCS at 6 months, p = .082. By contrast, the Center for Epidemiologic Studies Depression Scale at the beginning of the chiropractic training program was a significant predictor p < .001, multiple R2 = 7.1%. PCCS correlated with test anxiety worry and emotionality (r = .37, p < .001 and r = .35, p < .001, respectively). The top 4 stressors identified by students were (by priority) finances, time for a life outside school, personal competence/endurance, and curriculum/environment. CONCLUSION Our findings are consistent with perceived stress increases during medical school. Surprisingly, prematriculation GPA, a widely used academic performance predictor, was a poor predictor of PCCS, while depression level at matriculation was a moderate predictor. PCCS correlated with test anxiety worry and emotionality, known academic performance impediments.
Collapse
|
121
|
Sójka A, Stelcer B, Roy M, Mojs E, Pryliński M. Is there a relationship between psychological factors and TMD? Brain Behav 2019; 9:e01360. [PMID: 31339236 PMCID: PMC7649956 DOI: 10.1002/brb3.1360] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 04/15/2019] [Accepted: 04/24/2019] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Medical students are in a very demanding environment and are affected by high degree of stress. High levels of anxiety can affect a student's academic performance and also increase the risk of other health-related problems. This study aims to evaluate, thanks to the intensity of stress manifestations (4DSQ) together with the sense of coherence (SOC), the prevalence of TMD and oral parafunctions in students enrolled in the University of Medical Sciences. Moreover, it aims to evaluate the relationship between the psychosocial manifestations of stress and sense of coherence in relation to gender. MATERIALS AND METHODS A total of 324 students of Poznań University of Medical Sciences participated in this study. Students were assessed using a three-part questionnaire: one was to assess symptoms of TMD, the second part was 4DSQ, and the third was a SOC Questionnaire. RESULTS About one-third of the students in this study presented symptoms of TMD and perceived more intensively symptoms of distress, anxiety, somatization, and depression. They presented a higher level of somatic symptoms and a lower level of Sense of Coherence than students without TMD symptoms. CONCLUSION There is a strong negative relationship between the sense of coherence and the level of perceived distress, anxiety, somatization, and depression. Female students attending Medical School showed a higher level of somatization of stress but with a higher capacity to overcome challenges as compared to men.
Collapse
Affiliation(s)
- Anna Sójka
- Department of ProsthodonticsPoznań University of Medical SciencesPoznanPoland
| | - Bogusław Stelcer
- Department of Clinical PsychologyPoznań University of Medical SciencesPoznanPoland
| | - Marco Roy
- Department of ProsthodonticsPoznań University of Medical SciencesPoznanPoland
| | - Ewa Mojs
- Department of Clinical PsychologyPoznań University of Medical SciencesPoznanPoland
| | - Mariusz Pryliński
- Department of ProsthodonticsPoznań University of Medical SciencesPoznanPoland
| |
Collapse
|
122
|
Howell AN, Rheingold AA, Uhde TW, Guille C. Web-based CBT for the prevention of anxiety symptoms among medical and health science graduate students. Cogn Behav Ther 2019; 48:385-405. [PMID: 30526364 PMCID: PMC6559871 DOI: 10.1080/16506073.2018.1533575] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 09/27/2018] [Indexed: 10/27/2022]
Abstract
Medical and health science graduate students report greater anxiety problems than the general population, but they are less likely to seek treatment due to cultural and logistical barriers. One preventative approach that overcomes these barriers is web-based cognitive behavioral therapy (webCBT). It is unknown whether webCBT is effective for preventing anxiety escalation within this population. A randomized controlled trial was conducted, comparing the effects of webCBT versus a control group (CG). Medical university students (n=594; Mage=27; 67% female; 80% Caucasian) completed online baseline measures and four assigned online activities. Measures were re-administered after approximately three months. There was a small interaction effect between time of assessment and treatment condition. Anxiety severity was lower in the webCBT (M[SD]=2.88[3.36]) versus CG condition (M[SD]=3.69 [3.35]) at follow-up. This effect was moderate for students with mild, versus minimal, anxiety at baseline. The proportion of students with possible anxiety disorder was lower in the webCBT (4.5%) versus CG (8.5%) condition, and the proportion of mildly anxious students with a clinically significant increase in symptoms was lower in the webCBT (10%) versus CG (20%) condition. WebCBT may aid in preventing anxiety escalation in this population, particularly for at-risk students who report mild anxiety symptoms.
Collapse
Affiliation(s)
- Ashley N. Howell
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC
| | - Alyssa A. Rheingold
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC
| | - Thomas W. Uhde
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina (MUSC), Charleston, SC
| |
Collapse
|
123
|
Buery-Joyner SD, Ryan MS, Santen SA, Borda A, Webb T, Cheifetz C. Beyond mistreatment: Learner neglect in the clinical teaching environment. MEDICAL TEACHER 2019; 41:949-955. [PMID: 31017502 DOI: 10.1080/0142159x.2019.1602254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Medical student mistreatment has been recognized as a deterrent to education as it interferes with the learning process and contributes to student burnout and attrition. Medical schools and leaders in undergraduate medical education have expended tremendous effort in addressing this phenomenon in hopes of eradicating mistreatment. However, there is a spectrum of behaviors that negatively impact the learning environment beyond that which is considered frank mistreatment. In this conceptual article, the authors propose the concept of learner neglect for the consideration by educators and researchers. This is a term for a range of behaviors exhibited intentionally or unintentionally by a supervisor that prevent a learner from reaching his or her potential. While the behaviors may overlap with mistreatment, they do not always fit within the definition of mistreatment. This concept is illustrated in the context of optimal and suboptimal teaching behaviors that commonly occur within the ecosystem of clinical education. Descriptions and examples are provided for both intentional and unintentional learner neglect. The authors hypothesize possible short- and long-term impacts of learner neglect, describe contributors to its prevalence, and offer questions for key stakeholders to consider in an effort to recognize, study, and ameliorate this issue within medical education programs.
Collapse
Affiliation(s)
| | - Michael S Ryan
- Virginia Commonwealth University School of Medicine , Richmond , VA , USA
| | - Sally A Santen
- Virginia Commonwealth University School of Medicine , Richmond , VA , USA
| | - Allison Borda
- Virginia Commonwealth University School of Medicine , Richmond , VA , USA
| | - Timothy Webb
- Virginia Commonwealth University School of Medicine , Richmond , VA , USA
| | - Craig Cheifetz
- Virginia Commonwealth University School of Medicine Inova Campus , Falls Church , VA , USA
| |
Collapse
|
124
|
Gold JA, Hu X, Huang G, Li WZ, Wu YF, Gao S, Liu ZN, Trockel M, Li WZ, Wu YF, Gao S, Liu ZN, Rohrbaugh RM, Wilkins KM. Medical student depression and its correlates across three international medical schools. World J Psychiatry 2019; 9:65-77. [PMID: 31799151 PMCID: PMC6885454 DOI: 10.5498/wjp.v9.i4.65] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/26/2019] [Accepted: 05/23/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Medical students have high rates of depression, anxiety, and burnout that have been found to affect their empathy, professional behaviors, and performance as a physician. While studies have examined predictors for burnout and depression in the United States (US), no study, to our knowledge, has compared depression in medical students cross-culturally, or has attempted to examine the effect of factors influencing rates including burnout, exercise, stress, unmet mental health needs, and region.
AIM To examine rates of depression in three international cohorts of medical students, and determine variables that may explain these differences.
METHODS Convenience samples of medical students from three countries (US, China, and a Middle Eastern country whose name remains anonymous per request from the school) were surveyed in this observational study. Using the Patient Health Questionnaire-2 (PHQ-2) and a modified Maslach Burnout Inventory, depression and burnout were examined among medical students from the three cohorts (n = 473). Chi-square test and analysis of variance were used to examine differences in demographics, behavioral, and psychological variables across these three schools to identify potentially confounding descriptive characteristics. Analysis of covariance compared depression and the emotional exhaustion component of burnout identified through Principal Component Analysis across countries. Multiple linear regression was used to analyze the impact of demographic, behavioral, and psychological variables on screening positive for depression.
