A.N. Leep Hunderfund is associate professor of neurology, Mayo Clinic, and associate director of clinical learning environment optimization, Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota.
C.P. West is professor of medicine, medical education, and biostatistics, Divisions of General Internal Medicine and Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota; ORCID: https://orcid.org/0000-0003-1628-5023 .
Acad Med. 2022 Aug 1;97(8):1184-1194. doi: 10.1097/ACM.0000000000004709. Epub 2022 Jul 21.
To examine associations of social support and social isolation with burnout, program satisfaction, and organization satisfaction among a large population of U.S. residents and fellows and to identify correlates of social support and social isolation.
All residents and fellows enrolled in graduate medical education programs at Mayo Clinic sites were surveyed in February 2019. Survey items measured social support (emotional and tangible), social isolation, burnout, program satisfaction, and organization satisfaction. Factors of potential relevance to social support were collected (via the survey, institutional administrative records, and interviews with program coordinators and/or program directors) and categorized as individual, interpersonal, program, or work-related factors (duty hours, call burden, elective time, vacation days used before survey administration, required away rotations, etc.). Multivariable regression analyses were conducted to examine relationships between variables.
Of 1,146 residents surveyed, 762 (66%) from 58 programs responded. In adjusted models, higher emotional and tangible support were associated with lower odds of burnout and higher odds of program and organization satisfaction, while higher social isolation scores were associated with higher odds of burnout and lower odds of program satisfaction and organization satisfaction. Independent predictors of social support and/or social isolation included age, gender, relationship status, parental status, postgraduate year, site, ratings of the program leadership team, ratings of faculty relationships and faculty professional behaviors, satisfaction with autonomy, and vacation days used before survey administration.
This study demonstrates that social support and social isolation are strongly related to burnout and satisfaction among residents and fellows. Personal and professional relationships, satisfaction with autonomy, and vacation days are independently associated with social support and/or social isolation, whereas most program and work-related factors are not. Additional studies are needed to determine if social support interventions targeting these factors can improve well-being and enhance satisfaction with training.
在美国居民和研究员的大样本中,研究社会支持和社会隔离与倦怠、项目满意度和组织满意度的关系,并确定社会支持和社会隔离的相关因素。
2019 年 2 月,对梅奥诊所各站点的所有住院医师和研究员进行了调查。调查项目测量了社会支持(情感和有形)、社会隔离、倦怠、项目满意度和组织满意度。收集了与社会支持相关的潜在因素(通过调查、机构行政记录以及与项目协调员和/或项目主任的访谈),并将其归类为个人、人际、项目或与工作相关的因素(值班时间、值班负担、选修时间、调查前使用的休假天数、需要轮调等)。进行多变量回归分析以检查变量之间的关系。
在接受调查的 1146 名住院医师中,来自 58 个项目的 762 名(66%)住院医师做出了回应。在调整后的模型中,较高的情感支持和有形支持与较低的倦怠发生率和较高的项目和组织满意度几率相关,而较高的社会隔离得分与较高的倦怠发生率和较低的项目满意度和组织满意度几率相关。社会支持和/或社会隔离的独立预测因素包括年龄、性别、婚姻状况、父母状况、研究生年限、地点、对项目领导团队的评价、对师生关系和教师专业行为的评价、对自主权的满意度以及调查前使用的休假天数。
本研究表明,社会支持和社会隔离与住院医师和研究员的倦怠和满意度密切相关。个人和职业关系、对自主权的满意度以及休假天数与社会支持和/或社会隔离独立相关,而大多数项目和工作相关因素则不相关。需要进一步的研究来确定是否可以通过针对这些因素的社会支持干预措施来提高幸福感并增强培训满意度。