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Burtscher MJ, Koch A, Weigl M. Intraoperative teamwork and occupational stress during robot-assisted surgery: An observational study. APPLIED ERGONOMICS 2024; 121:104368. [PMID: 39146909 DOI: 10.1016/j.apergo.2024.104368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 06/28/2024] [Accepted: 08/07/2024] [Indexed: 08/17/2024]
Abstract
Robot-assisted surgery (RAS) differs from traditional OR set-ups in several ways such as operation of technology and obstructed team communication that potentially affect surgical staff's stress experiences. The current study investigates the effects of key intraoperative job demands and resources on mental workload and perceived stress in RAS. We focused on the role of intraoperative teamwork as a resource that potentially reduces occupational stress. Combining standardized expert observations in the OR with healthcare providers' self-reports, the study involved two types of robot-assisted, urological interventions. The sample consisted of 73 observed surgeries and included 242 post-operative surveys on perceived stress and mental workload from surgeons and surgical nurses. Multilevel regression analyses reveal differential effects for stress and workload. Importantly, whereas better surgical teamwork was associated with lower stress, it was unrelated to workload. Our findings provide a nuanced picture of occupational stress in RAS, particularly regarding the role of intraoperative teamwork.
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Affiliation(s)
- Michael J Burtscher
- Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Switzerland; Department of Psychology, University of Zurich, Switzerland.
| | - Amelie Koch
- Institute for Patient Safety, University Hospital Bonn, Germany
| | - Matthias Weigl
- Institute for Patient Safety, University Hospital Bonn, Germany
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O'Kelly F, O'Connor BR, O'Dowd E, Neylon K, Shackleton DH, Sheehan K, Cotter E, Conroy RM, O'Keeffe D, McGuire BB, Traynor O, Doherty EM. Are all surgeons the same? Assessing emotional intelligence and gender differences amongst surgical residency applicants in Ireland. Surgeon 2024:S1479-666X(24)00088-X. [PMID: 39142969 DOI: 10.1016/j.surge.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 07/25/2024] [Accepted: 08/08/2024] [Indexed: 08/16/2024]
Affiliation(s)
- F O'Kelly
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland; Department of Paediatric and Adolescent Urology, Beacon for Kids, Beacon Hospital, Sandyford, Dublin, Ireland.
| | - B R O'Connor
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland; Department of Paediatric Surgery, Children's Health Ireland at Crumlin, Dublin, Ireland
| | - E O'Dowd
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
| | - K Neylon
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
| | - D H Shackleton
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
| | - K Sheehan
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
| | - E Cotter
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
| | - R M Conroy
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
| | - D O'Keeffe
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
| | - B B McGuire
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
| | - O Traynor
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
| | - E M Doherty
- National Surgical Training Centre, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Ireland
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Zhang X, Zhang C, Gou J, Lee SY. The influence of psychosocial work environment, personal perceived health and job crafting on nurses' well-being: a cross-sectional survey study. BMC Nurs 2024; 23:373. [PMID: 38831334 PMCID: PMC11145890 DOI: 10.1186/s12912-024-02041-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/24/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND The World Health Organization urged governments to prioritize the health and work well-being of nursing staff by promoting a positive working environment. A safe and healthy physical and psychosocial work environment is a basic human right for nurses. Job crafting is a necessary skill when facing challenging working conditions. OBJECTIVES This cross-sectional correlational research based on the Job Demands-Resources Model aimed to explore the correlation between psychosocial work environment and work well-being among nurses working in the intensive care unit (ICU) and determine whether personal perceived health could mediate the relationship and whether job crafting can moderate the mediating effect. The study hypothesized that: 1. The psychosocial work environment would impact nurses' work well-being; 2. Personal perceived health would play a role as a mediator in the relationship between psychosocial work environment and work well-being; 3. Job crafting would moderate the relationship between personal perceived health and work well-being. METHODS A total of 655 registered nurses (RNs) from 7 ICUs in a teaching hospital in Beijing participated in this study. The RNs completed a battery questionnaire measuring their health, psychosocial work environment, well-being, and job crafting. PROCESS macros analysis was used to test mediating and moderating effects. RESULTS Personal perceived health mediated the relationship between psychosocial work environment and work well-being (b = 0.012, 95% CI [0.008, 0.016]). The moderated mediated analysis revealed that job crafting moderated perceived health's impact on work well-being (b = -0.007, 95% CI [- 0.010, - 0.003]). CONCLUSION A better psychosocial work environment with well-designed work organization and job content through job crafting could positively impact nurses' health and work well-being.
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Affiliation(s)
- Xin Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Chen Zhang
- Department of Nursing, Chinese Academy of Medical Sciences & Fuwai Hospital, Beijing, China
| | - Jiayan Gou
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shih-Yu Lee
- School of Nursing, Hungkuang University, No. 1018, Sec. 6, Taiwan Boulevard, Taichung, 43302, Taiwan, China.
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Yousef CC, Farooq A, Amateau G, Abu Esba LC, Burnett K, Alyas OA. The effect of job and personal demands and resources on healthcare workers' wellbeing: A cross-sectional study. PLoS One 2024; 19:e0303769. [PMID: 38809882 PMCID: PMC11135754 DOI: 10.1371/journal.pone.0303769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 04/30/2024] [Indexed: 05/31/2024] Open
Abstract
The COVID-19 pandemic presented many psychological stressors which affected healthcare worker wellbeing. The aim of this study was to understand the factors that affect the wellbeing of healthcare professionals in the Kingdom of Saudi Arabia using Job-Demand and Resource (JD-R) Model. The proposal model consisted of demand factors (Work load-job demand, loneliness-personal demand), support factors (organizational support-job resource, and resilience-personal resource), mediators (burnout and work engagement), and outcome (wellbeing) A cross-sectional, descriptive study was conducted across 276 healthcare workers from hospitals and primary healthcare centers, including healthcare professionals, health associate professionals, personal care workers, health management and support personnel, and health service providers, and others between February-March 2022. The proposed model was tested using partial least squares structural equation modeling. Among the respondents, the majority were female (198, 71,7%), married (180, 65.2%), healthcare professionals (206, 74.6%), being more than 10 years in the profession (149, 51.6%), and non-Saudi nationality (171, 62.0%). Burnout accounted for a significant effect on wellbeing. Of the demands (workload and loneliness) and the resources (organizational support and resilience), workload had the greatest impact on burnout. Healthcare organizations should invest in reducing workloads and promoting resilience to reduce burnout and increase healthcare worker wellbeing.