RESULTS Medical students from the Middle Eastern country had the highest rates of positive depression screens (41.1%), defined as a PHQ-2 score of ≥ 3, followed by China (14.1 %), and then the US (3.8%). More students in the Middle Eastern school had unmet mental health needs (50.8%) than at the medical school in China (34.8%) or the school in the US (32.8%) (Pearson chi-square significance < 0.05). Thus, PHQ-2 scores were adjusted for unmet mental health needs; however, the Middle Eastern country continued to have the highest depression. Adjusting for PHQ-2 score, medical students from the US scored the highest on emotional exhaustion (a measure of burnout). Demographic variables did not significantly predict medical student depression; however, lack of exercise, unmet mental health needs, stress, and emotional exhaustion predicted nearly half of depression in these cohorts. In comparison to the US, coming from the Middle Eastern country and China predicted higher levels of depression.
CONCLUSION Depression rates differ in three international cohorts of medical students. Measured factors contributed to some observed differences. Identifying site-specific prevention and intervention strategies in medical student mental health is warranted.
Collapse
Affiliation(s)
- Jessica A Gold
- Department of Psychiatry, Washington University in St Louis, St Louis, MO 63110, United States
| | - Xinran Hu
- Department of Psychiatry, Yale University, New Haven, CT 06511, United States
| | - Gan Huang
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Wan-Zhen Li
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Yi-Fan Wu
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Shan Gao
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Zhe-Ning Liu
- Central South University Xiangya School of Medicine, Changsha 410013, Hunan Province, China
| | - Mickey Trockel
- Department of Psychiatry, Stanford University, Stanford, CA 94305, United States
| | | | | | | | | | - Robert M Rohrbaugh
- Department of Psychiatry, Yale University, New Haven, CT 06511, United States
| | - Kirsten M Wilkins
- Department of Psychiatry, Yale University, New Haven, CT 06511, United States
| |
Collapse
|
125
|
Isaac V, McLachlan CS, Walters L, Greenhill J. Screening for burn-out in Australian medical students undertaking a rural clinical placement. BMJ Open 2019; 9:e029029. [PMID: 31289089 PMCID: PMC6615879 DOI: 10.1136/bmjopen-2019-029029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate Australian medical student burn-out during rural clinical placement. Second, to examine the association between perceived burn-out and rural career intent at the time of finishing their rural placement. DESIGN, SETTINGS AND PARTICIPANTS The 2016 Federation of Rural Australian Medical Educators evaluation survey is a cross-sectional study of medical students from 17 Australian universities. Specifically, those medical students who completed a full academic year or more at a Rural Clinical School (RCS). Responses from 638 medical students from regional Australia were analysed in the study of all eligible 756 medical students (response rate 84.3%). PRIMARY AND SECONDARY OUTCOME MEASURES The primary objective was to determine self-reported burn-out (emotional exhaustion) in rural placements for medical students. Secondary outcome measures were designed to explore interactions with rural practice self-efficacy and rural intentions. Logistic regression models explored factors associated with burn-out. RESULTS 26.5% of students reported experiencing burn-out during a rural placement. Factors associated with burn-out were female gender, rural origin, low preference for RCS, stress in the year prior to a rural clinical placement, perceived social isolation during rural placement and lower rural practice self-efficacy. Burn-out was not associated with rural career intentions. Social isolation and low rural self-efficacy were independently associated with burn-out during rural placement and together explained 10% of variance in burn-out (Model Nagelkerke R2=0.23). CONCLUSION Burn-out during rural placement may be a consequence of stress prior to a medical school placement. Social isolation and rural self-efficacy are amendable factors to mitigate medical student burn-out during rural placements.
Collapse
Affiliation(s)
- Vivian Isaac
- Flinders Rural Health South Australia, College of Medicine and Public Health, Flinders University, Renmark, South Australia, Australia
| | - Craig S McLachlan
- School of Health, Torrens University Australia, Sydney, New South Wales, Australia
| | - Lucie Walters
- Adelaide Rural Clinical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jennene Greenhill
- Flinders Rural Health South Australia, College of Medicine and Public Health, Flinders University, Renmark, South Australia, Australia
| |
Collapse
|
126
|
Henning MA, Chen J, Krägeloh CU, Hill EM, Booth R, Webster C. A Comparative, Multi-national Analysis of the Quality of Life and Learning Factors of Medical and Non-medical Undergraduate Students. MEDICAL SCIENCE EDUCATOR 2019; 29:475-487. [PMID: 34457504 PMCID: PMC8368428 DOI: 10.1007/s40670-019-00716-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE This study compares data from two medical student cohorts early in their training from New Zealand and Hong Kong and then makes further comparisons with a non-medical group. METHODS Questionnaires obtained information regarding educational site (universities situated in New Zealand, Hong Kong, and USA), gender, age, motivational beliefs, quality of life, and competitiveness. The study was split into two phases. The first phase focused on measuring and comparing the learning and wellbeing variables of two medical student cohorts. The second phase focussed on making further comparisons with non-medical student groups. RESULTS Responses were elicited from 353 students in medically oriented courses and 688 students with a non-medical orientation. For phase 1, the results indicated differences between the two medical student groups on measures of self-efficacy, intrinsic value, enjoyment of competition, and physical quality of life. For phase 2, differences between the medical and non-medical student groups were noted for self-efficacy, intrinsic value, enjoyment of competition, contentiousness, and physical and social quality of life. CONCLUSIONS The results provide insights into medical and non-medical students' learning and wellbeing experiences from multi-national, multi-discipline perspectives. The results suggest that wellbeing issues of students are likely context-specific and moderated by region, curriculum, gender, and culture.
Collapse
Affiliation(s)
- Marcus A. Henning
- Centre for Medical and Health Sciences Education, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| | - Julie Chen
- Department of Family Medicine and Primary Care and Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Christian U. Krägeloh
- Department of Psychology, AUT University, Private Bag 92006, Auckland, 1142 New Zealand
| | - Erin M. Hill
- Department of Psychology, West Chester University, West Chester, PA 19383 USA
| | - Roger Booth
- Molecular Medicine & Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, 1142 New Zealand
| | - Craig Webster
- Centre for Medical and Health Sciences Education, University of Auckland, Private Bag 92019, Auckland, 1142 New Zealand
| |
Collapse
|
127
|
Al-Hashemi T, Al-Huseini S, Al-Alawi M, Al-Balushi N, Al-Senawi H, Al-Balushi M, Jose S, Al-Adawi S. Burnout Syndrome Among Primary Care Physicians in Oman. Oman Med J 2019; 34:205-211. [PMID: 31110627 PMCID: PMC6505344 DOI: 10.5001/omj.2019.40] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Objectives Medical professionals are exposed to many job stressors everyday, which can lead to psychological disturbances as well as burnout syndrome. We sought to assess the level of burnout among primary care physicians (PCPs) in Oman and explore risk factors for its development. Methods We conducted a cross-sectional, analytical study among a random cluster sample of 190 PCP working in Muscat, Oman. Indices of burnout (emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA)) were noted using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). We also used a questionnaire to obtain sociodemographic and job characteristics data. We used a binary logistic regression model and both unadjusted and adjusted odds ratios for statistical analysis. Results The prevalence of burnout in all three dimensions was 6.3%. High levels of MBI-HSS subscales were reported on EE, DP and PA with 17.8%, 38.2%, and 21.5%, respectively. Logistic regression analysis revealed that working over 40 hours per week was the most important risk factor for burnout among PCPs. Conclusions A total of 6.3% of PCPs working in urban areas in Oman suffered burnout. Long working hours was strongly associated with high occupational burnout. Solutions to eliminate or decrease the rate of burnout involve institutional changes, primarily respecting weekly working hours, and in more severe cases psychotherapy help is very important.
