Institute for Professional Worklife, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN, 55415, USA.
Department of Medicine, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN, 55415, USA.
BMC Med Educ. 2024 May 2;24(1):484. doi: 10.1186/s12909-024-05480-5.
System contributors to resident burnout and well-being have been under-studied. We sought to determine factors associated with resident burnout and identify at risk groups.
We performed a US national survey between July 15 2022 and April 21, 2023 of residents in 36 specialties in 14 institutions, using the validated Mini ReZ survey with three 5 item subscales: 1) supportive workplace, 2) work pace/electronic medical record (EMR) stress, and 3) residency-specific factors (sleep, peer support, recognition by program, interruptions and staff relationships). Multilevel regressions and thematic analysis of 497 comments determined factors related to burnout.
Of 1118 respondents (approximate median response rate 32%), 48% were female, 57% White, 21% Asian, 6% LatinX and 4% Black, with 25% PGY 1 s, 25% PGY 2 s, and 22% PGY 3 s. Programs included internal medicine (15.1%) and family medicine (11.3%) among 36 specialties. Burnout (found in 42%) was higher in females (51% vs 30% in males, p = 0.001) and PGY 2's (48% vs 35% in PGY-1 s, p = 0.029). Challenges included chaotic environments (41%) and sleep impairment (32%); favorable aspects included teamwork (94%), peer support (93%), staff support (87%) and program recognition (68%). Worklife subscales were consistently lower in females while PGY-2's reported the least supportive work environments. Worklife challenges relating to burnout included sleep impairment (adjusted Odds Ratio (aOR) 2.82 (95% CIs 1.94, 4.19), absolute risk difference (ARD) in burnout 15.9%), poor work control (aOR 2.25 (1.42, 3.58), ARD 12.2%) and chaos (aOR 1.73 (1.22, 2.47), ARD 7.9%); program recognition was related to lower burnout (aOR 0.520 (0.356, 0.760), ARD 9.3%). These variables explained 55% of burnout variance. Qualitative data confirmed sleep impairment, lack of schedule control, excess EMR and patient volume as stressors.
These data provide a nomenclature and systematic method for addressing well-being during residency. Work conditions for females and PGY 2's may merit attention first.
居民倦怠和幸福感的系统贡献者研究不足。我们旨在确定与居民倦怠相关的因素，并确定风险群体。
我们于 2022 年 7 月 15 日至 2023 年 4 月 21 日，在美国 14 家机构的 36 个专业中，对住院医师进行了一项全国性调查，使用经过验证的 Mini ReZ 调查，该调查有三个 5 项分量表：1）支持性工作场所，2）工作节奏/电子病历（EMR）压力，和 3）住院医师特定因素（睡眠、同伴支持、计划认可、干扰和员工关系）。多水平回归和对 497 条评论的主题分析确定了与倦怠相关的因素。
在 1118 名受访者中（大致中位数回复率为 32%），48%为女性，57%为白人，21%为亚洲人，6%为拉丁裔，4%为黑人，其中 25%为 PGY1，25%为 PGY2，22%为 PGY3。专业包括内科（15.1%）和家庭医学（11.3%）。倦怠（42%）在女性中更高（51%比男性 30%，p=0.001）和 PGY2（48%比 PGY1 35%，p=0.029）。挑战包括混乱的环境（41%）和睡眠障碍（32%）；有利的方面包括团队合作（94%）、同伴支持（93%）、员工支持（87%）和计划认可（68%）。女性的工作生活分量表始终较低，而 PGY2 报告的工作环境最不支持。与倦怠相关的工作生活挑战包括睡眠障碍（调整后的优势比（aOR）2.82（95%CI 1.94，4.19），倦怠的绝对风险差异（ARD）15.9%）、工作控制不佳（aOR 2.25（1.42，3.58），ARD 12.2%）和混乱（aOR 1.73（1.22，2.47），ARD 7.9%）；计划认可与较低的倦怠相关（aOR 0.520（0.356，0.760），ARD 9.3%）。这些变量解释了 55%的倦怠方差。定性数据证实了睡眠障碍、缺乏日程控制、过多的 EMR 和患者量是压力源。
这些数据为住院医师期间的幸福感提供了一个命名法和系统方法。女性和 PGY2 的工作条件可能首先需要关注。
