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Kehoe C, Barrett E. Doctor's burnout and interventions. Ir J Psychol Med 2023; 40:302-304. [PMID: 32398166 PMCID: PMC7581997 DOI: 10.1017/ipm.2020.32] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/16/2020] [Accepted: 05/09/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Claire Kehoe
- The Lucena Clinic Rathgar, Dublin, Republic of Ireland,
| | - Elizabeth Barrett
- University College Dublin, Children Health Ireland, Dublin, Republic of Ireland
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Naidoo N, Azar AJ, Khamis AH, Gholami M, Lindsbro M, Alsheikh-Ali A, Banerjee Y. Design, Implementation, and Evaluation of a Distance Learning Framework to Adapt to the Changing Landscape of Anatomy Instruction in Medical Education During COVID-19 Pandemic: A Proof-of-Concept Study. Front Public Health 2021; 9:726814. [PMID: 34568264 PMCID: PMC8460872 DOI: 10.3389/fpubh.2021.726814] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/06/2021] [Indexed: 12/23/2022] Open
Abstract
This study presents the design of a DL-framework to deliver anatomy teaching that provides a microfiche of the onsite anatomy learning experience during the mandated COVID-19 lockdown. First, using nominal-group technique, we identified the DL learning theories to be employed in blueprinting the DL-framework. Effectiveness of the designed DL-framework in anatomy teaching was demonstrated using the exemplar of the Head and Neck (H&N) course during COVID-19 lockdown, in the pre-clerkship curriculum at our medical school. The dissemination of the DL-framework in the anatomy course was informed by the Analyse, Design, Develop, Implement, and Evaluate (ADDIE) model. The efficiency of the DL-framework was evaluated using the first two levels of Kirkpatrick's model. Versatility of the DL-framework was demonstrated by aligning its precepts with individual domains of key learning outcomes framework. The framework's blueprint was designed amalgamating principles of: Garrison's community inquiry, Siemens' connectivism and Harasim's online-collaborative-learning; and improved using Anderson's DL-model. Following the implementation of the DL-framework in the H&N course informed by ADDIE, the framework's efficiency was evaluated. In total, 70% students responded to the survey assessing perception toward DL (Kirkpatrick's Level: 1). Descriptive analysis of the survey results showed that the DL-framework was positively received by students and attested that students had an enriched learning experience, which promoted collaborative-learning and student-autonomy. For, Kirkpatrick's Level: 2 i.e., cognitive development, we compared the summative assessment performance in the H&N course across three cohort of students. The results show that the scores of the cohort, which experienced the course entirely through DL modality was statistically higher (P < 0.01) than both the other cohorts, indicating that shift to DL did not have an adverse effect on students' learning. Using Bourdieu's Theory of Practice, we showed that the DL-framework is an efficient pedagogical approach, pertinent for medical schools to adopt; and is versatile as it attests to the key domains of students' learning outcomes in the different learning outcomes framework. To our knowledge this is the first-study of its kind where a rationale and theory-guided approach has been availed not only to blueprint a DL framework, but also to implement it in the MBBS curriculum.
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Affiliation(s)
- Nerissa Naidoo
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Aida J. Azar
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Amar Hassan Khamis
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Mandana Gholami
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Marjam Lindsbro
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Alawi Alsheikh-Ali
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
- Dubai Health Authority (DHA) Building, Dubai, United Arab Emirates
| | - Yajnavalka Banerjee
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
- Centre for Medical Education, University of Dundee, Dundee, United Kingdom
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Lampe LC, Müller-Hilke B. Mindfulness-based intervention helps preclinical medical students to contain stress, maintain mindfulness and improve academic success. BMC MEDICAL EDUCATION 2021; 21:145. [PMID: 33663478 PMCID: PMC7934360 DOI: 10.1186/s12909-021-02578-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/22/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Stress among students is on the rise during early medical school and has been implicated in poor academic performance. Several methods are being discussed to efficiently reduce stress, among them mindfulness-based interventions. We therefore set out to assess how stress, mindfulness, and academic performance are connected and if an intervention on mindfulness based stress reduction could alleviate stress among medical students and improve their academic achievements. METHODS A non-randomized controlled trial including 143 medical students in their preclinical years was performed in 2019. The students completed two surveys - one in the first, the other in the third term - recording perceived stress and mindfulness via validated scales (PSS-10 and MAAS). In between both, 41 students participated in a voluntary mindfulness-based intervention including six two-hours courses. 86 students served as controls. Scholarly success was assessed via the scores achieved in six exams written during the observation period. RESULTS Stress was inversely related with mindfulness and with the results of the most challenging exam. The intervention on mindfulness based stress reduction helped to contain stress and maintain mindfulness during the observation period and this effect lasted for at least six months beyond completion of the intervention. In contrast, beneficial effects on scholarly success were transient and only detectable at completion of the intervention. CONCLUSION Our observation of short- and intermediate term effects resulting from six individual interventions on mindfulness based stress reduction is encouraging and calls for alternative strategies to induce long-lasting impacts.