Collapse
Affiliation(s)
- Tharaya Al-Hashemi
- Department of General Adult Psychiatry, Al Massarah Hospital, Muscat, Oman
| | - Salim Al-Huseini
- Psychiatry Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | - Mohammed Al-Alawi
- Psychiatry Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | - Naser Al-Balushi
- Psychiatry Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | - Hamed Al-Senawi
- Department of Behavioral Medicine, Sultan Qaboos University, Muscat, Oman
| | - Manal Al-Balushi
- Psychiatry Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | - Sachin Jose
- Studies and Research Section, Oman Medical Specialty Board, Muscat, Oman
| | - Samir Al-Adawi
- Department of Behavioral Medicine, Sultan Qaboos University, Muscat, Oman
| |
Collapse
|
128
|
Lannin DG, Tucker JR, Streyffeler L, Harder S, Ripley B, Vogel DL. How Medical Students' Compassionate Values Influence Help-Seeking Barriers. TEACHING AND LEARNING IN MEDICINE 2019; 31:170-177. [PMID: 30614278 DOI: 10.1080/10401334.2018.1522259] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
THEORY Despite high rates of psychiatric illnesses, medical students and medical professionals often avoid psychological help. Stigma may prevent medical students from seeking psychological help when experiencing distress, which may hinder their job performance and mental health. Compassionate values-preferred principles that guide attitudes and behaviors to focus on the wellness of others-may be a relevant predictor of medical students' perceptions of psychological help. The present study examined the association between medical students' compassionate values, help-seeking stigma, and help-seeking attitudes in a convenience sample of medical students. HYPOTHESES Rating compassionate values as more important than self-interested values will be associated with less stigma, which in turn will be associated with more positive help-seeking attitudes. METHOD There were 220 medical students in their 2nd year of medical training who were recruited in-class and through e-mail between January and March of 2017 at Des Moines University. Students were provided an anonymous online link to a survey composed of validated measures assessing values, psychological distress, and stigma and attitudes related to psychological help. RESULTS The survey response rate was 41%, leaving a final sample of 91. For every 1 SD increase in the relative importance of compassionate values over self-interested values, help-seeking stigma decreased 0.40 SDs, and help-seeking attitudes increased 0.23 SDs. CONCLUSIONS Prioritizing compassionate values more strongly than self-interested values is associated with medical students' perceiving psychological help-seeking more positively.
Collapse
Affiliation(s)
- Daniel G Lannin
- a Department of Psychology , Illinois State University , Normal , Illinois , USA
| | - Jeritt R Tucker
- b Department of Behavioral Medicine, Medical Humanities and Bioethics , Des Moines University , Des Moines , Iowa , USA
| | - Lisa Streyffeler
- b Department of Behavioral Medicine, Medical Humanities and Bioethics , Des Moines University , Des Moines , Iowa , USA
| | - Steven Harder
- c Department of Family Medicine , Des Moines University , Des Moines , Iowa , USA
| | - Bret Ripley
- c Department of Family Medicine , Des Moines University , Des Moines , Iowa , USA
| | - David L Vogel
- d Department of Psychology , Iowa State University , Ames , Iowa , USA
| |
Collapse
|
129
|
Mental health and quality of life of Brazilian medical students: Incidence, prevalence, and associated factors within two years of follow-up. Psychiatry Res 2019; 274:306-312. [PMID: 30831455 DOI: 10.1016/j.psychres.2019.02.041] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 01/27/2019] [Accepted: 02/17/2019] [Indexed: 11/23/2022]
Abstract
Medical students' mental health and quality of life (QoL) cause growing concern worldwide, but, to date, few longitudinal studies have followed these students. Our objective was to evaluate the incidence, prevalence, and factors associated with quality of life and symptoms of depression, anxiety, and stress of Brazilian medical students who were followed for a period of two years. Students' mental health (DASS-21), QoL (WHOQOL-Bref), and religiousness (DUREL) were evaluated in four different waves(four semesters). A total of 312 (54.2%) medical students responded to all four waves. Medical students demonstrated a high prevalence and incidence of emotional disorders. Almost half of the students presented high levels of depression, anxiety, and stress during the two-year follow-up; approximately one out of five students without symptoms at the baseline were considered new cases and these problems have a cyclical nature. Baseline factors such as depression, anxiety, stress, having low income, being female, being in the early stages of medical training and non-white were associated with poorer mental health and quality of life in the follow-up. Our results show that medical students have a high prevalence and incidence of mental health disorders during their medical training. This data may help educators plan preventive strategies.
Collapse
|
130
|
Milam LA, Cohen GL, Mueller C, Salles A. The Relationship Between Self-Efficacy and Well-Being Among Surgical Residents. JOURNAL OF SURGICAL EDUCATION 2019; 76:321-328. [PMID: 30245061 PMCID: PMC6380924 DOI: 10.1016/j.jsurg.2018.07.028] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/11/2018] [Accepted: 07/30/2018] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Residency is a challenging time in the lives of physicians. In this study, we examined the relationship between general self-efficacy, defined as the belief in one's own capabilities in a variety of situations, and burnout and psychological well-being in a sample of surgical residents. DESIGN In the context of a larger study, a cross-sectional survey was administered to residents. The survey included measures of general self-efficacy, the emotional exhaustion and personal accomplishment domains of burnout, and general psychological well-being. We examined correlations between self-efficacy and these well-being outcomes and used multivariable linear regression models that controlled for age, gender, postgraduate year, ethnicity, and the interaction between gender and self-efficacy. SETTING We surveyed residents at Stanford Health Care, a tertiary care center, between the fall of 2010 and the spring of 2013. PARTICIPANTS One hundred and seventy nine residents from 9 surgical subspecialties responded to the survey for a response rate of 76%. RESULTS Residents reported high levels of self-efficacy, and over a third reported high emotional exhaustion. Eighty-nine percent of residents had average or high personal accomplishment. In adjusted regression analyses, general self-efficacy was negatively predictive of emotional exhaustion (B = -0.43, p = 0.0127) and positively predictive of personal accomplishment (B = 0.33, p = 0.0185) and general psychological well-being (B = 0.34, p = 0.0010). There was no interaction between gender and general self-efficacy in regression analyses (ps ≥ 0.6776). CONCLUSIONS Among other factors, self-efficacy appears to be significantly predictive of resident well-being. High self-efficacy suggests that residents feel prepared and capable. Interventions to improve residents' general self-efficacy should be explored as a possible mechanism to improve well-being.
Collapse
Affiliation(s)
- Laurel A Milam
- Washington University in St. Louis, Department of Surgery, St. Louis, Missouri
| | - Geoffrey L Cohen
- Stanford University, Department of Psychology, Stanford, California
| | | | | |
Collapse
|
131
|
Erschens R, Keifenheim KE, Herrmann-Werner A, Loda T, Schwille-Kiuntke J, Bugaj TJ, Nikendei C, Huhn D, Zipfel S, Junne F. Professional burnout among medical students: Systematic literature review and meta-analysis. MEDICAL TEACHER 2019; 41:172-183. [PMID: 29656675 DOI: 10.1080/0142159x.2018.1457213] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND This systematic review and meta-analysis aim to summarize the available evidence on the prevalence of professional burnout among medical students. METHODS The review was performed according to the PRISMA guidelines. Databases were systematically searched for peer-reviewed articles, reporting burnout among medical students published between 2000 and 2017. The meta-analysis was conducted on the available data on burnout rates in medical students measured with the Maslach Burnout Inventory (MBI-HSS). RESULTS Fifty-eight out of 3006 studies were found eligible for inclusion. Twelve of these studies met the criteria for meta-analysis. Weighted mean values for the three sub-dimensions of the MBI-HSS were M = 22.93 (SD = 10.25) for Emotional Exhaustion, M = 8.88 (SD = 5.64) for Depersonalization, and M = 35.11 (SD = 8.03) for Personal Accomplishment. Prevalence rates for professional burnout ranged from 7.0% to 75.2%, depending on country-specific factors, applied instruments, cutoff-criteria for burnout symptomatology. CONCLUSION This review underlines the burden of burnout among medical students. Future research should explicitly focus on specific context factors and student group under investigation. Such efforts are necessary to control for context-dependent confounders in research on medical students' mental health impairment to enable more meaningful comparisons and adequate prevention strategies.