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Affiliation(s)
- Consuela Cheriece Yousef
- Pharmaceutical Care Department, Ministry of National Guard-Health Affairs, Dammam, Saudi Arabia
- King Abdullah International Medical Research Center, Al Ahsa, Saudi Arabia
- King Saud bin Abdul-Aziz University for Health Sciences, Al Ahsa, Saudi Arabia
| | - Ali Farooq
- Department of Computer and Information Sciences, University of Strathclyde, Glasgow, United Kingdom
- Qatar Computing Research Institute, Hammad bin Khalifa University, Doha, Qatar
| | - Gigi Amateau
- Department of Gerontology, College of Health Professions, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Laila Carolina Abu Esba
- Pharmaceutical Care Department, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Keisha Burnett
- Department of Clinical Laboratory Sciences, Cytopathology Practice Program, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America
| | - Omar Anwar Alyas
- College of Medicine, Royal College of Surgeons in Ireland—Medical University of Bahrain, Kingdom of Bahrain
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Jorissen A, van de Kant K, Ikiz H, van den Eertwegh V, van Mook W, de Rijk A. The importance of creating the right conditions for group intervision sessions among medical residents- a qualitative study. BMC MEDICAL EDUCATION 2024; 24:375. [PMID: 38580954 PMCID: PMC10996180 DOI: 10.1186/s12909-024-05342-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND The burnout rates among residents urge for adequate interventions to improve resilience and prevent burnout. Peer reflection, also called group intervision sessions, is a potentially successful intervention to increase the resilience of young doctors. We aimed to gain insight into the perceived added value of intervision sessions and the prerequisite conditions to achieve this, according to residents and intervisors. Our insights might be of help to those who think of implementing intervision sessions in their institution. METHODS An explorative, qualitative study was performed using focus groups and semi-structured interviews with both residents (n = 8) and intervisors (n = 6) who participated in intervision sessions in a university medical center in the Netherlands. The topic list included the perceived added value of intervision sessions and factors contributing to that. The interviews were transcribed verbatim and coded using NVivo. Thematic analysis was subsequently performed. RESULTS According to residents and intervisors, intervision sessions contributed to personal and professional identity development; improving collegiality; and preventing burn-out. Whether these added values were experienced, depended on: (1) choices made during preparation (intervisor choice, organizational prerequisites, group composition, workload); (2) conditions of the intervision sessions (safety, depth, role of intervisor, group dynamics, pre-existent development); and (3) the hospital climate. CONCLUSIONS Intervision sessions are perceived to be of added value to the identity development of medical residents and to prevent becoming burned out. This article gives insight in conditions necessary to reach the added value of intervision sessions. Optimizing preparation, meeting prerequisite conditions, and establishing a stimulating hospital climate are regarded as key to achieve this.
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Affiliation(s)
- Anouk Jorissen
- Department of Social Medicine, Care and Public Health, Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Kim van de Kant
- Academy for Postgraduate Medical Training, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202 AZ, the Netherlands.
- Department of Family Medicine, Care and Public Health, Research Institute (CAPHRI), Maastricht University, PO Box 5800, Maastricht, 6202 AZ, the Netherlands.
| | - Habibe Ikiz
- Department of Gynecology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Valerie van den Eertwegh
- Skillslab, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Walther van Mook
- Academy for Postgraduate Medical Training, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202 AZ, the Netherlands
- Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School of Health Professions Education (SHE), Maastricht University, Maastricht, the Netherlands
| | - Angelique de Rijk
- Department of Social Medicine, Care and Public Health, Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Gates RS, Kemp MT, Evans J, Liesman D, Pumiglia L, Matusko N, George BC, Sandhu G. The Demands of Surgery Residency: More Than Just Duty Hours? J Surg Res 2023; 290:293-303. [PMID: 37327639 DOI: 10.1016/j.jss.2023.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 03/24/2023] [Accepted: 04/15/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Efforts to improve surgical resident well-being could be accelerated with an improved understanding of resident job demands and resources. In this study, we sought to obtain a clearer picture of surgery resident job demands by assessing how residents distribute their time both inside and outside of the hospital. Furthermore, we aimed to elucidate residents' perceptions about current duty hour regulations. METHODS A cross-sectional survey was sent to 1098 surgical residents at 27 US programs. Responses regarding work hours, demographics, well-being (utilizing the physician well-being index), and perceptions of duty hours in relation to education and rest, were collected. Data were evaluated using descriptive statistics and content analysis. RESULTS A total of 163 residents (14.8% response rate) were included in the study. Residents reported a median total patient care hours per week of 78.0 h. Trainees spent 12.5 h on other professional activities. Greater than 40% of residents were "at risk" for depression and suicide based on physician well-being index scores. Four major themes associated with education and rest were identified: 1) duty hour definitions and reporting mechanisms do not completely reflect the amount of work residents perform, 2) quality patient care and educational opportunities do not fit neatly within the duty hour framework, 3) resident perceptions of duty hours are impacted the educational environment, and 4) long work hours and lack of adequate rest negatively affect well-being. CONCLUSIONS The breadth and depth of trainee job demands are not accurately captured by current duty hour reporting mechanisms, and residents do not believe that their current work hours allow for adequate rest or even completion of other clinical or academic tasks outside of the hospital. Many residents are unwell. Duty hour policies and resident well-being may be improved with a more holistic accounting of resident job demands and greater attention to the resources that residents have to offset those demands.
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Affiliation(s)
- Rebecca S Gates
- Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, Michigan.
| | - Michael T Kemp
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Julie Evans
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Daniel Liesman
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Luke Pumiglia
- University of Michigan Medical School, Ann Arbor, Michigan
| | - Niki Matusko
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Brian C George
- Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Gurjit Sandhu
- Center for Surgical Training and Research, Department of Surgery, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan
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Mikulski MF, Terzo M, Jacquez Z, Beckerman Z, Brown KM. Duty Hours on Surgery Clerkship: From Compliance Nightmare to Leadership and Professional Development Opportunity. JOURNAL OF SURGICAL EDUCATION 2023; 80:797-805. [PMID: 37019710 DOI: 10.1016/j.jsurg.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/16/2023] [Accepted: 03/17/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To evaluate the impact of an innovative leadership development initiative in the core surgery clerkship that addressed duty hours compliance and time-off requests. DESIGN A combination of deductive and inductive analysis of medical student reflections written after rotating on Acute Care Surgery over 2 academic years (2019-2020 and 2020-2021) was performed. Reflections were part of criteria to receive honors and a prompt was given to discuss their experience in creating their own call schedules. We utilized a combined deductive and inductive process to identify predominant themes within the reflections. Once established, we quantitatively identified frequency and density of themes cited, along with qualitative analysis to determine barriers and lessons learned. SETTING Dell Seton Medical Center, Dell Medical School at The University of Texas at Austin, a tertiary academic facility. PARTICIPANTS There were 96 students who rotated on Acute Care Surgery during the study period, 64 (66.7%) of whom completed the reflection piece. RESULTS We identified 10 predominant themes through the combined deductive and inductive processes. Barriers were cited by most students (n = 58, 91%), with communication being the most commonly discussed theme when cited with a mean 1.96 references per student. Learned leadership skills included: communication, independence, teamwork, negotiating skills, reflection of best practices by residents, and realizing the importance of duty hours. CONCLUSIONS Transferring duty hour scheduling responsibilities to medical students resulted in multiple professional development opportunities while decreasing administrative burden and improving adherence to duty hour requirements. This approach requires further validation, but may be considered at other institutions seeking to improve the leadership and communication skills of its students, while improving adherence to duty hour restrictions.