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Affiliation(s)
- Luisa Charlotte Lampe
- Core Facility for Cell Sorting & Cell Analysis, Laboratory for Clinical Immunology, University Medical Center Rostock, Rostock, Germany
| | - Brigitte Müller-Hilke
- Core Facility for Cell Sorting & Cell Analysis, Laboratory for Clinical Immunology, University Medical Center Rostock, Rostock, Germany.
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Elhadi M, Khaled A, Malek AB, El-Azhari AEA, Gwea AZ, Zaid A, Elturki SM, Aburgegah A, Abu Ageila MAK, Alhadi A, Albashkar HA, Alshareef AM, Ben Nama AB, Sahboun NAM, Ahmed H. Prevalence of anxiety and depressive symptoms among emergency physicians in Libya after civil war: a cross-sectional study. BMJ Open 2020; 10:e039382. [PMID: 32859667 PMCID: PMC7454180 DOI: 10.1136/bmjopen-2020-039382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES We aimed to identify the prevalence of depression and anxiety among physicians working in the emergency departments of nine tertiary care centres in Libya. DESIGN This was a cross-sectional study. SETTING Nine main tertiary centres in Libya PARTICIPANTS: Emergency department doctors were surveyed between December 2018 and February 2019. INTERVENTION The standardised Hospital Anxiety and Depression Scale (HADS) was selected as a measurement tool for analysing anxiety and depression symptoms; a HADS score of 8 indicated anxiety as well as depression symptoms. The primary outcomes were anxiety and depression, which were tabulated with independent sociodemographic variables. χ2 tests were conducted to compare the prevalence of anxiety and depression between the groups. Statistical analysis was performed using SPSS V.25. RESULTS A total of 108 out of 150 (72%) emergency physicians from all levels participated in the study and took the survey. The emergency physicians had a mean±SD age of 31.2±4.5 years, and were predominantly males (74 out of 108, 68.5%). Overall, 49 (45.4%) physicians reached the cut-off score to define both depression and anxiety (ie, a score ≥8). In terms of violence, 71 (65.7%) reported incidents of verbal violence, while 26 (24.1%) reported physical violence or abuse by militias. In addition, 28 reported being threatened by militias. CONCLUSION The high prevalence rate of anxiety and depression is of concern, and the high rate of physical and verbal abuse highlights the range of abuse endured by doctors in Libya. Therefore, screening for anxiety and depression at regular intervals is needed to avoid the deterioration of mental health, which can increase the risk of suicide and dropping out, and decrease the level of healthcare for patients.
