Dataset Information

Association of Weekly Protected Nonclinical Time With Resident Physician Burnout and Well-being.

ABSTRACT:

Importance

Burnout among physicians is high, with resulting concern about quality of care. With burnout beginning early in physician training, much-needed data are lacking on interventions to decrease burnout and improve well-being among resident physicians.

Objectives

To design a departmental-level burnout intervention, evaluate its association with otolaryngology residents' burnout and well-being, and describe how residents used and perceived the study intervention.

Design, setting, and participants

A prospective, nonrandomized crossover study was conducted from September 25, 2017, to June 24, 2018, among all 19 current residents in the Department of Otolaryngology at the University of Minnesota. Statistical analysis was performed from June 28 to August 7, 2018.

Interventions

All participants were assigned 2 hours per week of protected nonclinical time alternating with a control period of no intervention at 6-week intervals.

Main outcomes and measures

Burnout was measured by the Maslach Burnout Inventory and Mini-Z Survey. Well-being was measured by the Resident and Fellow Well-Being Index and a quality-of-life single-item self-assessment. In addition to a baseline demographic survey, participants completed the aforementioned surveys at approximately 6-week intervals during the study period.

Results

Among the 19 residents in the study (10 men [53%]), the overall protected time intervention (week 0 to week 32) was associated with a mean decrease of 0.63 points (95% CI, -1.03 to -0.22 points) in the Maslach Burnout Inventory emotional exhaustion score, indicating a clinically meaningful decrease in burnout, and a mean decrease of 1.26 points (95% CI, -2.18 to -0.34 points) in the Resident and Fellow Well-Being Index score, indicating a clinically meaningful improvement in well-being. The baseline to week 32 mean changes in the Maslach Burnout Inventory depersonalization score, Maslach Burnout Inventory personal accomplishment score, and quality-of-life single-item self-assessment were not clinically meaningful. There were clinically meaningful improvements in 4 of 6 tested Mini-Z Questionnaire items from baseline to week 32: job stress (weighted ? statistic, 0.21; 95% CI, -0.11 to 0.53), burnout (weighted ? statistic, 0.25; 95% CI, -0.02 to 0.53), control over workload (weighted ? statistic, 0.26; 95% CI, -0.01 to 0.53), and sufficient time for documentation (weighted ? statistic, 0.31; 95% CI, 0.08 to 0.54).

Conclusions and relevance

This study found that 2 hours per week of protected nonclinical time was associated with decreased burnout and increased well-being in a small sample of otolaryngology residents. Future randomized clinical studies in larger cohorts are warranted to infer causality of decreased burnout and increased well-being as a result of protected nonclinical time.

SUBMITTER: Stevens K

PROVIDER: S-EPMC7018397 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Association of Weekly Protected Nonclinical Time With Resident Physician Burnout and Well-being.

Stevens Kristin K Davey Cynthia C Lassig Amy Anne AA

JAMA otolaryngology-- head & neck surgery 20200201 2

<h4>Importance</h4>Burnout among physicians is high, with resulting concern about quality of care. With burnout beginning early in physician training, much-needed data are lacking on interventions to decrease burnout and improve well-being among resident physicians.<h4>Objectives</h4>To design a departmental-level burnout intervention, evaluate its association with otolaryngology residents' burnout and well-being, and describe how residents used and perceived the study intervention.<h4>Design, s ...[more]

PMID: 31895461

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Project description:BACKGROUND: Medical knowledge and clinical performance ratings are major criteria for assessing the competence of resident physicians. However, these assessments may be influenced by residents' mental health. The relationship between residents' well-being and empathy and assessments of their global performance remains unclear. OBJECTIVE: To determine whether resident well-being and empathy are associated with assessments of their medical knowledge and clinical performance. DESIGN, SETTING, AND PARTICIPANTS: We studied 730 clinical performance assessments completed by peers, supervising residents, and allied health professionals; 193 mini-clinical evaluation exercise (mini-CEX) evaluations; and 260 in-training examinations (ITE) of Mayo Clinic internal medicine residents between January 2009 and August 2010. Multivariate generalized estimating equations were used to evaluate associations between residents' well-being and empathy and assessments of their knowledge and clinical performance. MEASUREMENTS: Independent variables were empathy using the Interpersonal Reactivity Index (IRI), burnout using the Maslach Burnout Inventory, depression using a standardized two-question screening instrument, and quality of life using a Linear Analog Self-Assessment item and the Medical Outcomes Study Short Form (SF-8). Dependent variables were mini-CEX, ITE, and the validated six-item Mayo clinical performance assessment. RESULTS: 202 residents (64.7%) provided both well-being and at least one category of assessment data. In multivariate models, residents' scores on the IRI empathy measure of "the tendency to adopt the psychological view of others" were associated with higher peer ratings on "desirability as a physician for a family member" (beta?=?0.023, 95% CI?=?0.007-0.039, p?=?0.004). Additionally, burnout was associated with higher supervisor ratings of communication (beta?=?0.309, 95% CI?=?0.100-0.517, p?=?0.004). There were no observed associations between ITE or mini-CEX scores and resident quality of life, burnout, fatigue, depression, or empathy. CONCLUSIONS: Most dimensions of resident well-being were not associated with residents' knowledge scores and assessments of their clinical performance by other members of the health care team, which supports the trustworthiness of these measures. Nonetheless, correlations of resident empathy and burnout with assessments completed by peers and supervising residents suggest that some ratings of residents may be influenced by interpersonal factors.

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Dataset Information

Association of Weekly Protected Nonclinical Time With Resident Physician Burnout and Well-being.

Importance

Objectives

Design, setting, and participants

Interventions

Main outcomes and measures

Results

Conclusions and relevance

Publications

Association of Weekly Protected Nonclinical Time With Resident Physician Burnout and Well-being.

Similar Datasets

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