Department of Emergency Medicine, University of Washington, Seattle, WA.
Department of Surgery, Northwestern University, Chicago, IL.
Ann Emerg Med. 2023 Jun;81(6):706-714. doi: 10.1016/j.annemergmed.2022.10.015. Epub 2023 Feb 7.
The influence of workplace mistreatment on the well-being and career satisfaction of emergency medicine residents is unknown. This study examined the relationships between burnout, career choice regret, and workplace mistreatment in a national sample of emergency medicine residents.
This was a secondary analysis of a survey study on the prevalence of workplace mistreatment among emergency residents. Residents who reported emotional exhaustion or depersonalization at least once per week were considered to have burnout. Residents who reported dissatisfaction with their decision to become an emergency physician were considered to have career choice regret. Respondents also reported the type (discrimination, abuse, sexual harassment) and frequency of mistreatment over the academic year. Multivariable logistic regression, adjusting for program characteristics, was used to examine resident characteristics associated with burnout and career choice regret, with the frequency of mistreatment as a covariate.
Of the 8,162 eligible residents, 7,680 (94.1 %) participated. About a third of respondents reported burnout (2,188 of 6,902, 31.7%), whereas a minority (224 of 6,923, 3.2%) reported career choice regret. Of the 7,087 responses on mistreatment frequency, 2,117 (29.9%) reported "a few times per year," and 1,296 (18.3%) reported "a few times per month or more." Compared with residents who never experienced mistreatment, residents who reported increasing frequencies of mistreatment were associated with having burnout-from mistreatment a few times per year (OR [odds ratio],1.6; 99% CI [confidence interval], 1.3 to 1.9) to a few times per month or more (OR, 3.3; 99% CI, 2.7 to 4.1). Compared with residents without burnout, residents who reported burnout were associated with having career choice regret (OR, 11.3; 99% CI, 7.0 to 18.1). After adjusting for burnout, there were no significant relationships between the frequency of mistreatment and career choice regret.
Workplace mistreatment is associated with burnout, but not career choice regret, among emergency medicine residents. Efforts to address workplace mistreatment may improve emergency medicine residents' professional well-being.
工作场所虐待对急诊医学住院医师的幸福感和职业满意度的影响尚不清楚。本研究调查了全国范围内急诊医学住院医师中职业倦怠、职业选择后悔与工作场所虐待之间的关系。
这是一项对急诊住院医师工作场所虐待发生率的调查研究的二次分析。每周至少报告一次情绪疲惫或去人性化的住院医师被认为患有职业倦怠。报告对成为急诊医生的决定不满意的住院医师被认为有职业选择后悔。受访者还报告了学术年期间虐待的类型（歧视、虐待、性骚扰）和频率。多变量逻辑回归，调整了项目特征，用于检查与职业倦怠和职业选择后悔相关的居民特征，以虐待频率为协变量。
在符合条件的 8162 名住院医师中，有 7680 名（94.1%）参与了调查。约三分之一的受访者报告职业倦怠（6902 名中的 2188 名，31.7%），而少数（6923 名中的 224 名，3.2%）报告职业选择后悔。在 7087 份关于虐待频率的答复中，2117 份（29.9%）报告“每年几次”，1296 份（18.3%）报告“每月几次或更多次”。与从未遭受过虐待的住院医师相比，报告虐待频率增加的住院医师与职业倦怠相关——从每年几次（比值比 [OR]，1.6；99%置信区间 [CI]，1.3 至 1.9）到每月几次或更多次（OR，3.3；99%CI，2.7 至 4.1）。与没有职业倦怠的住院医师相比，报告职业倦怠的住院医师与职业选择后悔相关（OR，11.3；99%CI，7.0 至 18.1）。调整职业倦怠后，虐待频率与职业选择后悔之间没有显著关系。
工作场所虐待与急诊医学住院医师的职业倦怠有关，但与职业选择后悔无关。努力解决工作场所虐待问题可能会改善急诊医学住院医师的职业幸福感。