Collapse
Affiliation(s)
- Rebecca Erschens
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Katharina Eva Keifenheim
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Anne Herrmann-Werner
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Teresa Loda
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Juliane Schwille-Kiuntke
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| | - Till Johannes Bugaj
- b Department of General Internal Medicine and Psychosomatics , University Medical Hospital Heidelberg , Heidelberg , Germany
| | - Christoph Nikendei
- b Department of General Internal Medicine and Psychosomatics , University Medical Hospital Heidelberg , Heidelberg , Germany
| | - Daniel Huhn
- b Department of General Internal Medicine and Psychosomatics , University Medical Hospital Heidelberg , Heidelberg , Germany
| | - Stephan Zipfel
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
- c Deanery of Students' Affairs , University's Faculty of Medicine , Tuebingen , Germany
| | - Florian Junne
- a Department of Psychosomatic Medicine and Psychotherapy , University Hospital Tuebingen , Tuebingen , Germany
| |
Collapse
|
132
|
Adam S, Mohos A, Kalabay L, Torzsa P. Potential correlates of burnout among general practitioners and residents in Hungary: the significant role of gender, age, dependant care and experience. BMC FAMILY PRACTICE 2018; 19:193. [PMID: 30541461 PMCID: PMC6290496 DOI: 10.1186/s12875-018-0886-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/29/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Burnout is increasingly prevalent among general practitioners (GPs) in Hungary, which may lead to functional impairment and, subsequently, to poor quality of patient care. However, little is known about potential predictors of burnout among GPs. The aim of this study was to explore psychosocial correlates of burnout among GPs and residents in Hungary. METHODS We collected socio-demographic and work-related data with self-administered questionnaires in a cross-sectional study among GPs (N = 196) and residents (N = 154). We assessed burnout with the Maslach Burnout Inventory Human Services Survey (MBI-HSS) and calculated the mean level of burnout and the proportion of physicians suffering from low, intermediate and high degree of burnout. To identify potential socio-demographic and work-related correlates of burnout among physicians, we determined Spearman's and Mann-Whitney U correlation coefficients and conducted stepwise linear regression analyses. We deployed Mann-Whitney U test to explore gender disparity in the level of burnout between female and male physicians and between general practitioners and residents. RESULTS The prevalence of moderate to high level emotional exhaustion, depersonalisation, and impaired personal accomplishment was 34.7, 33.5 and 67.8% as well as 41.0, 43.1, and 71.1% among GPs and residents, respectively. Residents reported significantly lower level of personal accomplishment vs GPs. We identified a significantly higher level of depersonalization among male physicians compared to female physicians. Age correlated negatively with emotional exhaustion and depersonalization and positively with personal accomplishment among GPs. Dependant care was positively associated with burnout among female GPs. Female residents were more likely to report depersonalization. High workload was positively correlated with depersonalization among female GPs. Younger age emerged as the strongest predictor of emotional exhaustion. Male gender and fewer years of experience predicted depersonalization best, and male gender showed a significant predictive relationship with low personal accomplishment. CONCLUSION We identified specific socio-demographic and work-related correlates of burnout, which may guide the development of specific and effective organizational decisions to attenuate occupational stress and subsequent burnout as well as functional impairment among GPs, and thus, may improve the quality of patient care.
Collapse
Affiliation(s)
- Szilvia Adam
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Andras Mohos
- Department of Family Medicine, Faculty of Medicine ,University of Szeged, Szeged, Hungary
| | - Laszlo Kalabay
- Department of Family Medicine, Medical Faculty, Semmelweis University, Budapest, Hungary
| | - Peter Torzsa
- Department of Family Medicine, Medical Faculty, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
133
|
Huhn D, Schmid C, Erschens R, Junne F, Herrmann-Werner A, Möltner A, Herzog W, Nikendei C. A Comparison of Stress Perception in International and Local First Semester Medical Students Using Psychometric, Psychophysiological, and Humoral Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2820. [PMID: 30544950 PMCID: PMC6313433 DOI: 10.3390/ijerph15122820] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 12/27/2022]
Abstract
(1) Medical doctors and medical students show increased psychological stress levels. International medical students seem to be particularly vulnerable. (2) We compared different methods of assessing stress levels in international and local first year medical students. First, study participants completed questionnaires related to stress, depression, empathy, and self-efficacy (MBI, PSQ, PHQ-9, JSPE-S, and GSE) at three separate points in time (T1 to T3). Second, their heart rate variabilities (HRVs) were recorded in an oral examination, a seminar, and in a relaxing situation. Third, hair samples were collected at the beginning and at the end of the semester to assess the cortisol concentration. (3) Included were 20 international and 20 local first semester medical students. At T1, we found considerable differences between international and local students in the JSPE-S; at T2 in the MBI factor "professional efficacy", the PHQ-9, and in the JSPE-S; and at T3 in the MBI factors "cynicism" and "professional efficacy", the PHQ-9, and in the JSPE-S. International and local students also differed concerning their HRVs during relaxation. Over the course of the semester, international students showed changes in the MBI factors "emotional exhaustion" and "professional efficacy", the PHQ-9, and the GSE. Local students showed changes in the GSE. No effects were found for students' hair cortisol concentrations. (4) All participants showed low levels of stress. However, while international students experienced their stress levels to decrease over the course of the semester, local students found their stress levels to increase.
Collapse
Affiliation(s)
- Daniel Huhn
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, 69115 Heidelberg, Germany.
| | - Carolin Schmid
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, 69115 Heidelberg, Germany.
| | - Rebecca Erschens
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tubingen, Eberhard-Karls-University Tubingen, 72076 Tubingen, Germany.
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tubingen, Eberhard-Karls-University Tubingen, 72076 Tubingen, Germany.
| | - Anne Herrmann-Werner
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tubingen, Eberhard-Karls-University Tubingen, 72076 Tubingen, Germany.
| | - Andreas Möltner
- Competence Centre for Examinations in Medicine, Baden-Württemberg, 69120 Heidelberg, Germany.
| | - Wolfgang Herzog
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, 69115 Heidelberg, Germany.
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, 69115 Heidelberg, Germany.
| |
Collapse
|
134
|
Hill MR, Goicochea S, Merlo LJ. In their own words: stressors facing medical students in the millennial generation. MEDICAL EDUCATION ONLINE 2018; 23:1530558. [PMID: 30286698 PMCID: PMC6179084 DOI: 10.1080/10872981.2018.1530558] [Citation(s) in RCA: 204] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 09/05/2018] [Accepted: 09/21/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND Medical student exposure to stressors is associated with depression, burnout, somatic distress, decreases in empathy, serious thoughts about dropping out of medical school, suicidal ideation, and poor academic performance. Despite this, there have been no recent, multicenter, qualitative studies assessing medical students' perceptions of their greatest stressor(s). OBJECTIVE The goal of this study was to identify the most significant stressors noted by medical students themselves, in order to inform the development of programs and policies to reduce medical student distress. DESIGN Medical students from the nine schools in the state of Florida were invited to complete an anonymous online questionnaire assessing wellness and distress. Students were notified that all responses were voluntary and that individual responses would not be linked to themselves or their program. This paper focuses on students' responses to fixed-response items regarding their experience of stress and open-ended responses to the following question: 'What do you consider to be the greatest stressor(s) facing medical students?' Qualitative data were analyzed using the Grounded Theory method of data analysis. RESULTS Results confirmed the impact of several stressors highlighted in previous studies (e.g., excessive workload, difficulties with studying and time management, conflicts in work-life balance and relationships, medical school peer relations, health concerns, and financial stressors). However, students also reported unique system-level concerns that have not consistently been highlighted in past research (e.g., medical school administrative failures, concerns about lack of assistance with career planning, and assessment-related performance pressure. CONCLUSIONS Though individually focused interventions have demonstrated some success, medical students self-report stressors that may be better addressed through system-level changes.
Collapse
Affiliation(s)
- Monica R. Hill
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Shelby Goicochea
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Lisa J. Merlo
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
- CONTACT Lisa J. Merlo McKnight Brain Institute,Gainesville, FL 32610
| |
Collapse
|
135
|
Portoghese I, Leiter MP, Maslach C, Galletta M, Porru F, D’Aloja E, Finco G, Campagna M. Measuring Burnout Among University Students: Factorial Validity, Invariance, and Latent Profiles of the Italian Version of the Maslach Burnout Inventory Student Survey (MBI-SS). Front Psychol 2018; 9:2105. [PMID: 30483171 PMCID: PMC6240654 DOI: 10.3389/fpsyg.2018.02105] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/12/2018] [Indexed: 11/13/2022] Open
Abstract
Burnout has a long tradition of studies in the workplace and recently researchers suggested burnout is also rising among university students. The Maslach Burnout Inventory (MBI) is considered a valid measure of burnout. However, the student version of the MBI (MBI-SS) has received limited empirical support. The aim of this paper is to analyze the factorial validity, invariance, and latent profiles of the Italian version of the MBI-SS in a sample university students. A total of 7757 Italian university students participated in an online cross-sectional survey. Results from explorative and confirmatory factor analyses showed acceptable fits for the Italian version of the MBI-SS. In addition, multigroup analyses supported full-metric invariance of MBI-SS within gender and academic level (bachelor vs. master). Finally, results from latent profile analysis showed that a three latent profile model was the better solution for the data: (a) burned-out (high levels of exhaustion, cynicism (CY), and low professional efficacy (PE); n = 2665, 34.2%); (b) overextended (high levels of exhaustion, moderate other, n = 3953, 51.0%); and (c) engaged (moderate exhaustion, low CY, and high PE, n = 1149, 14.8%). The resulting three-profile solution in the present study partially agrees with a prior study as it replicated three of the five-profile solution identified. In sum, we suggest that the MBI-SS is valid and reliable and represents a robust instrument for the measurement of burnout among Italian speaking university students.