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Affiliation(s)
- Matthew F Mikulski
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas; Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin & Dell Children's Medical Center, Austin, Texas.
| | - Madison Terzo
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Zachary Jacquez
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Ziv Beckerman
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas; Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin & Dell Children's Medical Center, Austin, Texas; Duke Cardiothoracic Surgery Clinic, Durham, North Carolina
| | - Kimberly M Brown
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
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Soto E, Lewis M, Estrada CA, de la Torre JI, O'Beirne R, Martin C, Corey B. Barriers and Facilitators for Under-Represented in Medicine (URiM) Medical Students Interested in Surgical Sub-specialties. Am J Surg 2023; 225:660-666. [PMID: 37455798 PMCID: PMC10344418 DOI: 10.1016/j.amjsurg.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Little is known on drivers and detractors underrepresented in medicine (URiM) medical students face. Methods Using the nominal group technique (NGT), we explored experiences that strengthen or weaken the enthusiasm to pursue a career in surgery among URiM medical students (October 2021- April 2022); participants voted on the three most important experiences (weight of 3= top rated, = 1 for the lowest rated). Responses from NGT with at least one vote were weighted, ranked, and categorized. Results Seventeen students participated. Experiences that strengthen enthusiasm (36 responses with at least one vote) involved mentorship and role models (weighted sum percentage, 35%), demonstrating grit (15%), lifestyle (15%), patient interactions (14%), technical skills (11%), community and team (10%), and intellectual stimulation (1%). Experiences that weaken enthusiasm (33 responses with at least one vote) include the minority experience (weighted sum percentage, 51%), quality of life (25%), toxic environment (13%), lack of information (7%), and finances (5%). Conclusions Mentorship, demonstrating grit, and feeling a sense of community were important positive experiences or attitudes. The minority experience, toxic environment, perceptions of self-worth, and lifestyle misconceptions perceived by URiM must be addressed to increase diversity, equity, and inclusion.
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Affiliation(s)
- Edgar Soto
- University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Marshall Lewis
- University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Carlos A Estrada
- Division of General Internal Medicine, Department of Medicine, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
- Birmingham Veterans Affairs Medical Center; Birmingham, Alabama
| | - Jorge I de la Torre
- Birmingham Veterans Affairs Medical Center; Birmingham, Alabama
- Division of Plastic Surgery, Department of Surgery, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Ronan O'Beirne
- Office of Continuing Medical Education, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Colin Martin
- Division of Pediatric Surgery, Department of Surgery, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
| | - Britney Corey
- Birmingham Veterans Affairs Medical Center; Birmingham, Alabama
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham Marnix E. Heersink School of Medicine; Birmingham, Alabama
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Louwen C, Reidlinger D, Milne N. Profiling health professionals' personality traits, behaviour styles and emotional intelligence: a systematic review. BMC MEDICAL EDUCATION 2023; 23:120. [PMID: 36803372 PMCID: PMC9938999 DOI: 10.1186/s12909-023-04003-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 01/04/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Non-cognitive traits have been theorised to predict characteristics, career choice and outcomes of health professionals and could represent a homogenous group. This study aims to profile and compare personality traits, behaviour styles and emotional intelligence of health practitioners across a variety of professions. METHODS Empirical literature was systematically reviewed. A two-concept search strategy was applied to four databases (CINAHL, PubMed, Embase, ProQuest). Title/abstract and full text articles were screened against inclusion and exclusion criteria. Methodological quality was assessed using Mixed Methods Appraisal Tool. Data was synthesised narratively and meta-aggregated where feasible. RESULTS Three hundred twenty-one studies representing 153 assessment tools of personality (n = 83 studies), behaviour (n = 8), and emotional intelligence (n = 62) were included. Most studies (n = 171) explored personality (medicine, nursing, nursing assistants, dentistry, allied health, paramedics), revealing variation in traits across professions. Behaviour styles were least measured with only ten studies exploring these across four health professions (nursing, medicine, occupational therapy, psychology). Emotional intelligence (n = 146 studies) varied amongst professions (medicine, nursing, dentistry, occupational therapy, physiotherapy, radiology) with all exhibiting average to above-average scores. CONCLUSION Personality traits, behaviour styles and emotional intelligence are all key characteristics of health professionals reported in the literature. There is both heterogeneity and homogeneity within and between professional groups. The characterisation and understanding of these non-cognitive traits will aid health professionals to understand their own non-cognitive features and how these might be useful in predicting performance with potential to adapt these to enhance success within their chosen profession.
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Affiliation(s)
- C. Louwen
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Robina, Gold Coast, QLD 4226 Australia
| | - D. Reidlinger
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Robina, Gold Coast, QLD 4226 Australia
| | - N. Milne
- Faculty of Health Sciences and Medicine, Bond Institute of Health and Sport, Bond University, Robina, Gold Coast, QLD 4226 Australia
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Golisch KB, Sanders JM, Rzhetsky A, Tatebe LC. Addressing Surgeon Burnout Through a Multi-level Approach: A National Call to Action. CURRENT TRAUMA REPORTS 2023; 9:28-39. [PMID: 36688090 PMCID: PMC9843106 DOI: 10.1007/s40719-022-00249-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/19/2023]
Abstract
Purpose of Review Physician burnout is an epidemic and there are unique aspects of surgery that dictate rates of burnout among general surgeons and surgical trainees. This review characterizes the scope of burnout and its drivers within the field of surgery and advocates for strategies to address burnout at the individual, institutional, and national levels. Recent Findings Rates of burnout in surgery are increasing with higher numbers of young and female surgeons affected. Contributing factors are generally related to work-life balance, longer hours, and mistreatment in the workplace. Attempts have been made at implementing structured initiatives in an effort to combat work dissatisfaction and emotional exhaustion. Still, rates of burnout continue to increase. Summary General surgeons and trainees are at high risk for burnout with resulting attrition, depression, and suicidal ideation. The solution to burnout must be addressed at individual, institutional, and national levels. Further research into the factors leading to surgeon burnout and enactment of effective strategies to mitigate burnout must be pursued.
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Affiliation(s)
- Kimberly B. Golisch
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Jes M. Sanders
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | | | - Leah C. Tatebe
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
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Trends in Surgeon Burnout in the US and Canada: Systematic Review and Meta-Regression Analysis. J Am Coll Surg 2023; 236:253-265. [PMID: 36519921 DOI: 10.1097/xcs.0000000000000402] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Burnout among surgeons is increasingly recognized as a crisis. However, little is known about changes in burnout prevalence over time. We evaluated temporal trends in burnout among surgeons and surgical trainees of all specialties in the US and Canada. STUDY DESIGN We systematically reviewed MEDLINE, Embase, and PsycINFO for studies assessing surgeon burnout from January 1981 through September 2021. Changes in dichotomized Maslach Burnout Inventory scores and mean subscale scores over time were assessed using multivariable random-effects meta-regression. RESULTS Of 3,575 studies screened, 103 studies representing 63,587 individuals met inclusion criteria. Publication dates ranged from 1996 through 2021. Overall, 41% of surgeons met criteria for burnout. Trainees were more affected than attending surgeons (46% vs 36%, p = 0.012). Prevalence remained stable over the study period (-4.8% per decade, 95% CI -13.2% to 3.5%). Mean scores for emotional exhaustion declined and depersonalization declined over time (-4.1 per decade, 95% CI -7.4 to -0.8 and -1.4 per decade, 95% CI -3.0 to -0.2). Personal accomplishment scores remained unchanged. A high degree of heterogeneity was noted in all analyses despite adjustment for training status, specialty, practice setting, and study quality. CONCLUSIONS Contrary to popular perceptions, we found no evidence of rising surgeon burnout in published literature. Rather, emotional exhaustion and depersonalization may be decreasing. Nonetheless, burnout levels remain unacceptably high, indicating a need for meaningful interventions across training levels and specialties. Future research should be deliberately designed to support longitudinal integration through prospective meta-regression to facilitate monitoring of trends in surgeon burnout.
