Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio.
Cincinnati Research on Education in Surgical Training (CREST), Department of Surgery, University of Cincinnati, Cincinnati, Ohio.
J Surg Educ. 2019 Sep-Oct;76(5):1241-1247. doi: 10.1016/j.jsurg.2019.02.009. Epub 2019 Mar 8.
Increasing reports on resident burnout have resulted in efforts to improve trainee well-being. Medical student burnout, however, is not well understood. We set out to evaluate burnout among third-year medical students and explore its impact on clerkship performance.
Analysis of prospectively-collected survey data from medical students on the third-year surgery clerkship was performed. Surveys included an institution-specific pre- and postclerkship survey, the 12-item Grit Scale, and the Maslach Burnout Inventory.
University of Cincinnati College of Medicine.
Between 2016 and 2017, 166 students completed the surgery clerkship and were asked to complete the surveys. Sixty-two students (37.4%) completed all surveys and were included in this study.
Among the third-year medical student participants, there was no difference in burnout before vs after the clerkship (22.6% vs 17.7%, p = 0.41). Students with burnout had significantly lower grit scores (3.10 ± 0.66) compared to those without burnout (3.63 ± 0.50, p = 0.01). Linear regression analysis demonstrated that increasing grit was associated with decreasing emotional exhaustion (p = 0.01), decreasing depersonalization (p = 0.04), and increasing personal achievement (p = 0.03). Finally, 75% of students with resolution of burnout developed an interest in surgery, whereas all students who developed burnout after the clerkship had no interest in surgery (p = 0.03). Upon completion of the rotation, burnout was not associated with poorer quality of clerkship experience or decreased clerkship performance (p > 0.05 for each).
Although traditionally considered a difficult rotation, we found no increase in medical student burnout following the surgery clerkship. Higher grit scores were associated with decreased burnout, though burnout did not have a negative impact on student experience or performance. Clerkships should continue to set high expectations and maximize educational opportunities without significant apprehension that it may have a negative impact on students.
越来越多的住院医师倦怠报告促使人们努力改善学员的幸福感。然而，医学生的倦怠感还没有被很好地理解。我们着手评估三年级医学生的倦怠感，并探讨其对实习表现的影响。
对在辛辛那提大学医学院进行三年级外科实习的医学生进行前瞻性调查数据的分析。调查包括机构特定的实习前和实习后调查、12 项坚毅量表和马斯拉赫倦怠量表。
辛辛那提大学医学院。
在 2016 年至 2017 年间，有 166 名学生完成了外科实习，并被要求完成调查。62 名学生（37.4%）完成了所有调查，并被纳入本研究。
在三年级医学生参与者中，实习前后的倦怠感没有差异（22.6%比 17.7%，p=0.41）。有倦怠感的学生的坚毅评分明显较低（3.10±0.66），而没有倦怠感的学生的坚毅评分较高（3.63±0.50，p=0.01）。线性回归分析表明，坚毅程度的增加与情绪疲惫（p=0.01）、去人性化（p=0.04）和个人成就感（p=0.03）的减少有关。最后，75%的倦怠感得到缓解的学生对手术产生了兴趣，而所有在实习后出现倦怠感的学生都对手术不感兴趣（p=0.03）。完成轮转后，倦怠感与较差的实习体验或实习表现下降无关（每个 p > 0.05）。
尽管传统上认为外科实习是一个困难的轮转，但我们发现外科实习后医学生的倦怠感并没有增加。较高的坚毅评分与较低的倦怠感相关，尽管倦怠感对学生的体验或表现没有负面影响。实习应该继续设定高标准并充分利用教育机会，而不必过分担心这可能对学生产生负面影响。