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Affiliation(s)
| | - Ala Khaled
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | | | | | | | - Ahmed Zaid
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | | | | | | | | | | | | | | | | | - Hazem Ahmed
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
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Srinivasa S, Gurney J, Koea J. Potential Consequences of Patient Complications for Surgeon Well-being: A Systematic Review. JAMA Surg 2020; 154:451-457. [PMID: 30916741 DOI: 10.1001/jamasurg.2018.5640] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Patient complications occur in all areas of surgery, and managing them is an important part of surgical practice. Several investigations have examined whether surgeon health affects patient outcomes; however, to date, whether adverse patient outcomes affect surgeon well-being has not been comprehensively examined. Objective To examine how surgical complications in their patients affect the health of surgeons, in particular emotional outcomes, coping strategies, and support mechanisms. Evidence Review A systematic literature review was conducted to identify studies evaluating how patient complications affect surgeons with the aim of determining emotional outcomes, coping strategies, and support mechanisms. Studies pertaining to burnout alone or not conducted in surgeons were excluded. The databases searched included MEDLINE, Embase, PubMed, Web of Science, and Google Scholar, with all literature available on these data sets until the search date of May 1, 2018; collected data were analyzed between May 2 and June 1, 2018. The reference lists of all included studies, as well as related review articles, were manually searched to identify further relevant studies. An inductive approach was used to identify common themes. Findings Nine case series or cross-sectional studies from the United Kingdom or North America were found (8518 unique participants), with 1 study in surgical trainees. Across all studies, surgeons were affected emotionally after complications, with adverse consequences in their professional and personal lives. Four themes were identified within the literature: the adverse emotional influence of complications (anxiety, guilt, sadness, shame, interference with professional and leisure activities) after intraoperative adverse events; coping mechanisms used by surgeons and trainees (limited discussion with colleagues, exercise, artistic or creative outlets, alcohol and substance abuse); institutional support mechanisms and barriers to support (clinical conferences, discussion with mentors, a perception that emotional distress would be perceived as a constitutional weakness); and the consequences of complications in future clinical practice (changes in practice, introduction of protocols, education of staff members, and participating in root-cause analysis). Conclusions and Relevance This study's findings suggest that complications affect surgeons adversely across multiple domains. Further efforts are required at a personal, departmental, institutional, and organizational level to provide effective support. This review highlights that the psychological consequences of patient complications seem to be an important occupational health issue for surgeons.
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Affiliation(s)
- Sanket Srinivasa
- Upper Gastrointestinal Unit, Department of Surgery, North Shore Hospital, Auckland, New Zealand
| | - Jason Gurney
- Cancer and Chronic Conditions Research Group, Department of Public Health, University of Otago on Wellington Harbor, Wellington, New Zealand
| | - Jonathan Koea
- Upper Gastrointestinal Unit, Department of Surgery, North Shore Hospital, Auckland, New Zealand
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Testing anxiety in undergraduate medical students and its correlation with different learning approaches. PLoS One 2019; 14:e0210130. [PMID: 30865635 PMCID: PMC6415780 DOI: 10.1371/journal.pone.0210130] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 12/17/2018] [Indexed: 12/20/2022] Open
Abstract
Objectives Undergraduate medical students experience a considerable amount of stress and anxiety due to frequent exams. The goal of the present study was to examine the development of exam related anxiety and to test for a correlation between anxiety and learning approaches. Methods A whole class of 212 medical students was invited to participate in the study. During their first term, trait anxiety and learning approaches were assessed by use of the state-trait-anxiety inventory (STAI-T) and the approaches-and-study-skills-inventory-for-students (ASSIST), respectively. Acute state anxiety was assessed twice in the course of the second term. To that extent, the STAI-S in combination with measuring salivary cortisol were employed immediately before two oral anatomy exams. Results Our most important results were that a surface learning approach correlated significantly with anxiety as a trait and that students with a predominantly strategic approach to learning were the least anxious yet academically most successful. Conclusion As surface learners are at risk of being academically less successful and because anxiety is a prerequisite for burn-out, we suggest that medical faculties place particular emphasis on conveying strategies for both, coping with stress and successful learning.
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Grigorescu S, Cazan AM, Grigorescu OD, Rogozea LM. The role of the personality traits and work characteristics in the prediction of the burnout syndrome among nurses-a new approach within predictive, preventive, and personalized medicine concept. EPMA J 2018; 9:355-365. [PMID: 30538787 PMCID: PMC6261904 DOI: 10.1007/s13167-018-0151-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 10/09/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The burnout syndrome is characterized by emotional exhaustion, depersonalization, and lack of personal accomplishment. It was identified in some professional categories, the most often being affected those in public health services. OBJECTIVES This study mainly aims to identify and analyze the value of the personality traits and work characteristics as predictive factors for the occurrence of the burnout syndrome in nurses, under the new approach of predictive, preventive, and personalized medicine. METHOD A total of 192 nurses were included in the study. The NEO-Five-Factor Inventory, the Copenhagen Burnout Inventory, and the Inventory of Nursing Work Characteristics were administered to all of the participants. RESULTS Some personality traits proved to be predictive factors for the occurrence of the burnout syndrome. Neuroticism, negative self-esteem, and negative emotionality predict burnout vulnerability. The negative correlations between sociability and the burnout dimensions show that the positive affectivity of the extraverted individuals and the strong positive orientation of the extraverts towards others are protective factors against burnout. There are also significant associations between certain personality traits and nursing work characteristics (work overload, the existence of problems in the department, and satisfaction in the professional and family life), which could be defined, also, as predictive factors for burnout. CONCLUSIONS This study confirms the influence of the Big Five personality traits and nursing work characteristics as predictive factors of the burnout occurrence, opening real possibilities to perform a targeted prevention and provide personalized interventions as organizational services.