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12
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Foote DC, Evans J, Engler T, Gutterman S, Lussiez A, Amortegui D, Bilimoria KY, Johnson JK, Hu YY, Sandhu G. How Program Directors Understand General Surgery Resident Wellness. JOURNAL OF SURGICAL EDUCATION 2022; 79:e48-e60. [PMID: 35948485 DOI: 10.1016/j.jsurg.2022.07.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/09/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Burnout among general surgery residents is prevalent. Guidance on how program directors (PDs) can effectively intervene on general surgery resident wellness is lacking. In this study, we explore how PDs learn about burnout among their residents and support their well-being. DESIGN Semi-structured interviews were conducted with PDs. Interviews were transcribed and coded by study team dyads who utilized an inductive coding approach, and then reconciled via consensus. Interpretive description was the qualitative analytical method. SETTING Program tours to 15 general surgery programs during the exploratory phase of the SECOND Trial. PARTICIPANTS Fifteen general surgery PDs. RESULTS PDs identified the utility of contextual information in understanding resident wellness and implementing program-specific resident wellness initiatives. Three themes relating to PD awareness of resident burnout and well-being were identified: (1) PDs used conventional and novel methods to collect data from multiple information sources, including residents, faculty, staff, institutional representatives, and anonymous parties. (2) These contextualized data inspired the development of responsive strategies to effect programmatic changes that improved education and wellness. (3) Barriers to acquiring and utilizing information exist, requiring careful analysis, creative problem solving, as well as persistence and dedication to resident wellness. CONCLUSIONS Qualitative analysis of general surgery residency PDs yielded insightful knowledge about gathering and responding to information to support resident wellness, including successful strategies and areas of caution. The experience of these PDs can guide others in evaluating their wellness goals and initiatives for their own residents.
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Affiliation(s)
- Darci C Foote
- Michigan Medicine, Department of Surgery, Ann Arbor, Michigan.
| | - Julie Evans
- Michigan Medicine, Department of Surgery, Ann Arbor, Michigan
| | - Tedi Engler
- Michigan Medicine, Department of Surgery, Ann Arbor, Michigan
| | | | - Alisha Lussiez
- Michigan Medicine, Department of Surgery, Ann Arbor, Michigan
| | - Daniela Amortegui
- Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Karl Y Bilimoria
- Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Julie K Johnson
- Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Yue-Yung Hu
- Surgical Outcomes and Quality Improvement Center, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois
| | - Gurjit Sandhu
- Michigan Medicine, Department of Surgery, Ann Arbor, Michigan.
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Sauder M, Zagales I, Zagales R, Das S, Sen-Crowe B, Bilski T, Kornblith L, Elkbuli A. Comprehensive Assessment of Burnout Among Surgical Trainees and Practicing Surgeons: A Systematic Review. JOURNAL OF SURGICAL EDUCATION 2022; 79:1188-1205. [PMID: 35624025 DOI: 10.1016/j.jsurg.2022.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Surgeon burnout has received increasing attention due to evidence of high prevalence across specialties. We aimed to (1) systematically characterize existing definitions of burnout, (2) evaluate tools to measure burnout, and (3) determine risk factors of surgical burnout. DESIGN PubMed, Google Scholar, and Embase databases were searched to identify burnout rates and tools used to measure the quality of life (QoL) published from January 2000-December 2021. PARTICIPANTS Surgical Trainees and Practicing Surgeons. RESULTS We identified 39 studies that defined surgical burnout, with 9 separate tools used to measure QoL. Surgeon burnout rates were found to be highest among general surgery trainees (20%-95%). Burnout among general surgery attendings ranged from 25% to 44%. Those most likely to experience burnout were younger and female. High rates of surgeon burnout were reported among all surgical specialties; however, these rates were lower than those of general surgeons. CONCLUSION Definitions of burnout vary throughout the surgical literature, but are consistently characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. The most utilized tool to measure surgical burnout has been the Maslach Burnout Inventory. Across specialties, there are high rates of burnout in both surgical trainees and attendings, indicating that this is a systemic issue within the field of surgery. Given the wide-scale nature of the problem, it is recommended that institutions provide support to surgical trainees and attending surgeons and that individual surgeons take steps toward mitigating burnout.
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Affiliation(s)
- Matthew Sauder
- Dr. Kiran.C. Patel College of Allopathic Medicine, NSU NOVA Southeastern University, Fort Lauderdale, Florida
| | - Israel Zagales
- Universidad Iberoamericana (UNIBE) Escuela de Medicina, Santo Domingo, Dominican Republic
| | - Ruth Zagales
- Florida International University, Miami, Florida
| | - Snigdha Das
- Dr. Kiran.C. Patel College of Allopathic Medicine, NSU NOVA Southeastern University, Fort Lauderdale, Florida
| | - Brendon Sen-Crowe
- Dr. Kiran.C. Patel College of Allopathic Medicine, NSU NOVA Southeastern University, Fort Lauderdale, Florida
| | - Tracy Bilski
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida
| | - Lucy Kornblith
- Department of Surgery, Division of Trauma and Surgical Critical Care, Zuckerberg San Francisco General Hospital, San Francisco, California; University of San Francisco, San Francisco, California
| | - Adel Elkbuli
- Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, Florida; Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida.
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Kratzke IM, Woods LC, Adapa K, Kapadia MR, Mazur L. The Sociotechnical Factors Associated With Burnout in Residents in Surgical Specialties: A Qualitative Systematic Review. JOURNAL OF SURGICAL EDUCATION 2022; 79:614-623. [PMID: 34836841 DOI: 10.1016/j.jsurg.2021.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/14/2021] [Accepted: 11/07/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The consequences of burnout remain prevalent within general surgery training programs, yet there is no comprehensive description of the factors associated with burnout. Using sociotechnical systems theory, this review aims to qualitatively evaluate the factors associated with burnout in surgical residents. DESIGN A systematic review of the literature was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review was conducted using PubMed, Web of Science, Scopus, and Embase. Two reviewers independently selected studies, extracted data, and assessed quality, with a third reviewer acting as a moderator to resolve conflicts. The Systems Engineering Initiative for Patient Safety framework was utilized to categorize factors as either contributing to or mitigating burnout. The study was registered with PROSPERO (CRD42021237448). SETTING Included studies were conducted within the United States and published prior to November 11, 2020. PARTICIPANTS Included studies were peer-reviewed primary data, that were written in English and evaluated the sociotechnical factors associated with burnout in surgical residents. RESULTS A total of 4387 articles were identified and after review, 15 studies were included for analysis. Reported burnout rates ranged from 17 to 94%, with a total mean rate of 57%. Factors found to contribute to burnout include financial stress, work-life imbalance, excessive charting, insufficient job resources, poor social support, and mistreatment. Mitigating factors include having time away from work, increased didactics, supportive faculty, attending social events, and the presence of program-based wellness initiatives. Consequences of burnout include depression, substance abuse, and decreased job satisfaction. CONCLUSIONS Reported burnout rates among surgical residents are high. A complex number of sociotechnical factors were found to contribute to burnout, yet many factors are also shown to mitigate burnout. Surgical residencies may address burnout by making changes based on the presence or absence of these factors within their program.
