The learning environment and resident burnout: a national study

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Abstract

Introduction

Concerns exist about the negative impact of burnout on the professional and personal lives of residents. It is suggested that the origins of burnout among residents are rooted in the learning environment. We aimed to evaluate the association between the learning environment and burnout in a national sample of Dutch residents.

Methods

We conducted a cross-sectional online survey among all Dutch residents in September 2015. We measured the learning environment using the three domain scores on content, organization, and atmosphere from the Scan of Postgraduate Educational Environment Domains (SPEED) and burnout using the Dutch version of the Maslach Burnout Inventory (UBOS-C).

Results

Of 1,231 responding residents (33 specialties), 185 (15.0%) met criteria for burnout. After adjusting for demographic (age, gender and marital status) and work-related factors (year of training, type of teaching hospital and type of specialty), we found a consistent inverse association between SPEED scores and the risk of burnout (aOR 0.54, 95% CI 0.46 to 0.62, p < 0.001).

Discussion

We found a strong and consistent inverse association between the perceived quality of the learning environment and burnout among residents. This suggests that the learning environment is of key importance in preventing resident burnout.

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Most cited references 23

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Effect of reducing interns' weekly work hours on sleep and attentional failures.

Steven Lockley, John Cronin, Erin Evans … (2004)

Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify work hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included extended work shifts and during an intervention schedule that limited scheduled work hours to 16 or fewer consecutive hours. Twenty interns were studied during two three-week rotations in intensive care units, each during both the traditional and the intervention schedule. Subjects completed daily sleep logs that were validated with regular weekly episodes (72 to 96 hours) of continuous polysomnography (r=0.94) and work logs that were validated by means of direct observation by study staff (r=0.98). Seventeen of 20 interns worked more than 80 hours per week during the traditional schedule (mean, 84.9; range, 74.2 to 92.1). All interns worked less than 80 hours per week during the intervention schedule (mean, 65.4; range, 57.6 to 76.3). On average, interns worked 19.5 hours per week less (P<0.001), slept 5.8 hours per week more (P<0.001), slept more in the 24 hours preceding each working hour (P<0.001), and had less than half the rate of attentional failures while working during on-call nights (P=0.02) on the intervention schedule as compared with the traditional schedule. Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours. Copyright 2004 Massachusetts Medical Society.

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Stress, burnout and doctors' attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates

IC McManus, A. A. Keeling, E Paice … (2004)

Background The study investigated the extent to which approaches to work, workplace climate, stress, burnout and satisfaction with medicine as a career in doctors aged about thirty are predicted by measures of learning style and personality measured five to twelve years earlier when the doctors were applicants to medical school or were medical students. Methods Prospective study of a large cohort of doctors. The participants were first studied when they applied to any of five UK medical schools in 1990. Postal questionnaires were sent to all doctors with a traceable address on the current or a previous Medical Register. The current questionnaire included measures of Approaches to Work, Workplace Climate, stress (General Health Questionnaire), burnout (Maslach Burnout Inventory), and satisfaction with medicine as a career and personality (Big Five). Previous questionnaires had included measures of learning style (Study Process Questionnaire) and personality. Results Doctors' approaches to work were predicted by study habits and learning styles, both at application to medical school and in the final year. How doctors perceive their workplace climate and workload is predicted both by approaches to work and by measures of stress, burnout and satisfaction with medicine. These characteristics are partially predicted by trait measures of personality taken five years earlier. Stress, burnout and satisfaction also correlate with trait measures of personality taken five years earlier. Conclusions Differences in approach to work and perceived workplace climate seem mainly to reflect stable, long-term individual differences in doctors themselves, reflected in measures of personality and learning style.

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The learning environment and medical student burnout: a multicentre study.

Paul Novotny, C Thomas, Sarah Power … (2009)

Little is known about specific personal and professional factors influencing student distress. The authors conducted a comprehensive assessment of how learning environment, clinical rotation factors, workload, demographics and personal life events relate to student burnout. All medical students (n = 3080) at five medical schools were surveyed in the spring of 2006 using a validated instrument to assess burnout. Students were also asked about the aforementioned factors. A total of 1701 medical students (response rate 55%) completed the survey. Learning climate factors were associated with student burnout on univariate analysis (odds ratio [OR] 1.36-2.07; all P < or = 0.02). Being on a hospital ward rotation or a rotation requiring overnight call was also associated with burnout (ORs 1.69 and 1.48, respectively; both P < or = 0.02). Other workload characteristics (e.g. number of admissions) had no relation to student burnout. Students who experienced a positive personal life event had a lower frequency of burnout (OR 0.70; P < or = 0.02), whereas those who experienced negative personal life events did not have a higher frequency of burnout than students who did not experience a negative personal life event. On multivariate analysis personal characteristics, learning environment and personal life events were all independently related to student burnout. Although a complex array of personal and professional factors influence student well-being, student satisfaction with specific characteristics of the learning environment appears to be a critical factor. Studies determining how to create a learning environment that cultivates student well-being are needed.