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Affiliation(s)
- Simona Grigorescu
- Transilvania University of Brasov, 29, Eroilor Street, 500036 Brasov, Romania
- Emergency Clinical Children Hospital Brasov, 45, Nicopole Street, 500063 Brașov, Romania
| | - Ana-Maria Cazan
- Transilvania University of Brasov, 29, Eroilor Street, 500036 Brasov, Romania
| | - Ovidiu Dan Grigorescu
- Transilvania University of Brasov, 29, Eroilor Street, 500036 Brasov, Romania
- Emergency Clinical County Hospital Brasov, 25-27, Calea Bucuresti Street, 500326 Brașov, Romania
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Baier N, Roth K, Felgner S, Henschke C. Burnout and safety outcomes - a cross-sectional nationwide survey of EMS-workers in Germany. BMC Emerg Med 2018; 18:24. [PMID: 30126358 PMCID: PMC6102842 DOI: 10.1186/s12873-018-0177-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 08/10/2018] [Indexed: 12/21/2022] Open
Abstract
Background The association between burnout and patient safety has been analyzed in many studies for nurses, physicians, and residents. However, studies concerning prehospital emergency medical services (EMS) workers are limited, although they are particularly under risk for emotional stress. This study aims to descriptively analyze the overall degree of burnout among EMS-workers, and potential adverse events that might harm patients as well as the relationship between burnout and perceived safety outcomes for EMS-workers in Germany. Methods EMS-workers were recruited via German EMS-journals, social media and a professional association to participate in an online survey. The questionnaire includes the ´Maslach Burnout Inventory´ (MBI), the ‘Emergency Medical Services Safety Inventory’ (EMS-SI), and items about job satisfaction and the individual person. Data was descriptively analyzed by calculating frequencies, means, percentages and Pearson correlation coefficients. The association between burnout and patient safety was analyzed using linear and logistic regression models. Results A total of n = 1101 questionnaires were considered for data analysis. The vast majority of participants were male, younger than 40 years old, and full-time employees with an EMS-experience of 12 years on average. Between 19.9 and 40% of the participants showed a high degree of burnout in one of the burnout dimensions. Safety compromising behavior was the outcome measure with the highest percentage of participants reporting a negative outcome measure. The dimensions emotional exhaustion and depersonalization were positively associated with the safety outcomes injury and safety compromising behavior. Additionally, experiences, job satisfaction and the intention to leave the current job were significantly associated with the outcome measures. Conclusion This is the first study that examines the association between the degree of burnout and patient safety for EMS-workers. The results suggest that an expansion of psychological support for EMS-workers should be considered. Further research should concentrate on the complex relations between working conditions, burnout and patient safety. Electronic supplementary material The online version of this article (10.1186/s12873-018-0177-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Natalie Baier
- Institute of Health Care Management, Berlin Centre of Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17. Juni 135 (H80), 10623, Berlin, Germany.