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Affiliation(s)
- Ian M Kratzke
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Lindsay C Woods
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Karthik Adapa
- Division of Health Engineering, Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Muneera R Kapadia
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Lukasz Mazur
- Division of Health Engineering, Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Zhou T, Xu C, Wang C, Sha S, Wang Z, Zhou Y, Zhang X, Hu D, Liu Y, Tian T, Liang S, Zhou L, Wang Q. Burnout and well-being of healthcare workers in the post-pandemic period of COVID-19: a perspective from the job demands-resources model. BMC Health Serv Res 2022; 22:284. [PMID: 35236354 PMCID: PMC8888816 DOI: 10.1186/s12913-022-07608-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/08/2022] [Indexed: 12/14/2022] Open
Abstract
Background The present study aimed 1) to examine the effects of epidemic-related job stressors, perceived social support and organizational support on the burnout and well-being of Chinese healthcare workers in the period of COVID-19 regular epidemic prevention and control and 2) to investigate the moderating effects of social support and organizational support on the relationship between job stressors and burnout and well-being within the theoretical framework of the Job Demands-Resources (JD-R) model. Methods A sample of healthcare workers (N = 3477) from 22 hospitals in Beijing, China participated in the cross-sectional investigation in October 2020 and reported epidemic-related job stressors, perceived social support, organizational support, burnout, anxiety and depression symptoms. Results 1) Medical doctors, females, people aged from 30 to 50, and those who worked in the second line during the pandemic reported higher scores of psychological symptoms and burnout in the period of regular epidemic prevention and control; 2) Epidemic-related job stressors positively predicted burnout, anxiety, and depression among healthcare workers; 3) Perceived social support and organizational support were negatively related to reported burnout, anxiety and depression symptoms; 4) Social support reduced the adverse effects of epidemic-related job stressors on anxiety and depression but enhanced the association between stressors and burnout; 5) Organizational support mitigated the adverse effects of epidemic-related job stressors on depression. Conclusion The results shed light on preventing burnout and enhancing the psychological well-being of healthcare workers under epidemic prevention and control measures by reducing epidemic-related job stressors and strengthening personal and organizational support systems.
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Affiliation(s)
- Ting Zhou
- Department of Medical Psychology, School of Health Humanities, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Changshun Xu
- Beijing Hospitals Authority, No.70 Zaolinqian Road, Xicheng District, Beijing, 100053, China
| | - Cunliang Wang
- Beijing Hospitals Authority, No.70 Zaolinqian Road, Xicheng District, Beijing, 100053, China
| | - Sha Sha
- Beijing Anding Hospital of Capital Medical University, No.5 Ankang Hutong, Deshengmenwai Street, Xicheng District, Beijing, 100088, China
| | - Zhe Wang
- Beijing Anding Hospital of Capital Medical University, No.5 Ankang Hutong, Deshengmenwai Street, Xicheng District, Beijing, 100088, China
| | - You Zhou
- New York Psychoanalytic Society & Insititute, New York, USA
| | - Xinran Zhang
- Beijing Anding Hospital of Capital Medical University, No.5 Ankang Hutong, Deshengmenwai Street, Xicheng District, Beijing, 100088, China
| | - Die Hu
- Department of Medical Psychology, School of Health Humanities, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yinqi Liu
- Beijing Anding Hospital of Capital Medical University, No.5 Ankang Hutong, Deshengmenwai Street, Xicheng District, Beijing, 100088, China
| | - Tengfei Tian
- Beijing Anding Hospital of Capital Medical University, No.5 Ankang Hutong, Deshengmenwai Street, Xicheng District, Beijing, 100088, China
| | - Sixiang Liang
- Beijing Anding Hospital of Capital Medical University, No.5 Ankang Hutong, Deshengmenwai Street, Xicheng District, Beijing, 100088, China
| | - Li Zhou
- Beijing Anding Hospital of Capital Medical University, No.5 Ankang Hutong, Deshengmenwai Street, Xicheng District, Beijing, 100088, China
| | - Qian Wang
- Beijing Anding Hospital of Capital Medical University, No.5 Ankang Hutong, Deshengmenwai Street, Xicheng District, Beijing, 100088, China.
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16
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Abi-Jaoudé JG, Kennedy-Metz LR, Dias RD, Yule SJ, Zenati MA. Measuring and Improving Emotional Intelligence in Surgery: A Systematic Review. Ann Surg 2022; 275:e353-e360. [PMID: 34171871 PMCID: PMC8683575 DOI: 10.1097/sla.0000000000005022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Evaluate how emotional intelligence (EI) has been measured among surgeons and to investigate interventions implemented for improving EI. SUMMARY BACKGROUND EI has relevant applications in surgery given its alignment with nontechnical skills. In recent years, EI has been measured in a surgical context to evaluate its relationship with measures such as surgeon burnout and the surgeon-patient relationship. METHODS A systematic review was conducted by searching MEDLINE, EMBASE, CINAHL, and PSYCINFO databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MeSH terms and keywords included "emotional intelligence," "surgery," and "surgeon." Eligible studies included an EI assessment of surgeons, surgical residents, and/or medical students within a surgical context. RESULTS The initial search yielded 4627 articles. After duplicate removal, 4435 articles were screened by title and abstract and 49 articles proceeded to a full-text read. Three additional articles were found via hand search. A total of 37 articles were included. Studies varied in surgical specialties, settings, and outcome measurements. Most occurred in general surgery, residency programs, and utilized self-report surveys to estimate EI. Notably, EI improved in all studies utilizing an intervention. CONCLUSIONS The literature entailing the intersection between EI and surgery is diverse but still limited. Generally, EI has been demonstrated to be beneficial in terms of overall well-being and job satisfaction while also protecting against burnout. EI skills may provide a promising modifiable target to achieve desirable outcomes for both the surgeon and the patient. Future studies may emphasize the relevance of EI in the context of surgical teamwork.
