Northwestern University, Chicago, IL, USA.
Cleveland Clinic, Cleveland, OH, USA.
Acad Psychiatry. 2020 Aug;44(4):388-393. doi: 10.1007/s40596-020-01226-9. Epub 2020 May 5.
The authors examine the associations of generational affiliation on empathy and burnout in a sample of millennial (born between 1982 and 2000) and Generation X (born between 1965 and 1981) residents and fellows.
At a single large institution during the 2013-2014 academic year, residents and fellows were asked to complete the Jefferson Scale of Physician Empathy and Maslach Burnout Inventory (MBI). Responses were combined with GME database content. Multivariable regression analysis included generation affiliation, race, gender, and post-graduate year (PGY) as covariates.
The study sample included 388 millennial (mean age = 29.3) and 200 Generation X trainees (mean age = 34.6), with the response rate being 96.5%. Groups were statistically different by gender (p < 0.001) and PGY level (p < 0.001). After adjustment for gender, race, and PGY level, no statistically significant differences were found between millennial and Generation X groups in mean scores of empathy or burnout. Empathy was associated with PGY level (p = 0.0008) and race (p < 0.0001), with decreased empathy in advanced training levels and increased empathy in Hispanic/Latino race. Burnout rate was associated with PGY level (p = 0.001) but not generational affiliation (p = 0.6). The MBI depersonalization subscale was associated with PGY level (p < 0.001) and race (p = 0.0034), with decreased depersonalization in advanced training levels and Hispanic/Latino race. The emotional exhaustion and personal accomplishment MBI subscales did not demonstrate any significant associations in the multivariable regression model.
In a compared sample of millennial and Generation X residents and fellows, PGY level and Hispanic/Latino race (though not generation affiliation) were significantly associated with both empathy and MBI depersonalization subscale scores, while only PGY level was significantly associated with burnout rate. This study presents further evidence of de-escalating burnout and declining empathy over the course of medical residency.
本研究旨在考察千禧一代（出生于 1982 年至 2000 年之间）和 X 世代（出生于 1965 年至 1981 年之间）住院医师和研究员群体中，代际关系与同理心和倦怠的关联。
在 2013-2014 学年期间，于一家大型医疗机构，要求住院医师和研究员完成杰斐逊医生同理心量表（Jefferson Scale of Physician Empathy）和 Maslach 倦怠量表（MBI）。将回应与 GME 数据库内容相结合。多变量回归分析包括代际关系、种族、性别和研究生年级（PGY）作为协变量。
研究样本包括 388 名千禧一代（平均年龄=29.3）和 200 名 X 世代受训者（平均年龄=34.6），回应率为 96.5%。两组在性别（p<0.001）和 PGY 水平（p<0.001）方面存在统计学差异。在调整性别、种族和 PGY 水平后，千禧一代和 X 世代在同理心或倦怠的平均得分方面没有统计学上的显著差异。同理心与 PGY 水平（p=0.0008）和种族（p<0.0001）相关，高级培训水平的同理心降低，西班牙裔/拉丁裔种族的同理心增加。倦怠率与 PGY 水平（p=0.001）相关，但与代际关系无关（p=0.6）。MBI 去人格化量表与 PGY 水平（p<0.001）和种族（p=0.0034）相关，高级培训水平和西班牙裔/拉丁裔种族的去人格化程度降低。MBI 情绪耗竭和个人成就感子量表在多变量回归模型中没有显示出任何显著关联。
在比较的千禧一代和 X 世代住院医师和研究员样本中，PGY 水平和西班牙裔/拉丁裔种族（而非代际关系）与同理心和 MBI 去人格化子量表评分显著相关，而只有 PGY 水平与倦怠率显著相关。本研究进一步证明了在医学住院医师培训过程中，倦怠程度降低和同理心下降。
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