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      Assessment of burnout in veterinary medical students using the Maslach Burnout Inventory-Educational Survey: a survey during two semesters

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      , ,
      BMC Medical Education
      BioMed Central
      Veterinary, Students, Burnout, Maslach

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          Abstract

          Background

          Burnout among veterinary students can result from known stressors in the absence of a support system. The objectives of this study were to evaluate use of the Maslach Burnout Inventory-Educator Survey (MBI-ES) to assess burnout in veterinary students and evaluate the factors that predict the MBI-ES scores.

          Methods

          The MBI-ES was administered to first (Class of 2016) and second year (Class of 2015) veterinary medical students during the 2012-2013 academic year in the fall and spring semesters. Factor analysis and test reliability for the survey were determined. Mean scores for the subscales determining burnout namely emotional exhaustion (EE), depersonalization (DP) and lack of personal accomplishment (PA) were calculated for both classes in the 2 semesters. Multiple regression analysis was performed to evaluate other factors that predict the MBI-ES scores.

          Results

          A non-probability sampling method was implemented consisting of a voluntary sample of 170 and 123 students in the fall and spring semesters, respectively. Scores for EE, DP and PA were not different between the 2 classes within the same semester. Mean ± SD scores for EE, DP and PA for the fall semester were 22.9 ± 9.6, 5.0 ± 4.8 and 32.3 ± 6.7, respectively. Mean ± SD scores for EE, DP and PA the spring semester were 27.8 ± 10.7, 6.5 ± 6.1and 31.7 ± 6.8, respectively. The EE score was higher in spring compared to fall while DP and PA scores were not different between the 2 semesters. Living arrangements specifically as to whether or not a student lived with another veterinary medical students was the only variable significantly associated with the MBI-ES scores. Students in this study had moderate levels of burnout based on the MBI-ES scores.

          Conclusions

          The MBI-ES was an acceptable instrument for assessing burnout in veterinary medical students. The EE scores were higher in the spring semester as compared to the fall semester. Thus students in the first and second years of veterinary school under the current curriculum experience the greatest levels of emotional exhaustion during the spring semester. This has administrative implications for the school, when considering the allocation and use of resources for student support systems during each semester.

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          Most cited references38

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          Self-Efficacy : The Exercise of Control

          1 Theoretical Perspectives The Nature of Human Agency Human Agency in Triadic Reciprocal Causation Determinism and the Exercise of Self-Influence Related Views of Personal Efficacy 2 The Nature and Structure of Self-Efficacy Perceived Self-Efficacy as a Generative Capability Active Producers versus Passive Foretellers of Performances The Self-Efficacy Approach to Personal Causation Multidimensionality of Self-Efficacy Belief Systems Self-Efficacy Causality Sources of Discordance Between Efficacy Judgment and Action 3 Sources of Self-Efficacy Enactive Mastery Experience Vicarious Experience Verbal Persuasion Physiological and Affective States Integration of Efficacy Information 4 Mediating Processes Cognitive Processes Motivational Processes Affective Processes Selection Processes 5 Developmental Analysis of Self-Efficacy Origins of a Sense of Personal Agency Familial Sources of Self-Efficacy Peers and the Broadening and Validation of Self-Efficacy School as an Agency for Cultivating Self-Efficacy Growth of Self-Efficacy through Transitional Experiences of Adolescence Self-Efficacy Concerns of Adulthood Reappraisals of Self-Efficacy with Advancing Age 6 Cognitive Functioning Students' Cognitive Self-Efficacy Teachers' Perceived Efficacy Collective School Efficacy 7 Health Functioning Biological Effects of Perceived Self-Efficacy Perceived Self-Efficacy in Health Promoting Behavior Prognostic Judgments and Perceived Self-Efficacy 8 Clinical Functioning Anxiety and Phobic Dysfunctions Depression Eating Disorders Alcohol and Drug Abuse 9 Athletic Functioning Development of Athletic Skills Self-Regulation of Athletic Performance Collective Team Efficacy Psychobiological Effects of Physical Exercise 10 Organizational Functioning Career Development and Pursuits Mastery of Occupational Roles Self-Efficacy in Organizational Decision Making Self-Efficacy in Enactment of Occupational Roles Collective Organizational Efficacy 11 Collective Efficacy Gauging Collective Efficacy Political Efficacy Enablement by Media Modes of Influence Enablement for Sociocultural Change Underminers of Collective Efficacy References Name and Subject Indexes.
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            Burnout and self-reported patient care in an internal medicine residency program.