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Affiliation(s)
- Joanne G. Abi-Jaoudé
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Lauren R. Kennedy-Metz
- Medical Robotics and Computer Assisted Surgery Lab, Boston, MA, USA; Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; Division of Cardiac Surgery, VA Boston Healthcare System, West Roxbury, MA, USA
| | - Roger D. Dias
- Human Factors and Cognitive Engineering Lab, Boston, MA, USA; STRATUS Center for Medical Simulation, Department of Emergency Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Steven J. Yule
- Department of Clinical Surgery, University of Edinburgh, Edinburgh, Scotland; and Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Marco A. Zenati
- Medical Robotics and Computer Assisted Surgery Lab, Boston, MA, USA; Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; Division of Cardiac Surgery, VA Boston Healthcare System, West Roxbury, MA, USA
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17
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Burnout and Emotional Intelligence in Neurosurgical Advanced Practice Providers Across the United States: A Cross-Sectional Analysis. World Neurosurg 2021; 155:e335-e344. [PMID: 34425289 DOI: 10.1016/j.wneu.2021.08.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Although much research has examined nursing and physician burnout, the advanced practice provider (APP) population has not yet been studied. The goal of the present study was to survey APPs in neurosurgery to determine whether greater emotional intelligence (EI) is protective against burnout. METHODS An 80-item survey was created that incorporated the Maslach Burnout Inventory Human Services Survey for Medical Personnel, the Trait Emotional Intelligence Questionnaire-short form, and original questions developed by us. The collective survey was distributed, administered, and collected using the web-based REDCap (Research Electronic Data Capture) platform. Statistical analyses were completed using a comparison between participants with and without burnout. RESULTS A total of 106 neurosurgical APPs (26 men, 80 women) completed the survey, of whom, 57 (54%) reported current burnout. High average scores for personal accomplishment and global EI were inversely related to burnout (P = 0.034 and P = 0.003, respectively). In addition, the following factors were associated with burnout: inadequate support staff in the work place (P = 0.008), inadequate time off work (P < 0.001), inadequate administrative time (P = 0.009), not experiencing support from one's supervisor (P = 0.017), insufficient time for continuing medical education (P < 0.001), an inability to separate work from personal time (P < 0.001), and an inability to advance within one's professional field (P = 0.043). CONCLUSIONS For neurosurgical APPs, EI is protective against burnout. Many opportunities exist at the individual and organizational level to alleviate burnout among neurosurgical APPs. Targeted strategies to improve work-life balance, EI, support systems, and opportunities for career development among neurosurgical APPs might enhance employment satisfaction and reduce burnout.
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18
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Relationship between burnout and mistreatment: Who plays a role? Am J Surg 2021; 222:1060-1065. [PMID: 34325910 DOI: 10.1016/j.amjsurg.2021.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 01/06/2021] [Accepted: 06/18/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Surgery residents have high burnout rates and mistreatment occurs during training. We hypothesized that residents who reported mistreatment would be more likely to experience burnout. METHODS A multi-institutional observational study asked residents to complete the Maslach Burnout Inventory and to rate how often they experienced mistreatment. Scores in the high-risk range for emotional exhaustion or depersonalization were classified as burnout. Associations between mistreatment behaviors, program, sex, post graduate year(PGY), and clinical status were measured by Spearman's correlation, linear regression, and logistic regression. RESULTS We invited 398 residents to participate; 180 responded(45%). 52%(n = 93) were female, there was an even distribution among PGY, and seven programs were represented. Almost half of the cohort (48%) reported high risk for burnout and 68% reported experiencing mistreatment. Mistreatment by senior physician team members were correlated with EE(rho = 0.184,p = 0.016) and DP(rho = 0.181,p = 0.016). CONCLUSION While overall burnout was not significantly associated with mistreatment behaviors, both burnout and mistreatment were commonly reported.
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19
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Foote DC, Donkersloot JN, Sandhu G, Ziegler K, Lau J. Identifying institutional factors in general surgery resident wellness and burnout. Am J Surg 2021; 223:53-57. [PMID: 34332743 DOI: 10.1016/j.amjsurg.2021.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Effects of the institutional macrocosm on general surgery resident wellbeing have not been well studied. We sought to identify organizational factors that impact resident wellness and burnout. METHODS Using a modified Delphi technique, an open-ended survey and two subsequent iterations were distributed to wellness stakeholders at two institutions to identify and stratify institutional factors in six burnout domains. RESULTS Response rates for each survey round were 29/106 (27%), 30/46 (65%) and 21/30 (70%). Top factors identified in each domain were: CONCLUSION: A modified Delphi technique prioritized institutional wellness and burnout factors. Top factors identified were compensation, vacation time, and autonomy. These results can direct future scholarship of barriers/facilitators of resident wellbeing.
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Affiliation(s)
- Darci C Foote
- Beaumont Health, Department of Surgery, 3601 W. 13 Mile Road, Royal Oak, MI, 48073, USA; Michigan Medicine, Department of Surgery, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - John N Donkersloot
- Michigan Medicine, Department of Surgery, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Gurjit Sandhu
- Michigan Medicine, Department of Surgery, 1500 E. Medical Center Dr., Ann Arbor, MI, 48109, USA
| | - Kathryn Ziegler
- Beaumont Health, Department of Surgery, 3601 W. 13 Mile Road, Royal Oak, MI, 48073, USA
| | - James Lau
- Loyola University, Department of Surgery, 2160 South 1st Avenue, Maywood, IL, 60153, USA.
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20
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Burhamah W, AlKhayyat A, Oroszlányová M, Jafar H, AlKhayat A, Alabbad J. The predictors of depression and burnout among surgical residents: A cross-sectional study from Kuwait. Ann Med Surg (Lond) 2021; 65:102337. [PMID: 33996067 PMCID: PMC8093889 DOI: 10.1016/j.amsu.2021.102337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Surgical residency often poses a challenge to residents, with long working hours and a stressful work environment. Surgical residents are at an increased risk of burnout and depression. Such mental health burdens could go so far as to affect treatment outcomes. AIM To assess the prevalence and risk factors for depression and burnout among residents across surgical specialties in Kuwait. MATERIALS AND METHODS An online questionnaire was sent to the residents enrolled to the surgical residency programs in Kuwait, from the period of January 2020-February 2020. Variables collected included; age, gender, marital status, smoking history, exercise, specialty, year of training, on-call frequency, assessment of burnout (using the abbreviated Maslach Burnout Inventory (aMBI)) and assessment of depressive symptoms (using the Patient Health Questionnaire-9 (PHQ-9) score). RESULTS A total of 85 surgical residents between the age of 20 and 40 years responded. Most (64.7%) were male and 35.3% female. More than half were married (51.8%) and 41.2% were single. The majority of the residents were in general surgery (43.5%), with the least being in otolaryngology (7.1%) and neurosurgery (5.9%). The prevalence of depressive symptoms was 55.3%, and 51.8% had a high overall burnout score. CONCLUSION Addressing burnout at all stages during residency training is paramount in improving standard of care as well as increasing the wellness of residents.
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Affiliation(s)
- Waleed Burhamah
- Department of General Surgery, Mubarak AlKabeer Hospital, Kuwait
| | | | - Melinda Oroszlányová
- College of Engineering and Technology, American University of the Middle East, Kuwait
| | | | - Ali AlKhayat
- Department of General Surgery, Mubarak AlKabeer Hospital, Kuwait
| | - Jasim Alabbad
- Department of General Surgery, Mubarak AlKabeer Hospital, Kuwait
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Copeland AE, Mackinnon V, Axelrod DE, Farrokhyar F, Avram R, Coroneos CJ. Job Satisfaction Among Plastic Surgery Residents in Canada. Plast Surg (Oakv) 2021; 30:151-158. [PMID: 35572079 PMCID: PMC9096853 DOI: 10.1177/22925503211007237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: Resident wellness is a focus of medical training and is prioritized in both
Canadian and American accreditation processes. Job satisfaction is an
important component of wellness that is not examined in the literature. The
purpose of this study was to analyze job satisfaction in a national sample
of plastic surgery residents, and identify factors that influence
satisfaction. Methods: We designed a cross-sectional survey adapted from existing instruments, with
attention to thorough item generation and reduction as well as pilot and
clinical sensibility testing. All plastic surgery residents at Canadian
institutions were surveyed regarding overall job satisfaction as well as
personal- and program-specific factors that may affect satisfaction.
