Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
Tübingen Institute for Medical Education, University of Tübingen, Tübingen, Germany.
BMC Med Educ. 2024 Aug 14;24(1):875. doi: 10.1186/s12909-024-05854-9.
Meta-analyses indicate a high prevalence of burnout among medical students. Although studies have investigated different coping strategies and health interventions to prevent burnout, professional experience's influence on burnout resilience as seldom been explored. Therefore, in our study we aimed to examine the self-efficacy's mediating role in the relationship between past vocational training and burnout resilience. In the process, we also analysed the associations between study-related variables and burnout resilience.
In our cross-sectional study, we analysed the data of 2217 medical students at different stages of their university education (i.e. 1st, 3rd, 6th, 10th semester, and final year) at five medical faculties in Germany. The questionnaire included items addressing variables related to medical school, previous professional and academic qualifications, and validated instruments for measuring burnout and self-efficacy.
The overall prevalence of burnout was 19.7%, as defined by high scores for emotional exhaustion and notable values in at least one of the other two dimensions (cynicism or academic efficacy). Higher levels for self-efficacy (p < .001), having children (p = .004), and financing education with personal earnings (p = .03) were positively associated with burnout resilience, whereas having education financed by a partner or spouse (p = .04) had a negative association. In a mediation analysis, self-efficacy exerted a suppressor effect on the relationship between vocational training and burnout resilience (indirect effect = 0.11, 95% CI [0.04, 0.19]).
Self-efficacy's suppressor effect suggests that the positive association between vocational training and burnout resilience identified in the mediation analysis disappears for students who have completed vocational training but do not feel efficacious. Those and other findings provide important insights into the psychological mechanisms underlying the development of burnout resilience in medical students and suggest the promotion of self-efficacy in medical education.
荟萃分析表明，医学生群体中 burnout 的发生率较高。尽管已有研究调查了不同的应对策略和健康干预措施来预防 burnout，但职业经验对 burnout 适应力的影响却很少被探究。因此，在我们的研究中，我们旨在检验自我效能感在过去职业培训与 burnout 适应力之间的中介作用，并分析与学业相关的变量与 burnout 适应力之间的关系。
在我们的横断面研究中，我们分析了德国五所医学院校五个不同学习阶段（即第 1、3、6、10 学期和最后学年）的 2217 名医学生的数据。问卷包括与医学院校、之前的职业和学术资格相关的变量，以及用于测量 burnout 和自我效能感的验证工具。
根据情绪耗竭得分高且至少另外两个维度（玩世不恭或学业效能）中有显著值，定义 burnout 的总发生率为 19.7%。自我效能感较高（p<0.001）、有孩子（p=0.004）和个人收入供教育经费（p=0.03）与 burnout 适应力呈正相关，而由配偶或伴侣供教育经费（p=0.04）与 burnout 适应力呈负相关。在中介分析中，自我效能感对职业培训与 burnout 适应力之间的关系产生了抑制作用（间接效应=0.11，95%CI [0.04，0.19]）。
自我效能感的抑制作用表明，在中介分析中识别出的职业培训与 burnout 适应力之间的正相关关系，对于已经完成职业培训但感到没有效能的学生而言会消失。这些发现和其他发现为医学生 burnout 适应力发展的心理机制提供了重要的见解，并提示在医学教育中促进自我效能感。