            Burnout is a syndrome of depersonalization, emotional exhaustion, and a sense of low personal accomplishment. Little is known about burnout in residents or its relationship to patient care. To determine the prevalence of burnout in medical residents and explore its relationship to self-reported patient care practices. Cross-sectional study using an anonymous, mailed survey. University-based residency program in Seattle, Washington. 115 internal medicine residents. Burnout was measured by using the Maslach Burnout Inventory and was defined as scores in the high range for medical professionals on the depersonalization or emotional exhaustion subscales. Five questions developed for this study assessed self-reported patient care practices that suggested suboptimal care (for example, "I did not fully discuss treatment options or answer a patient's questions" or "I made...errors that were not due to a lack of knowledge or inexperience"). Depression and at-risk alcohol use were assessed by using validated screening questionnaires. Of 115 (76%) responding residents, 87 (76%) met the criteria for burnout. Compared with non-burned-out residents, burned-out residents were significantly more likely to self-report providing at least one type of suboptimal patient care at least monthly (53% vs. 21%; P = 0.004). In multivariate analyses, burnout--but not sex, depression, or at-risk alcohol use--was strongly associated with self-report of one or more suboptimal patient care practices at least monthly (odds ratio, 8.3 [95% CI, 2.6 to 26.5]). When each domain of burnout was evaluated separately, only a high score for depersonalization was associated with self-reported suboptimal patient care practices (in a dose-response relationship). Burnout was common among resident physicians and was associated with self-reported suboptimal patient care practices.
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              Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study.

              Medical errors are associated with feelings of distress in physicians, but little is known about the magnitude and direction of these associations. To assess the frequency of self-perceived medical errors among resident physicians and to determine the association of self-perceived medical errors with resident quality of life, burnout, depression, and empathy using validated metrics. Prospective longitudinal cohort study of categorical and preliminary internal medicine residents at Mayo Clinic Rochester. Data were provided by 184 (84%) of 219 eligible residents. Participants began training in the 2003-2004, 2004-2005, and 2005-2006 academic years and completed surveys quarterly through May 2006. Surveys included self-assessment of medical errors and linear analog scale assessment of quality of life every 3 months, and the Maslach Burnout Inventory (depersonalization, emotional exhaustion, and personal accomplishment), Interpersonal Reactivity Index, and a validated depression screening tool every 6 months. Frequency of self-perceived medical errors was recorded. Associations of an error with quality of life, burnout, empathy, and symptoms of depression were determined using generalized estimating equations for repeated measures. Thirty-four percent of participants reported making at least 1 major medical error during the study period. Making a medical error in the previous 3 months was reported by a mean of 14.7% of participants at each quarter. Self-perceived medical errors were associated with a subsequent decrease in quality of life (P = .02) and worsened measures in all domains of burnout (P = .002 for each). Self-perceived errors were associated with an odds ratio of screening positive for depression at the subsequent time point of 3.29 (95% confidence interval, 1.90-5.64). In addition, increased burnout in all domains and reduced empathy were associated with increased odds of self-perceived error in the following 3 months (P=.001, P<.001, and P=.02 for depersonalization, emotional exhaustion, and lower personal accomplishment, respectively; P=.02 and P=.01 for emotive and cognitive empathy, respectively). Self-perceived medical errors are common among internal medicine residents and are associated with substantial subsequent personal distress. Personal distress and decreased empathy are also associated with increased odds of future self-perceived errors, suggesting that perceived errors and distress may be related in a reciprocal cycle.
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                Author and article information

                Contributors
                mchigerwe@ucdavis.edu
                kaboudreaux@ucdavis.edu
                jeilkiw@ucdavis.edu
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                28 November 2014
                28 November 2014
                2014
                : 14
                : 1
                : 255
                Affiliations
                [ ]Medicine and Epidemiology, University of California-Davis, School of Veterinary Medicine, Davis, CA USA
                [ ]Dean’s Office, University of California-Davis, School of Veterinary Medicine, Davis, CA USA
                [ ]Surgical and Radiological Sciences and Dean’s Office, University of California-Davis, School of Veterinary Medicine, Davis, CA USA
                Article
                255
                10.1186/s12909-014-0255-4
                4256738
                25429983
                3a719def-bfed-4d8b-9a45-30edfa9d17a5
                © Chigerwe et al.; licensee BioMed Central Ltd. 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 28 March 2014
                : 18 November 2014
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2014

                Education
                veterinary,students,burnout,maslach
                Education
                veterinary, students, burnout, maslach

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