Predictors of satisfaction were identified using multivariable regression
models. Results: The response rate was 40%. Median overall job satisfaction was 4.0 on a
5-point Likert scale. Operative experience was considered both the most
important element of a training program, and the area in most need of
improvement. Senior training year (P < .01), shorter
commute time (P = .04), fewer duty hours
(P = .02), fewer residents (P <
.01), and more fellows (P < .01) were associated with
significantly greater job satisfaction. Conclusions: This is the first study to gather cross-sectional data on job satisfaction
from a national sample of plastic surgery residents. The results from this
study can inform programs in making tangible changes tailored to their
trainees’ needs. Moreover, our findings may be used to inform a
prospectively studied targeted intervention to increase job satisfaction and
resident wellness to address North American accreditation standards.
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Affiliation(s)
- Andrea E. Copeland
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Victoria Mackinnon
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Daniel E. Axelrod
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Forough Farrokhyar
- Department of Health, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ronen Avram
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Christopher J. Coroneos
- Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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22
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Neal MT, Lyons MK. Empowering qualities and skills for leaders in neurosurgery. Surg Neurol Int 2021; 12:9. [PMID: 33500824 PMCID: PMC7827298 DOI: 10.25259/sni_899_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 12/17/2020] [Indexed: 12/04/2022] Open
Abstract
Neurosurgeons may have multiple roles including clinician, educator, researcher, and administrator. Leaders in neurosurgery have the added responsibilities of setting a vision, communicating the vision, implementing a plan to achieve it, and gaining commitment from the team and other stakeholders. For success in the current era of U.S. health care, neurosurgical leaders must deliver despite challenges such as reduced resources, increased protocolized care, automation, and depersonalization. In this work, we describe five empowering strategies that can help leaders perform best. The steps include deepening self-awareness, leading with honesty, developing emotional intelligence, improving coaching skills, and becoming a better influencer. Leaders that take these steps to invest in their leadership skills will reap broad benefits.
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Affiliation(s)
- Matthew T Neal
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States
| | - Mark K Lyons
- Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona, United States
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Ahmed F, Zhao F, Faraz NA, Qin YJ. How inclusive leadership paves way for psychological well-being of employees during trauma and crisis: A three-wave longitudinal mediation study. J Adv Nurs 2020; 77:819-831. [PMID: 33231300 PMCID: PMC7753635 DOI: 10.1111/jan.14637] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/08/2020] [Accepted: 10/28/2020] [Indexed: 12/22/2022]
Abstract
Aims Nurses are at the forefront of public health emergencies facing psychological pressures ensuing from the loss of patients and potential risk of infection while treating the infected. This study examines whether inclusive leadership has a causal relationship with psychological distress and to assess the mediation effect of psychological safety on this relationship in the long run. The hypotheses are developed and interpreted with the help of theoretical underpinnings from job demands resources theory and the theory of shattered assumptions. Design Three‐wave longitudinal study. Methods Questionnaire was used to carry out three waves of data collection from 405 nurses employed at five hospitals in Wuhan during the COVID‐19 outbreak between the months of January–April 2020. Partial least square structural equation modelling (PLS‐SEM) was used to analyze data while controlling for age, gender, education, experience, and working hours. Results Results supported the hypothesized relationships where inclusive leadership indicated significant inverse causal relationship with psychological distress and a positive causal relationship with psychological safety. Mediation effect of psychological safety was found significant, while the model explained 73.9% variance in psychological distress. Conclusion Inclusive leadership, through its positive and supportive characteristics, can pave way for such mechanisms that improve the psychological safety of employees in the long run and curbs psychological distress. Impact This is the first longitudinal study to examine the relationship between inclusive leadership and psychological distress in health care and also examines the mediating mechanism of psychology safety. There is scarcity of empirical research on factors that determine and affect behavioural mechanism of healthcare workers during traumatic events and crisis. Clinical leaders and healthcare policy makers must invest in and promote inclusive and supportive environment characterized with open and accessible leaders at workplace to improve psychological safety; it helps reduce levels of psychological distress.
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Affiliation(s)
- Fawad Ahmed
- School of Management, Wuhan University of Technology, Wuhan, P.R. China
| | - Fuqiang Zhao
- School of Management, Wuhan University of Technology, Wuhan, P.R. China
| | | | - Yuan Jian Qin
- School of Management, Wuhan University of Technology, Wuhan, P.R. China
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Gleason F, Baker SJ, Wood T, Wood L, Hollis RH, Chu DI, Lindeman B. Emotional Intelligence and Burnout in Surgical Residents: A 5-Year Study. JOURNAL OF SURGICAL EDUCATION 2020; 77:e63-e70. [PMID: 32819871 DOI: 10.1016/j.jsurg.2020.07.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/26/2020] [Accepted: 07/30/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE We sought to characterize the interactions of burnout with internal and external factors over the past 5 years for surgery residents at our institution. We hypothesized that burnout levels would be consistent among years, inversely related to emotional intelligence (EI) and job resources, and directly related to disruptive behaviors. DESIGN General surgery residents at a single institution were invited to complete a survey each year from 2015 to 2019 that included a combination of the 22-item Maslach-Burnout Inventory, 30-item trait EI questionnaire, as well as focused questions assessing disruptive behaviors (8 items), job resources (8 items), and demographic characteristics. Burnout was defined as scoring high in depersonalization (≥ 10 points) or emotional exhaustion (≥ 27 points). Student's t tests and Wilcoxon tests were used to compare continuous variables; chi-square and Fisher's exact tests were used to compare categorical variables, as appropriate. Spearman's rho was used to calculate correlation. A logistic regression and separate linear regression model were constructed to assess relation of variables to burnout. SETTING The general surgery residency program at the University of Alabama at Birmingham, Birmingham, Alabama, a large tertiary care academic center. RESULTS An average of 47 surveys were completed each year, for a total of 236 (response rate 81%). One hundred seventeen (58.5%) met criteria for burnout. Burnout rates each year ranged from 68% to 53%, with the lowest value occurring in 2019. Incidence of burnout was lowest among the postgraduate year (PGY) 1 class and highest among the PGY5 class (38% versus 64%, p = 0.02). Individuals without burnout had higher scores for EI overall (5.7 versus 5.3, p < 0.001) as well as in each of its 4 subcomponents (p < 0.001). Individuals who were subjected to disruptive behaviors, particularly others taking credit for work and public humiliation, were more likely to experience burnout (p = 0.02). Those with burnout also had significantly lower scores in each of the 4 domains of the Job Resources model (p < 0.01). On multivariate logistic regression, increasing PGY level remained a significant predictor of burnout risk. Each of the sub-domains of EI and jobs resources inversely corelated with burnout, while disruptive behaviors directly correlated with burnout. ON subsequent multivariable linear regression, resident well-being and professional development remained independent predictors of lower burnout scores. CONCLUSIONS Burnout is prevalent among trainees at our institution, but a trend toward improvement has been shown over 5 years. Burnout rates increase each year of surgical training beyond PGY2. Factors that mitigate burnout include resident well-being and professional development. Disruptive behaviors lead to increase burnout rates.