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Author and article information

Contributors

Stefan N. van Vendeloo: stefanvanvendeloo@gmail.com

Bio :

Stefan N. van Vendeloo

MD, is an orthopaedic surgeon at Isala Hospital, Zwolle, the Netherlands.

David J. Prins:

Bio :

David J. Prins

MD, is a resident doctor in pulmonology at Medical Center Leeuwarden, Leeuwarden, the Netherlands.

Cees C. P. M. Verheyen:

Bio :

Cees C.P.M. Verheyen

MD, PhD, is an orthopaedic surgeon at Isala Hospital, Zwolle, the Netherlands.

Jelle T. Prins:

Bio :

Jelle T. Prins

MD, PhD, is the dean at MCL Academy, Medical Center Leeuwarden, Leeuwarden, the Netherlands.

Fleur van den Heijkant:

Bio :

Fleur van den Heijkant

MD, is a resident doctor in urology at Maastricht University Medical Centre, Maastricht, the Netherlands.

Frank M. M. A. van der Heijden:

Bio :

Frank M.M.A. van der Heijden

MD, PhD, is a psychiatrist at the Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands.

Paul L. P. Brand:

Bio :

Paul L.P. Brand

MD, PhD, is professor of clinical medical education at the Postgraduate School of Medicine UMCG, Groningen, the Netherlands and a paediatrician at Princess Amalia Children’s Centre, Isala Hospital, Zwolle, the Netherlands.

Journal

Journal ID (nlm-ta): Perspect Med Educ

Journal ID (iso-abbrev): Perspect Med Educ

Title: Perspectives on Medical Education

Publisher: Bohn Stafleu van Loghum (Houten )

ISSN (Print): 2212-2761

ISSN (Electronic): 2212-277X

Publication date (Electronic): 23 February 2018

Publication date PMC-release: 23 February 2018

Publication date (Print): April 2018

Volume: 7

Issue: 2

Pages: 120-125

Affiliations

[1 ]ISNI 0000 0001 0547 5927, GRID grid.452600.5, Department of Orthopedic Surgery and Traumatology, , Isala Hospital, ; Zwolle, The Netherlands

[2 ]ISNI 0000 0004 0419 3743, GRID grid.414846.b, Department of Pulmonology, , Medical Center Leeuwarden, ; Leeuwarden, The Netherlands

[3 ]ISNI 0000 0004 0419 3743, GRID grid.414846.b, MCL Academy, , Medical Center Leeuwarden, ; Leeuwarden, The Netherlands

[4 ]ISNI 0000 0004 0480 1382, GRID grid.412966.e, Department of Urology, , Maastricht University Medical Centre, ; Maastricht, The Netherlands

[5 ]ISNI 0000 0004 0501 6079, GRID grid.418157.e, Vincent van Gogh Institute for Psychiatry, ; Venray, The Netherlands

[6 ]ISNI 0000 0001 0547 5927, GRID grid.452600.5, Department of Pediatrics, , Isala Hospital, ; Zwolle, The Netherlands

[7 ]ISNI 0000 0000 9558 4598, GRID grid.4494.d, Postgraduate School of Medicine, , University Medical Center Groningen, ; Groningen, The Netherlands

Article

Publisher ID: 405

DOI: 10.1007/s40037-018-0405-1

PMC ID: 5889377

PubMed ID: 29476425

SO-VID: 236ea644-9149-4b64-b8c2-b0260fe23733

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Funding

Funded by: Stichting SWG

Funded by: CarriereCentrum Zorg

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ScienceOpen disciplines: Education

Keywords: learning environment,burnout,residency,postgraduate medical education

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ScienceOpen disciplines: Education

Keywords: learning environment, burnout, residency, postgraduate medical education

The learning environment and resident burnout: a national study

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Abstract

Introduction

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Results

Discussion

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Malaysian Journal of Learning and Instruction

Most cited references 23

Effect of reducing interns' weekly work hours on sleep and attentional failures.

Stress, burnout and doctors' attitudes to work are determined by personality and learning style: A twelve year longitudinal study of UK medical graduates

The learning environment and medical student burnout: a multicentre study.

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