| | - Karsten Roth
- Institute of Health Care Management, Berlin Centre of Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17. Juni 135 (H80), 10623, Berlin, Germany.,ASB Köln e.V, Sülzburgstraße 146, 050937, Köln, Germany
| | - Susanne Felgner
- Institute of Health Care Management, Berlin Centre of Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17. Juni 135 (H80), 10623, Berlin, Germany
| | - Cornelia Henschke
- Institute of Health Care Management, Berlin Centre of Health Economics Research (BerlinHECOR), Technische Universität Berlin, Straße des 17. Juni 135 (H80), 10623, Berlin, Germany
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Cheval B, Cullati S, Pihl-Thingvad J, Mongin D, Von Arx M, Chopard P, Courvoisier DS. Impact of CAre-related Regret Upon Sleep (ICARUS) cohort study: protocol of a 3-year multicentre, international, prospective cohort study of novice healthcare professionals. BMJ Open 2018; 8:e022172. [PMID: 29588326 PMCID: PMC5875595 DOI: 10.1136/bmjopen-2018-022172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 02/09/2018] [Accepted: 02/13/2018] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Healthcare professionals are particularly at risk of developing numerous physical and psychological health problems. The experiences of emotional burden associated with providing healthcare, notably care-related regret, have been associated with these health problems, but only using cross-sectional data so far. Evidence of a causal impact of regret has not been assessed. The Impact of CAre-related Regret Upon Sleep (ICARUS) study is the first prospective and international cohort study established to examine how newly practising healthcare professionals adapt to their challenging job by assessing the impact of care-related regret on sleep and job quitting. METHOD AND ANALYSIS The ICARUS cohort study will include newly practising healthcare professionals working in acute care hospitals and clinics recruited between May 2017 and November 2019. Data collection, which will begin as soon as the participant starts working with patients, will consist of a 1-year weekly assessment using a secure web survey. Follow-up data will be collected at 6, 12, 18 and 24 months after the end of the first year. We will collect detailed information on the experience of care-related regret (ie, highest regret intensity, accumulation of regrets and coping strategies related to regrets), sleep problems and job quitting. Moreover, quality of life, health status and burnout will be assessed during the follow-up. Several confounders factors, including sociodemographic characteristics, personality, night shifts and work environment characteristics, will be assessed. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of Geneva Canton, Switzerland (CCER2016-02041), the Ethics Committee of London South Bank University (HSCSEP/17/06) and the University Research Ethics Committee of Bedfordshire (UREC106). Other study centres deemed local ethical approval unnecessary since the main ethics committee (Geneva) had already accepted the project. Results will be published in relevant scientific journals and be disseminated in international conferences. Fully anonymised data and questionnaires will be freely accessible to everyone (scientists and general public).
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Affiliation(s)
- Boris Cheval
- Quality of Care Service, University Hospital of Geneva, Geneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Stéphane Cullati
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
- Swiss NCCR “Lives: Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Denmark
| | - Jesper Pihl-Thingvad
- Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark
- National Center of Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - Denis Mongin
- Quality of Care Service, University Hospital of Geneva, Geneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Martina Von Arx
- Swiss NCCR “Lives: Overcoming Vulnerability: Life Course Perspectives”, University of Geneva, Geneva, Denmark
- Institute of Demography and Socioeconomics, University of Geneva, Geneva, Switzerland
| | - Pierre Chopard
- Quality of Care Service, University Hospital of Geneva, Geneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Delphine S Courvoisier
- Quality of Care Service, University Hospital of Geneva, Geneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
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Alcantara J, Ohm J, Alcantara J. The quality of life of chiropractors using PROMIS: Results from a practice-based research network. Complement Ther Clin Pract 2017; 29:142-146. [PMID: 29122252 DOI: 10.1016/j.ctcp.2017.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 09/12/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Joel Alcantara
- The International Chiropractic Pediatric Association, Media, PA, USA; Life Chiropractic College West, 25001 Industrial Blvd, Hayward, CA, 94545, USA.
| | - Jeanne Ohm
- The International Chiropractic Pediatric Association, Media, PA, USA; Private Practice of Chiropractic Media, 327 N Middletown Rd, Media, PA, 19063, USA.
| | - Junjoe Alcantara
- Private Practice of Chiropractic, 25 San Miguel Avenue, Suite 2615 Medical Plaza Ortigas, Ortigas Business Center, Pasig City, Manila, Philippines.