Collapse
Affiliation(s)
- Igor Portoghese
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italy
| | | | - Christina Maslach
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Maura Galletta
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italy
| | - Fabio Porru
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ernesto D’Aloja
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italy
| | - Gabriele Finco
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italy
| | - Marcello Campagna
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università degli Studi di Cagliari, Cagliari, Italy
| |
Collapse
|
136
|
Attenello FJ, Buchanan IA, Wen T, Donoho DA, McCartney S, Cen SY, Khalessi AA, Cohen-Gadol AA, Cheng JS, Mack WJ, Schirmer CM, Swartz KR, Prall JA, Stroink AR, Giannotta SL, Klimo P. Factors associated with burnout among US neurosurgery residents: a nationwide survey. J Neurosurg 2018; 129:1349-1363. [PMID: 29424650 DOI: 10.3171/2017.9.jns17996] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 09/25/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVEExcessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, burnout has garnered much attention in recent years. Using a national survey, the authors formally evaluated burnout among neurosurgery trainees.METHODSAn 86-item questionnaire was disseminated to residents in the American Association of Neurological Surgeons database between June and November 2015. Questions evaluated personal and workplace stressors, mentorship, career satisfaction, and burnout. Burnout was assessed using the previously validated Maslach Burnout Inventory. Factors associated with burnout were determined using univariate and multivariate logistic regression.RESULTSThe response rate with completed surveys was 21% (346/1643). The majority of residents were male (78%), 26-35 years old (92%), in a stable relationship (70%), and without children (73%). Respondents were equally distributed across all residency years. Eighty-one percent of residents were satisfied with their career choice, although 41% had at some point given serious thought to quitting. The overall burnout rate was 67%. In the multivariate analysis, notable factors associated with burnout included inadequate operating room exposure (OR 7.57, p = 0.011), hostile faculty (OR 4.07, p = 0.008), and social stressors outside of work (OR 4.52, p = 0.008). Meaningful mentorship was protective against burnout in the multivariate regression models (OR 0.338, p = 0.031).CONCLUSIONSRates of burnout and career satisfaction are paradoxically high among neurosurgery trainees. While several factors were predictive of burnout, including inadequate operative exposure and social stressors, meaningful mentorship proved to be protective against burnout. The documented negative effects of burnout on patient care and health care economics necessitate further studies for potential solutions to curb its rise.
Collapse
Affiliation(s)
- Frank J Attenello
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Ian A Buchanan
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Timothy Wen
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Daniel A Donoho
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Shirley McCartney
- 2Department of Neurosurgery, Oregon Health & Science University, Portland, Oregon
| | - Steven Y Cen
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | | | - Aaron A Cohen-Gadol
- 4Goodman Campbell Brain and Spine, Department of Neurosurgery, Indiana University, Indianapolis, Indiana
| | - Joseph S Cheng
- 5Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - William J Mack
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | | | - Karin R Swartz
- 7Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - J Adair Prall
- 8Department of Neurosurgery, Littleton Adventist Hospital, Littleton, Colorado
| | - Ann R Stroink
- 9Central Illinois Neuro Health Science, Bloomington, Illinois; and
| | - Steven L Giannotta
- 1Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Paul Klimo
- 10Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee
| |
Collapse
|
137
|
Jenkins TM, Kim J, Hu C, Hickernell JC, Watanaskul S, Yoon JD. Stressing the journey: using life stories to study medical student wellbeing. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:767-782. [PMID: 29730708 DOI: 10.1007/s10459-018-9827-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 05/01/2018] [Indexed: 05/27/2023]
Abstract
While previous studies have considered medical student burnout and resilience at discrete points in students' training, few studies examine how stressors and resilience-building factors can emerge before, and during, medical school. Our study focuses on students' life stories to comprehensively identify factors contributing to student wellbeing. We performed a secondary analysis of life-story interviews with graduating fourth year medical students. These interviews were originally conducted in 2012 as part of the Project on the Good Physician, and then re-analyzed, focusing on student wellbeing. Respondents were encouraged to identify turning points in their life stories. De-identified transcripts were then coded using a consensus-based iterative process. 17 of 21 respondents reported feeling burned out at least once during medical school. Students identified three major stressors: negative role models, difficult rotations, and the United States Medical Licensing Examination Step 1. Two "motivational stressors"-financial concerns and personal life events-emerged as sources of stress that also motivated students to persevere. Finally, students identified four factors-positive role models, support networks, faith and spirituality, and passion-that helped them reframe stressors, making the struggle seem more worthwhile. These findings suggest that a life-story approach can add granularity to current understandings of medical student wellbeing. Initiatives to reduce stress and burnout should extend beyond the immediate medical school context and consider how past challenges might become future sources of resilience. This study also provides an example of secondary analysis of qualitative data, an approach which could be useful to future research in medical education.
Collapse
Affiliation(s)
- Tania M Jenkins
- Department of Sociology, Temple University, Room 713 Gladfelter Hall, 1115 Polett Walk, Philadelphia, PA, 19122, USA.
| | - Jenny Kim
- Department of Biological Sciences, University of Chicago, Chicago, IL, USA
| | - Chelsea Hu
- Department of Economics, University of Chicago, Chicago, IL, USA
- Department of Political Science, University of Chicago, Chicago, IL, USA
| | | | - Sarah Watanaskul
- The MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, IL, USA
| | - John D Yoon
- Department of Medicine, MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, IL, USA
| |
Collapse
|
138
|
Abstract
Objectives: To study burnout among pediatric residents at King Abdulazaiz University Hospital in Jeddah, Saudi Arabia. Methods: This is a cross-sectional survey that was administered to all pediatric residents enrolled in the Saudi Paediatric Board program (PGY1-PGY4) in a large tertiary academic hospital in the Western region of Saudi Arabia (King Abdulaziz University Hospital). The survey were sent via E-mail to 50 registered general pediatric residents. Results: Seventy percent of the pediatric residents completed the survey. More than 70% of residents experiencing severe burnout. Forty-three percent suffering emotional exhaustion, 71.8% experiencing depersonalization and 40.6% suffering from low accomplishment. Conclusion: Burnout syndrome appear to be a serious threat to resident well-being in our program. Moreover, pediatric residents in our institute experienced higher levels of depersonalization than their peers nationally and internationally.
Collapse
Affiliation(s)
- Roaa S Jamjoom
- Paediatric Emergency, King Abdulaziz University Jeddah, Kingdom of Saudi Arabia. E-mail.