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Affiliation(s)
- Frank Gleason
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Tara Wood
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Lauren Wood
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Daniel I Chu
- University of Alabama at Birmingham, Birmingham, Alabama
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Mullins CH, Gleason F, Wood T, Baker SJ, Cortez AR, Lovasik B, Sandhu G, Cooper A, Hildreth AN, Simmons JD, Delman KA, Lindeman B. Do Internal or External Characteristics More Reliably Predict Burnout in Resident Physicians: A Multi-institutional Study. JOURNAL OF SURGICAL EDUCATION 2020; 77:e86-e93. [PMID: 33077415 DOI: 10.1016/j.jsurg.2020.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 07/17/2020] [Accepted: 09/28/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Surgical residents have been shown to experience high rates of burnout. Whether this is influenced predominately by intrinsic characteristics, external factors, or is multifactorial has not been well studied. The aim of this study was to explore the relationship between these elements and burnout. We hypothesized that residents with higher emotional intelligence scores, greater resilience and mindfulness, and better work environments would experience lower rates of burnout. METHODS General surgery residents at 7 sites in the US were invited to complete an electronic survey in 2019 that included the 2-item Maslach Burnout Inventory, Brief Emotional Intelligence Scale, Revised Cognitive and Affective Mindfulness Scale, 2-Item Connor-Davidson Resilience Scale, Utrecht Work Engagement Scale, and Job Resources scale of the Job Demands-Resources Questionnaire. Individual constructs were assessed for association with burnout, using multivariable logistic regression models. Residents' scores were evaluated in aggregate, in groups according to demographic characteristics, and by site. RESULTS Of 284 residents, 164 completed the survey (response rate 58%). A total of 71% of respondents were at high risk for burnout, with sites ranging from 57% to 85% (p = 0.49). Burnout rates demonstrated no significant difference across gender, PGY level, and respondent age. On bivariate model, no demographic variables were found to be associated with burnout, but the internal characteristics of emotional intelligence, resilience and mindfulness, and the external characteristics of work engagement and job resources were each found to be protective against burnout (p < 0.001 for all). However, multivariable models examining internal and external characteristics found that no internal characteristics were associated with burnout, while job resources (coeff. -1.0, p-value <0.001) and work engagement (coeff. -0.76, p-value 0.032) were significantly protective factors. Rates of engagement overall were high, particularly with respect to work "dedication." CONCLUSIONS A majority of residents at multiple institutions were at high risk for burnout during the study period. Improved work engagement and job resources were found to be more strongly associated with decreased burnout rates when compared to internal characteristics. Although surgical residents appear to already be highly engaged in their work, programs should continue to explore ways to increase job resources, and further research should be aimed at elucidating the mediating effect of internal characteristics on these external factors.
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Affiliation(s)
- C Haddon Mullins
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Frank Gleason
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Tara Wood
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Samantha J Baker
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | | | | | - Gurjit Sandhu
- Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Amanda Cooper
- Department of Surgery, Penn State, Hershey, Pennsylvania
| | - Amy N Hildreth
- Department of Surgery, Wake Forest University, Winston-Salem, North Carolina
| | - Jon D Simmons
- Department of Surgery, University of South Alabama, Mobile, Alabama
| | - Keith A Delman
- Department of Surgery, Emory University, Atlanta, Georgia
| | - Brenessa Lindeman
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
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Zhao F, Ahmed F, Faraz NA. Caring for the caregiver during COVID-19 outbreak: Does inclusive leadership improve psychological safety and curb psychological distress? A cross-sectional study. Int J Nurs Stud 2020; 110:103725. [PMID: 32810720 PMCID: PMC7390759 DOI: 10.1016/j.ijnurstu.2020.103725] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Public health emergencies and epidemics shatter the assumptions of the world as a safe place. Healthcare workers are at the forefront of such pressures resulting from a persistent threat to their safety and well being. It is therefore important to study such mechanisms that can influence and predict the psychological distress of nurses OBJECTIVES: While there is an increasing number of studies on positive outcomes of leadership styles, their influence on curbing unwanted adverse outcomes is scarce. This study aims to observe the influence of an inclusive leadership style on psychological distress while assessing the mediating role of psychological safety. It uses the theoretical lens of job demands-resources theory and the theory of shattered assumptions to develop and test hypotheses. DESIGN Cross-Sectional Study with Temporal Separation SETTINGS AND PARTICIPANTS: The researchers recruited 451 on-duty registered nurses from 5 hospitals providing patient care during the highly infectious phase of COVID-19 in January 2020 in Wuhan city, the epicentre of the outbreak in China METHODS: After obtaining permission from hospital administration, data were collected through an online questionnaire survey in three stages with temporal separation to avoid common method bias. Partial least square structural equation modelling was used to analyze data. The study controlled for effects of age, gender, experience, working hours and education. RESULTS Hypothesized relationships proved significant. Inclusive leadership has an inverse relationship with psychological distress with a strong path-coefficient. Psychological safety mediates the relationship between inclusive leadership and psychological distress while explaining 28.6% variance. Multi-group analysis results indicate no significant differences between respondents based on these control variables CONCLUSIONS: Recurring or prolonged experiences of stress and anxiety at the workplace, without a mechanism to counter such effects, can culminate into psychological distress. Inclusive leadership style can serve as such a mechanism to curb psychological distress for healthcare workers by creating a psychologically safe environment.
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Affiliation(s)
- Fuqiang Zhao
- School of Management, Wuhan University of Technology, Wuhan 430070, PR China.
| | - Fawad Ahmed
- School of Management, Wuhan University of Technology, Wuhan 430070, PR China.
| | - Naveed Ahmad Faraz
- School of Management, Wuhan University of Technology, Wuhan 430070, PR China.
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The Role of Emotional Intelligence in Predicting a Successful Career for Plastic Surgeons: A Systematic Review. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2699. [PMID: 32537355 PMCID: PMC7253246 DOI: 10.1097/gox.0000000000002699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/21/2020] [Indexed: 12/30/2022]
Abstract
The definition of a successful career in plastic surgery is both a highly variable and personal one. Career success is underpinned by a combination of skills and is often multifactorial in nature. Although clinical and academic factors have long been key determinants of success, modern medical practice is now underlining the previously understated non-clinical skills as a major contributory element. Emotional intelligence (EI) has shown clear benefits in a successful career in the business world, where it was originally popularized. As a successful career in surgery also requires proficient understanding of human emotions, the clear similarities drawn with corporate success have resulted in a growing interest in EI in the medical domain. Despite such interest, the role of EI as a predictor of career success in plastic surgery has been poorly defined. This systematic review aims to define EI, to explore its role in medical and nonmedical fields, and to investigate its impact on a successful career in plastic surgery.
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