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Dewa CS, Loong D, Bonato S, Trojanowski L, Rea M. The relationship between resident burnout and safety-related and acceptability-related quality of healthcare: a systematic literature review. BMC MEDICAL EDUCATION 2017; 17:195. [PMID: 29121895 PMCID: PMC5680598 DOI: 10.1186/s12909-017-1040-y] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 11/02/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND There has been increasing interest in examining the relationship between physician wellbeing and quality of patient care. However, few reviews have specifically focused on resident burnout and quality of patient care. The purpose of this systematic literature review of the current scientific literature is to address the question, "How does resident burnout affect the quality of healthcare related to the dimensions of acceptability and safety?" METHODS This systematic literature review uses a multi-step screening process of publicly available peer-reviewed studies from five electronic databases: (1) Medline Current, (2) Medline In-process, (3) PsycINFO, (4) Embase, and (5) Web of Science. RESULTS The electronic literature search resulted in the identification of 4638 unique citations. Of these, 10 articles were included in the review. Studies were assessed for risk of bias. Of the 10 studies that met the inclusion criteria, eight were conducted in the US, one in The Netherlands, and one in Mexico. Eight of the 10 studies focused on patient safety. The results of these included studies suggest there is moderate evidence that burnout is associated with patient safety (i.e., resident self-perceived medical errors and sub-optimal care). There is less evidence that specific dimensions of burnout are related to acceptability (i.e., quality of care, communication with patients). CONCLUSIONS The results of this systematic literature review suggest a relationship between patient safety and burnout. These results potentially have important implications for the medical training milieu because residents are still in training and at the same time are asked to teach students. The results also indicate a need for more evidence-based interventions that support continued research examining quality of care measures, especially as they relate to acceptability.
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Affiliation(s)
- Carolyn S. Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, 2230 Stockton Boulevard, Sacramento, CA 95817 USA
- Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1 Canada
| | - Desmond Loong
- Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1 Canada
| | - Sarah Bonato
- Library Services, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1 Canada
| | - Lucy Trojanowski
- Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, M5S 2S1 Canada
| | - Margaret Rea
- School of Medicine and Betty Irene Moore School of Nursing, UC Davis Health System, 4610 X Street, Education Building, 4th floor, Room 4101B, Sacramento, CA 95817 USA
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Dewa CS, Loong D, Bonato S, Trojanowski L. The relationship between physician burnout and quality of healthcare in terms of safety and acceptability: a systematic review. BMJ Open 2017; 7:e015141. [PMID: 28637730 PMCID: PMC5734243 DOI: 10.1136/bmjopen-2016-015141] [Citation(s) in RCA: 241] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/24/2017] [Accepted: 04/21/2017] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES This study reviews the current state of the published peer-reviewed literature related to physician burnout and two quality of care dimensions. The purpose of this systematic literature review is to address the question, 'How does physician burnout affect the quality of healthcare related to the dimensions of acceptability and safety?' DESIGN Using a multiphase screening process, this systematic literature review is based on publically available peer-reviewed studies published between 2002 and 2017. Six electronic databases were searched: (1) MEDLINE Current, (2) MEDLINE In-process, (3) MEDLINE Epub Ahead of Print, (4) PsycINFO, (5) Embase and (6) Web of Science. SETTING Physicians practicing in civilian settings. PARTICIPANTS Practicing physicians who have completed training. PRIMARY AND SECONDARY OUTCOME MEASURES Quality of healthcare related to acceptability (ie, patient satisfaction, physician communication and physician attitudes) and safety (ie, minimising risks or harm to patients). RESULTS 4114 unique citations were identified. Of these, 12 articles were included in the review. Two studies were rated as having high risk of bias and 10 as having moderate risk. Four studies were conducted in North America, four in Europe, one in the Middle East and three in East Asia. Results of this systematic literature review suggest there is moderate evidence that burnout is associated with safety-related quality of care. Because of the variability in the way patient acceptability-related quality of care was measured and the inconsistency in study findings, the evidence supporting the relationship between burnout and patient acceptability-related quality of care is less strong. CONCLUSIONS The focus on direct care-related quality highlights additional ways that physician burnout affects the healthcare system. These studies can help to inform decisions about how to improve patient care by addressing physician burnout. Continued work looking at the relationship between dimensions of acceptability-related quality of care measures and burnout is needed to advance the field.
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Affiliation(s)
- Carolyn S Dewa
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, California, USA
- Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, Canada
| | - Desmond Loong
- Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sarah Bonato
- Library Services, Centre for Addiction and Mental Health, Toronto, Canada
| | - Lucy Trojanowski
- Centre for Research on Employment and Workplace Health, Centre for Addiction and Mental Health, Toronto, Canada
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