| | | |
Collapse
|
139
|
Ahmad W, Ashraf H, Talat A, Khan AA, Baig AA, Zia I, Sarfraz Z, Sajid H, Tahir M, Sadiq U, Imtiaz H. Association of burnout with doctor-patient relationship and common stressors among postgraduate trainees and house officers in Lahore-a cross-sectional study. PeerJ 2018; 6:e5519. [PMID: 30221087 PMCID: PMC6136394 DOI: 10.7717/peerj.5519] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 08/06/2018] [Indexed: 12/19/2022] Open
Abstract
Introduction Burnout is defined as a prolonged state of physical and psychological exhaustion. Doctors, due to the demanding nature of their job, are susceptible to facing burnout, which has far reaching implications on their productivity and motivation. It affects the quality of care they provide to patients, thus eroding the doctor-patient relationship which embodies patient centeredness and autonomy. The study aims at addressing the stressors leading to burnout and its effect on the doctor-patient relationship. Methods A descriptive, cross-sectional study design with convenience (non-probability) sampling technique was employed in six major hospitals of Lahore, Pakistan. A total of 600 doctors were approached for the study which included house officers or "HOs" (recent graduates doing their 1 year long internship) and post-graduate trainees or "PGRs" (residents for 4-5 years in their specialties). Burnout was measured using the Copenhagen Burnout Inventor (CBI) while attitudes towards the doctor-patient relationship was measured using the Patient Practitioner Orientation Scale (PPOS), which measures two components of the relationship: power sharing and patient caring. Pearson correlation and linear regression analysis were used to analyze the data via SPSS v.21. Results A total of 515 doctors consented to take part in the study (response rate 85.83%). The final sample consisted of 487 doctors. The burnout score was not associated with the total and caring domain scores of PPOS (P > 0.05). However, it was associated with the power sharing sub-scale of PPOS. Multiple linear regression analysis yielded a significant model, by virtue of which CBI scores were positively associated with factors such as female gender, feeling of burn out, scoring high on sharing domain of PPOS and a lack of personal control while CBI scores were negatively associated with private medical college education, having a significant other, accommodation away from home and a sense of never ending competition. Burnout levels varied significantly between house officers and post graduate trainees. Twenty-three percent of the participants (mostly house officers) had high/very high burnout levels on the CBI (Kristenson's burnout scoring). Both groups showed significant differences with respect to working hours, smoking status and income. Conclusion Although burnout showed no significant association with total and caring domain scores of PPOS (scale used to assess doctor-patient relationship), it showed a significant association with the power sharing domain of PPOS suggesting some impact on the overall delivery of patient care. Thus, it necessitates the monitoring of stressors in order to provide an atmosphere where patient autonomy can be practiced.
Collapse
Affiliation(s)
- Waqas Ahmad
- CMH Lahore Medical College, Lahore, Pakistan
| | - Huma Ashraf
- CMH Lahore Medical College, Lahore, Pakistan
| | - Afnan Talat
- CMH Lahore Medical College, Lahore, Pakistan
| | | | | | - Iqra Zia
- CMH Lahore Medical College, Lahore, Pakistan
| | | | - Hifsa Sajid
- CMH Lahore Medical College, Lahore, Pakistan
| | | | - Usman Sadiq
- CMH Lahore Medical College, Lahore, Pakistan
| | - Hira Imtiaz
- CMH Lahore Medical College, Lahore, Pakistan
| |
Collapse
|
140
|
Barbosa ML, Ferreira BLR, Vargas TN, Ney da Silva GM, Nardi AE, Machado S, Caixeta L. Burnout Prevalence and Associated Factors Among Brazilian Medical Students. Clin Pract Epidemiol Ment Health 2018; 14:188-195. [PMID: 30258484 PMCID: PMC6128019 DOI: 10.2174/1745017901814010188] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 06/22/2018] [Accepted: 07/24/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study aims to identify the prevalence of burnout and associated factors in Brazilian medical students. METHODS In the largest medical school from Central Brazil, the Maslach Burnout Inventory-Student Survey and a socio-demographic questionnaire were adopted in this cross-sectional study. Correlations among the three dimensions of burnout were verified. RESULTS The evaluation of 399 students revealed a frequency of 12.0% of burnout. Women had a higher rate of burnout (8.0%) than men (4.0%). The fifth period had the higher frequency of burnout (27.1%), while the seventh grade had the lower frequency (2.1%). The students showed high scores only in emotional exhaustion (63.2%). Between the dimensions "emotional exhaustion" and "disbelief" found a significant correlation. CONCLUSION The fifth period of the Medicine course and the female gender are the most affected by burnout syndrome and therefore, the preventive actions to reduce stress among medical students should be directed mainly at these higher risk categories. The low burnout rate found in our study can attest that the PBL methodology and medical schools strategically located to meet regional demand may represent strategies for the prevention of burnout among medical students.
Collapse
Affiliation(s)
| | | | - Thaís Nunes Vargas
- Unit of Pedagogical Support - Unievangélica Faculty of Medicine, Anápolis, Brazil
| | | | - Antonio Egidio Nardi
- Laboratory of Panic and Respiration (LABPR), Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Sergio Machado
- Laboratory of Panic and Respiration (LABPR), Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Laboratory of Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University, Niterói, Brazil
| | - Leonardo Caixeta
- Laboratory of Panic and Respiration (LABPR), Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Associate Professor of Neurology, Internal Medicine Department, Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil
| |
Collapse
|
141
|
Kind N, Eckert A, Steinlin C, Fegert JM, Schmid M. Verbal and physical client aggression - A longitudinal analysis of professional caregivers' psychophysiological stress response and burnout. Psychoneuroendocrinology 2018; 94:11-16. [PMID: 29738960 DOI: 10.1016/j.psyneuen.2018.05.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/09/2018] [Accepted: 05/01/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We investigated the impact of verbal and physical client aggression on risk of developing high hair cortisol concentration (HCC) as an indicator of chronic stress exposure and burnout in a Swiss population of professional caregivers working in youth residential care. METHOD Participants (n = 121; 62.0% women) reported on client aggression and burnout symptoms and provided hair samples at four annual sampling points. HCC was determined in the first 1.5 cm hair segment. Sociodemographic variables, private stressors, burnout symptoms, and HCC were compared between participants reporting either 'no aggression', 'verbal' aggression, or 'verbal + physical' aggression. Cox proportional hazards regressions were calculated to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association between client aggression and risk of high HCC or burnout over the course of three years. RESULTS Professional caregivers reporting 'verbal + physical' aggression had higher HCC, more cognitive burnout symptoms, and greater burden in interpersonal domains. Both 'verbal' and 'verbal + physical' aggression were positively associated with burnout risk (verbal: HR = 1.83; 95% CI = 1.27-2.65; verbal + physical: HR = 2.44, 95% CI = 1.56-3.84). 'Verbal + physical' aggression was positively associated with risk of high HCC (HR = 1.58; 95% CI = 1.07-2.36). CONCLUSIONS This longitudinal analysis suggested that psychophysiological stress response is primarily associated with combined verbal and physical aggression. The emotional wearing-down associated with verbal aggression should however not be disregarded. Our exploratory findings could have implications for youth welfare policy, clinical child psychiatry, and future research.
Collapse
Affiliation(s)
- Nina Kind
- Child and Adolescent Psychiatry, University Basel, Psychiatric University Hospital Basel, Schanzenstrasse 13, 4056, Basel, Switzerland.
| | - Anne Eckert
- Neurobiological Laboratory, Transfaculty Research Platform Molecular & Cognitive Neuroscience, University Basel, Psychiatric University Hospital Basel, Wilhelm Klein-Strasse 27, 4012, Basel, Switzerland
| | - Célia Steinlin
- Zurich University of Applied Sciences, Institute of Applied Psychology, Pfingstweidstrasse 96, 8005, Zurich, Switzerland
| | - Jörg M Fegert
- University Hospital Ulm, Department for Child and Adolescent Psychiatry and Psychotherapy, Steinhövelstrasse 5, 89075 Ulm, Germany
| | - Marc Schmid
- Child and Adolescent Psychiatry, University Basel, Psychiatric University Hospital Basel, Schanzenstrasse 13, 4056, Basel, Switzerland
| |
Collapse
|
142
|
Colby L, Mareka M, Pillay S, Sallie F, van Staden C, du Plessis ED, Joubert G. The association between the levels of burnout and quality of life among fourth-year medical students at the University of the Free State. S Afr J Psychiatr 2018; 24:1101. [PMID: 30263208 PMCID: PMC6138180 DOI: 10.4102/sajpsychiatry.v24i0.1101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/26/2018] [Indexed: 11/03/2022] Open
Abstract
Background Society invests huge financial resources in training medical students. However, the academic and personal demands placed on these students can be taxing and may be detrimental to students' quality of life leading to high levels of burnout and academic dropout rates. Aim To determine the association between the levels of burnout and quality of life among fourth-year medical students at the University of the Free State (UFS). Setting School of Medicine, UFS, Bloemfontein. Methods All fourth-year medical students in their first semester of the clinical phase were included. Data were collected using anonymous self-report measures. The Maslach Burnout Inventory (MBI) measured the levels of burnout according to three subscales (emotional exhaustion, depersonalisation and personal achievement), and the World Health Organization Quality of Life Assessment (WHOQOL-BREF) measured the quality of life. Results Of the 121 enrolled fourth-year medical students, 91 (75.2%) completed the questionnaires. The MBI personal achievement subscale had the highest number of participants (n = 53; 58.2%) with high levels of reported burnout. Significant associations were found between the psychological health subscale of the WHOQOL-BREF and all three subscales of the MBI, in particular emotional exhaustion. Conclusion An association exists between the levels of burnout and quality of life among fourth-year medical students. This information could be of value to medical schools as they are in a position to implement interventions that promote students' well-being.
