Leep Hunderfund Andrea N, Saberzadeh Ardestani Bahar, Laughlin-Tommaso Shannon K, Jordan Barbara L, Melson Valerie A, Montenegro Monique M, Brushaber Danielle E, West Colin P, Dyrbye Liselotte N
Acad Med. 2025 Feb 1;100(2):191-202. doi: 10.1097/ACM.0000000000005892. Epub 2024 Sep 30.
This study examines sense of belonging (belongingness) in a large population of medical students, residents, and fellows and associations with learner burnout, organizational recruitment retention indicators, and potentially modifiable learning environment factors.
All medical students, residents, and fellows at Mayo Clinic sites were surveyed between October and November 2020 with items measuring sense of belonging in 3 contexts (school or program, organization, surrounding community), burnout (2 Maslach Burnout Inventory items), recruitment retention indicators (likelihood of recommending the organization and accepting a job offer), potentially modifiable learning environment factors, and demographics (age, gender, race and ethnicity, LGBTQ+ identification, disability, socioeconomic background).
Of 2,257 learners surveyed, 1,261 (56%) responded. The percentage of learners reporting a somewhat or very strong sense of belonging was highest in the school or program (994 of 1,227 [81%]) followed by the organization (957 of 1,222 [78%]) and surrounding community (728 of 1,203 [61%]). In adjusted analyses, learners with very strong organization belongingness had lower odds of burnout (odds ratio [OR], 0.05; 95% CI, 0.02-0.12) and higher odds of being likely to recommend the organization (OR, 505.23; 95% CI, 121.54-2,100.18) and accept a job offer (OR, 38.68; 95% CI, 15.72-95.15; all P < .001). School or program and community belongingness also correlated strongly with these outcomes. In multivariable analyses, social support remained associated with higher odds of belongingness in all 3 contexts; favorable ratings of faculty relationships and leadership representation remained associated with higher odds of belongingness in 2 contexts (school or program and organization); and favorable ratings of diversity, equity, and inclusion learning climate remained associated with belongingness in 1 context (community).
Sense of belonging among medical students, residents, and fellows varies across contexts, correlates strongly with burnout and organizational recruitment retention indicators, and is associated with multiple potentially modifiable learning environment factors.
本研究调查了大量医学生、住院医师和研究员的归属感，并探讨其与学习者倦怠、组织招聘留用指标以及潜在可改变的学习环境因素之间的关联。
2020年10月至11月期间，对梅奥诊所各站点的所有医学生、住院医师和研究员进行了调查，调查项目包括在三种情境（学校或项目、组织、周边社区）下的归属感、倦怠（马氏倦怠量表的2个项目）、招聘留用指标（推荐该组织和接受工作邀请的可能性）、潜在可改变的学习环境因素以及人口统计学特征（年龄、性别、种族和民族、LGBTQ+身份认同、残疾、社会经济背景）。
在接受调查的2257名学习者中，1261人（56%）做出了回应。报告有一定或非常强烈归属感的学习者比例在学校或项目中最高（1227人中的994人[81%]），其次是组织（1222人中的957人[78%]）和周边社区（1203人中的728人[61%]）。在调整分析中，组织归属感非常强烈的学习者倦怠几率较低（优势比[OR]，0.05；95%置信区间，0.02 - 0.12），推荐该组织的几率较高（OR，505.23；95%置信区间，121.54 - 2100.18），接受工作邀请的几率也较高（OR，38.68；95%置信区间，15.72 - 95.15；所有P <.001）。学校或项目以及社区归属感也与这些结果密切相关。在多变量分析中，社会支持在所有三种情境下仍与较高的归属感几率相关；对教师关系和领导代表性的好评在两种情境（学校或项目和组织）下仍与较高的归属感几率相关；对多样性、公平性和包容性学习氛围的好评在一种情境（社区）下仍与归属感相关。
医学生、住院医师和研究员的归属感在不同情境下有所不同，与倦怠和组织招聘留用指标密切相关，并且与多个潜在可改变的学习环境因素有关。
