Grech Marco
University of Malta, Msida, Malta.
J Med Educ Curric Dev. 2021 May 31;8:23821205211018700. doi: 10.1177/23821205211018700. eCollection 2021 Jan-Dec.
Burnout among postgraduate medical trainees is common. It is a syndrome characterised by emotional exhaustion, depersonalisation and reduced personal accomplishment. Burnout is seen as an organisational problem rather than the result of an individual's ability to cope with the stress at work. The educational environment can play a pivotal role in the prevention of burnout among postgraduate medical trainees. This narrative literature review is aimed at assessing the effect of the educational environment on burnout in postgraduate doctors-in-training.
A search of the databases Medline and PscyInfo for articles published between 2015 and 2020 was performed with the key words 'burnout' and 'educational environment' or 'clinical learning environment' or 'postgraduate medical education' or 'learning environment'.
A total of 27 studies were identified and reviewed by the author. The prevalence of burnout reported varied widely between studies, ranging from 10% to 62%. Many of the factors that contribute to burnout form part of the educational environment, for example, hours worked, mistreatment, harassment and perceptions of injustice. Residency itself is a stressful period wherein trainees have to balance their responsibilities towards their patients with their responsibilities at home, all while furthering their studies and taking on new responsibilities. Interventions to prevent burnout and tackle existing burnout are multiple but very little solid evidence exists to attest to their efficacy. More research is needed to identify the most effective ways to deal with burnout in postgraduate medical trainees.
医学研究生学员职业倦怠现象普遍。这是一种以情感耗竭、去个性化和个人成就感降低为特征的综合征。职业倦怠被视为一个组织问题，而非个人应对工作压力能力的结果。教育环境在预防医学研究生学员职业倦怠方面可发挥关键作用。本叙述性文献综述旨在评估教育环境对住院医师培训阶段医生职业倦怠的影响。
使用关键词“职业倦怠”和“教育环境”或“临床学习环境”或“医学研究生教育”或“学习环境”，在Medline和PscyInfo数据库中检索2015年至2020年发表的文章。
作者共识别并综述了27项研究。各研究报告的职业倦怠患病率差异很大，从10%到62%不等。许多导致职业倦怠的因素是教育环境的一部分，例如工作时长、虐待、骚扰和对不公正的认知。住院医师培训阶段本身压力就很大，学员们必须在对患者的责任和家庭责任之间取得平衡，同时还要继续学业并承担新的责任。预防职业倦怠和应对现有职业倦怠的干预措施多种多样，但几乎没有确凿证据证明其有效性。需要更多研究来确定应对医学研究生学员职业倦怠的最有效方法。