Collapse
Affiliation(s)
- Lauren Colby
- School of Medicine, University of the Free State, South Africa
| | - Moliehi Mareka
- School of Medicine, University of the Free State, South Africa
| | - She'neze Pillay
- School of Medicine, University of the Free State, South Africa
| | - Fatima Sallie
- School of Medicine, University of the Free State, South Africa
| | | | | | - Gina Joubert
- Department of Biostatistics (G31), University of the Free State, South Africa
| |
Collapse
|
143
|
Wiederhold BK, Cipresso P, Pizzioli D, Wiederhold M, Riva G. Intervention for Physician Burnout: A Systematic Review. Open Med (Wars) 2018; 13:253-263. [PMID: 29992189 PMCID: PMC6034099 DOI: 10.1515/med-2018-0039] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 05/15/2018] [Indexed: 11/16/2022] Open
Abstract
Burnout is an important problem for physicians, with a strong impact on their quality of life and a corresponding decrease in the quality of care with an evident economical burden for the healthcare system. However, the range of interventions used to decrease this problem could be very fragmented and with the aim to shed some light on this issue, this study reviews and summarizes the currently available studies. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify studies about intervention on physician burnout. Two authors independently searched into scientific databases to analyze and review the full papers that met the inclusion criteria. As a result, from an initial search of 11029 articles, 13 studies met full criteria and were included in this review. Of the 13 studies presented, only 4 utilized randomized controlled trials, therefore the results should be interpreted with caution. Future interventions should focus on a more holistic approach using a wider range of techniques. According to the studies selected in this review, it appears that a successful intervention for burnout should take into account the broad range of causes incorporating a variety of therapeutic tools.
Collapse
Affiliation(s)
- Brenda K Wiederhold
- Virtual Reality Medical Institute, Brussels, Belgium
- Virtual Reality Medical Center, San Diego, California, USA
- Tel. +1 858 642 0267 (office telephone)
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab., Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | | | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab., Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| |
Collapse
|
144
|
Abstract
Physician burnout, a work-related syndrome involving emotional exhaustion, depersonalization and a sense of reduced personal accomplishment, is prevalent internationally. Rates of burnout symptoms that have been associated with adverse effects on patients, the healthcare workforce, costs and physician health exceed 50% in studies of both physicians-in-training and practicing physicians. This problem represents a public health crisis with negative impacts on individual physicians, patients and healthcare organizations and systems. Drivers of this epidemic are largely rooted within healthcare organizations and systems and include excessive workloads, inefficient work processes, clerical burdens, work-home conflicts, lack of input or control for physicians with respect to issues affecting their work lives, organizational support structures and leadership culture. Individual physician-level factors also play a role, with higher rates of burnout commonly reported in female and younger physicians. Effective solutions align with these drivers. For example, organizational efforts such as locally developed practice modifications and increased support for clinical work have demonstrated benefits in reducing burnout. Individually focused solutions such as mindfulness-based stress reduction and small-group programmes to promote community, connectedness and meaning have also been shown to be effective. Regardless of the specific approach taken, the problem of physician burnout is best addressed when viewed as a shared responsibility of both healthcare systems and individual physicians. Although our understanding of physician burnout has advanced considerably in recent years, many gaps in our knowledge remain. Longitudinal studies of burnout's effects and the impact of interventions on both burnout and its effects are needed, as are studies of effective solutions implemented in combination. For medicine to fulfil its mission for patients and for public health, all stakeholders in healthcare delivery must work together to develop and implement effective remedies for physician burnout.
Collapse
Affiliation(s)
- C P West
- Department of Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - L N Dyrbye
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - T D Shanafelt
- Department of Medicine, Stanford University Medical Center, Stanford, CA, USA
| |
Collapse
|
145
|
Gauche C, de Beer LT, Brink L. Exploring demands from the perspective of employees identified as being at risk of burnout. Int J Qual Stud Health Well-being 2018; 12:1361783. [PMID: 28784048 PMCID: PMC5590620 DOI: 10.1080/17482631.2017.1361783] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Purpose: Burnout has become an occupational health concern. However, little is known about the experiences of individuals identified as being at risk of burnout. This study aimed to address this gap by exploring employees’ experiences of well-being who were identified as burnout risks. Method: Interviews were conducted with 26 employees who agreed to participate in the study. A phenomenological approach was taken, with a case study design as the research strategy. Results: Three major themes were identified: job demands, life demands, and health concerns. It was evident that participants were experiencing demanding conditions in both their work and personal lives, indicating burnout to be a multi-domain phenomenon. Conclusions: Professionals and managers should take note of these results to assist and support employees who are identified as being at risk of burnout.
Collapse
Affiliation(s)
- Cecile Gauche
- a WorkWell Research Unit , North-West University , Potchefstroom , South Africa
| | - Leon T de Beer
- a WorkWell Research Unit , North-West University , Potchefstroom , South Africa
| | - Lizelle Brink
- a WorkWell Research Unit , North-West University , Potchefstroom , South Africa
| |
Collapse
|
146
|
Talih F, Daher M, Daou D, Ajaltouni J. Examining Burnout, Depression, and Attitudes Regarding Drug Use Among Lebanese Medical Students During the 4 Years of Medical School. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2018; 42:288-296. [PMID: 29396837 DOI: 10.1007/s40596-017-0879-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 12/22/2017] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study aims to evaluate the prevalence of burnout, depressive symptoms, and anxiety symptoms and attitudes toward substance use in medical students as well as their evolution during the 4 years of medical school. METHODS A cross-sectional study was carried out at the American University of Beirut Medical Center (AUBMC) between September and December 2016. In total, 176 out of 412 eligible medical students responded. The survey was anonymous and administered via e-mail link to an electronic form. The study included general socio-demographic questions and standardized validated tools to measure depressive symptomatology (PHQ-9), burnout (Burnout Measure), anxiety (GAD-7), alcohol use (AUDIT), and substance abuse (DAST-10) as well as questions pertaining to attitudes toward recreational substance use. RESULTS Overall, 23.8% of medical students reported depressive symptomatology, with 14.5% having suicidal ideations. Forty-three percent were found to have burnout. Those who screened positive for burnout were more likely to be males, to be living away from their parents, and to have experienced a stressful life event during the last year. With the exception of burnout, there was no significant difference in the prevalence of depression or anxiety among the 4 years of medical school. There was a significant difference in alcohol use, illicit substance use, and marijuana use during the four medical school years. CONCLUSIONS The results of this study show high rates of depression, burnout, and suicidal ideation among medical students from the Middle East region. Increased rates of substance use were detected as well as a more tolerant attitude toward substance use in general, specifically cannabis. It is crucial that medical educators and policymakers keep tackling the complex multifactorial mental health issues affecting medical students and design effective solutions and support systems.
Collapse
Affiliation(s)
- Farid Talih
- American University of Beirut Medical Center, Beirut, Lebanon.
| | - Michel Daher
- American University of Beirut Medical Center, Beirut, Lebanon
| | - Dayane Daou
- American University of Beirut, Beirut, Lebanon
| | - Jean Ajaltouni
- American University of Beirut Medical Center, Beirut, Lebanon
| |
Collapse
|
147
|
Liu H, Yansane AI, Zhang Y, Fu H, Hong N, Kalenderian E. Burnout and study engagement among medical students at Sun Yat-sen University, China: A cross-sectional study. Medicine (Baltimore) 2018; 97:e0326. [PMID: 29642167 PMCID: PMC5908607 DOI: 10.1097/md.0000000000010326] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study aims to investigate burnout and study engagement among medical students at Sun Yat-sen University, China.A cross-sectional survey was conducted among undergraduate medical students of Sun Yat-sen University, China. A total of 453 undergraduate students completed a self-administered, structured questionnaire between January and February, 2016. Burnout and study engagement were measured using the Maslach Burnout Inventory-Student Survey (MBI-SS) and the UTRECHT Work Engagement Scale-Students (UWES-S), respectively. Subjects who scored high in emotional exhaustion subscale, high in cynicism subscale, and low in professional efficacy subscale simultaneously were graded as having high risk of burnout. Independent sample t tests and chi-square tests were used to compare the differences in burnout and work engagement between genders, majors, and grade levels.The means (standard deviations) of the MBI-SS subscales were 3.42 (1.45) for emotional exhaustion, 2.34 (1.64) for cynicism, and 3.04 (1.30) for professional efficacy. The means (standard deviations) of the UWES-S subscales were 3.13 (1.49) for vigor, 3.44 (1.47) for dedication and 3.00 (1.51) for absorption. Approximately 1 in 11 students experienced a high risk of burnout. There were no statistically significant gender differences in burnout and study engagement. There were also no statistically significant differences in burnout and study engagement subscales according to student major. Students in higher grades displayed increased burnout risk, higher mean burnout subscale score of cynicism, lower mean burnout subscale score of professional efficacy, and decreased mean study engagement subscale scores of dedication and absorption. There were strong correlations within study engagement subscales.Chinese medical students in this university experience a high level of burnout. Students at higher-grade level experience more burnout and decreased study engagement compared with students in lower level.
Collapse
Affiliation(s)
- Hongchun Liu
- Department of Preventive Dentistry, Guanghua School of Stomatology, Hospital of Stomatology
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Alfa Ibrahim Yansane
- Department of Preventive & Restorative Dental Sciences, The University of California, San Francisco School of Dentistry, San Francisco, CA
| | | | | | - Nanrui Hong
- Department of Prosthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Elsbeth Kalenderian
- Department of Preventive & Restorative Dental Sciences, The University of California, San Francisco School of Dentistry, San Francisco, CA
| |
Collapse
|
148
|
Boni RADS, Paiva CE, de Oliveira MA, Lucchetti G, Fregnani JHTG, Paiva BSR. Burnout among medical students during the first years of undergraduate school: Prevalence and associated factors. PLoS One 2018. [PMID: 29513668 PMCID: PMC5841647 DOI: 10.1371/journal.pone.0191746] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective To evaluate the prevalence and possible factors associated with the development of burnout among medical students in the first years of undergraduate school. Method A cross-sectional study was conducted at the Barretos School of Health Sciences, Dr. Paulo Prata. A total of 330 students in the first four years of medical undergraduate school were invited to participate in responding to the sociodemographic and Maslach Burnout Inventory-Student Survey (MBI-SS) questionnaires. The first-year group consisted of 150 students, followed by the second-, third-, and fourth-year groups, with 60 students each. Results Data from 265 students who answered at least the sociodemographic questionnaire and the MBI-SS were analyzed (response rate = 80.3%). One (n = 1, 0.3%) potential participant viewed the Informed Consent Form but did not agree to participate in the study. A total of 187 students (187/265, 70.6%) presented high levels of emotional exhaustion, 140 (140/265, 52.8%) had high cynicism, and 129 (129/265, 48.7%) had low academic efficacy. The two-dimensional criterion indicated that 119 (44.9%) students experienced burnout. Based on the three-dimensional criterion, 70 students (26.4%) presented with burnout. The year with the highest frequency of affected students for both criteria was the first year (p = 0.001). Personal attributes were able to explain 11% (ΔR = 0.11) of the variability of burnout under the two-dimensional criterion and 14.4% (R2 = 0.144) under the three-dimensional criterion. Conclusion This study showed a high prevalence of burnout among medical students in a private school using active teaching methodologies. In the first years of graduation, students’ personal attributes (optimism and self-perception of health) and school attributes (motivation and routine of the exhaustive study) were associated with higher levels of burnout. These findings reinforce the need to establish preventive measures focused on the personal attributes of first-year students, providing better performance, motivation, optimism, and empathy in the subsequent stages of the course.
Collapse
Affiliation(s)
- Robson Aparecido dos Santos Boni
- Barretos School of Health Sciences, Dr. Paulo Prata, Barretos, São Paulo, Brazil
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Carlos Eduardo Paiva
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Teaching and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Department of Clinical Oncology – Breast and Gynecology Division, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Marco Antonio de Oliveira
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Giancarlo Lucchetti
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- School of Medicine, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - José Humberto Tavares Guerreiro Fregnani
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Teaching and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Bianca Sakamoto Ribeiro Paiva
- Research Group on Palliative Care and Health-Related Quality of Life (GPQual) –Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- Teaching and Research Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
- * E-mail:
| |
Collapse
|
149
|
Johnson JC, Degenhardt BF, Smith CK, Wolf TM, Peterson DF. Tool for Predicting Medical Student Burnout From Sustained Stress Levels: Factor Analysis of the Medical Education Hassles Scale-R. J Osteopath Med 2018; 118:170-180. [PMID: 29480917 DOI: 10.7556/jaoa.2018.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Context Acute stress during medical school affects the health of students and is associated with burnout. The Medical Education Hassles Scale-R (MEHS-R) is designed to measure acute stress among medical students. Researchers using the MEHS-R primarily report overall hassles scores, which are unable to discriminate between different categories of hassles encountered. Objective The present study examined the factor structure of the MEHS-R to identify subscales that would be useful to categorize hassles for research and assessment purposes. Design Longitudinal, observational study. Setting Two osteopathic medical schools. Participants Five hundred six first-year medical students. Main Outcome Measure The MEHS-R was administered at orientation and 9 to 10 times throughout the first year, classified into examination, vacation, and routine medical school activity periods. Students rated the 101 items on a 4-point scale (0=none to 3=a great deal) to indicate how much of a hassle each item had been during the previous week. Demographic subgroups were males, females, married students, single students, whites, and ethnic minorities. Results Exploratory factor analysis was conducted on data collected at the first school during orientation. Seven subscales were identified: Academic and Time Pressures, Financial, Social, External Influences, Day-to-Day Functioning, Relationships With Immediate Family, and Health. Cronbach α were ≥0.75. Stability of these subscales was examined using confirmatory factor analysis. Both of the fit indices used indicated the 7-subscale model for the MEHS-R adequately fit the data obtained during examination and routine medical school activity periods, one fit index indicated adequate fit for the vacation period, and neither indicated adequate fit for the data from the second school. Of the 7 subscales, 5 had a strong correspondence with categories identified by the scale developers. Fit indices also indicated the 7-subscale model was adequately generalizable to the demographic subgroups with the exception of the ethnic minorities subgroup. Conclusions Exploratory factor analysis performed on the MEHS-R supported formation of subscales similar to categories identified during MEHS-R development. Results of the current study supported the use of the MEHS-R for the investigation of acute stress in medical students. In future research, targeted wellness interventions for medical students may be developed based on student responses to this instrument.
Collapse
|
150
|
Zivanovic R, McMillan J, Lovato C, Roston C. Death by Suicide among Canadian Medical Students: A National Survey-Based Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2018; 63. [PMID: 29513629 PMCID: PMC5846966 DOI: 10.1177/0706743717746663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To estimate a rate of death by suicide in the Canadian medical student population and examine the prevalence of institutional response policies for suicide. METHODS A survey was sent to all 17 Canadian medical undergraduate programs (MDUPs) to collect information on deaths by suicide over the past 10 years. In the case of a reported suicide, basic demographic data was collected. Respondents were asked to indicate whether internal statistics or response policies for suicide existed at their MDUP. RESULTS Responses were obtained from 16 of 17 (94%) MDUPs. Six suicides (50% female) were reported over the ten-year period from 2006 to 2016. The estimated cause-specific mortality rate was 5.9-8.7/100,000 medical students/year. There were seven (44%) MDUPs that kept statistics on student deaths including suicides and 10 (63%) reported having policies or guidelines regarding what to do in the event of a suicide. CONCLUSIONS Our estimated suicide rate falls within previously reported rates in medical students. While this may be lower than the national rate for Canadians between the ages of 20-30 years old, any suicide in the medical student community must be an impetus for national dialogue and further study. A strategy is needed to better define the prevalence, risk factors for and impact of medical student suicide in Canada.
Collapse
Affiliation(s)
- Rebecca Zivanovic
- 1 Resident, Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Janette McMillan
- 2 Student Affairs, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris Lovato
- 3 School of Population & Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christina Roston
- 2 Student Affairs, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|