Higinbotham Alissa S, Patrie James T, Peters Katherine B
From the Department of Neurology (A.S.H) and Department of Public Health (J.T.P.), University of Virginia School of Medicine, Charlottesville, VA; and Department of Neurology and Neurosurgery (K.B.P.), Duke University School of Medicine, Durham, NC.
Neurol Educ. 2024 Sep 5;3(3):e200144. doi: 10.1212/NE9.0000000000200144. eCollection 2024 Sep 25.
There are no dedicated studies specifically assessing burnout in neurology residency program directors (PDs). A study of residency and fellowship directors across specialties found neurology residency PDs had the highest work-related Copenhagen Burnout Inventory (CBI) score, which may reflect high-level burnout in neurology in general. Indeed, the American Academy of Neurology Burnout Task Force reported burnout in 60% of neurologists. The aims of this study are to determine the level of burnout in adult and pediatric neurology residency PDs, and to determine whether perception of value is related to burnout.
In an IRB-approved study, 184 neurology residency PDs were emailed an anonymous survey consisting of the full CBI, demographic information, and 2 items addressing perception of value in the PD role: "I feel valued by my department in my educational role," to which the participant could respond "strongly disagree, disagree, agree, or strongly agree," and "satisfaction with current percent effort for the educational role," to which the participant could respond "very dissatisfied, dissatisfied, satisfied, or very satisfied." Data were analyzed through analysis of variance and ordinal logistic regression.
A total of 85 PDs (46%) responded to the survey. The average ± SEM personal, work-related, and patient-related CBI scores were 41.8 ± 2.2, 39.7 ± 2.2, and 32.4 ± 2.2, respectively. Higher personal and work-related CBI scores were associated with less positive perception of value (proportional odds ratio 1.03, 95% CI 1.01-1.06, = 0.004 and proportional odds ratio 1.04; 95% CI 1.01-1.06, = 0.003, respectively). Higher personal and work-related CBI scores were also associated with greater dissatisfaction with percent effort granted for the PD role. Level of burnout did not differ between adult and pediatric PDs. Burnout was not related to sex, years in practice, years as PD, academic rank, or percentage effort granted for the PD role.
Despite working in a field associated with high burnout, neurology residency PDs were found to have lower-level burnout than previously reported. Ninety-four percent of the PDs reported feeling valued in their role which was associated with lower-level personal and work-related burnout and may represent a key target for reflection and burnout intervention in the future.
目前尚无专门针对神经科住院医师培训项目主任(PD)职业倦怠情况的研究。一项针对各专业住院医师及专科培训项目主任的研究发现,神经科住院医师培训项目主任的工作相关哥本哈根职业倦怠量表(CBI)得分最高,这可能反映出神经科总体职业倦怠程度较高。事实上,美国神经病学学会职业倦怠特别工作组报告称,60%的神经科医生存在职业倦怠。本研究的目的是确定成人及儿童神经科住院医师培训项目主任的职业倦怠程度,并确定价值认知与职业倦怠是否相关。
在一项经机构审查委员会(IRB)批准的研究中,向184名神经科住院医师培训项目主任发送了一份匿名调查问卷,其中包括完整的CBI量表、人口统计学信息,以及两个关于对PD角色价值认知的问题:“我在教育角色上得到所在科室的重视”,参与者可回答“强烈不同意、不同意、同意或强烈同意”;以及“对当前用于教育角色的工作投入百分比的满意度”,参与者可回答“非常不满意、不满意、满意或非常满意”。通过方差分析和有序逻辑回归对数据进行分析。
共有85名PD(46%)回复了调查问卷。个人、工作相关和患者相关的CBI平均得分±标准误分别为41.8±2.2、39.7±2.2和32.4±2.2。个人和工作相关的CBI得分越高,价值认知越不积极(比例优势比分别为1.03,95%置信区间1.01 - 1.06,P = 0.004和比例优势比1.04;95%置信区间1.01 - 1.06,P = 0.003)。个人和工作相关的CBI得分越高,对PD角色工作投入百分比的不满程度也越高。成人和儿童PD的职业倦怠程度没有差异。职业倦怠与性别、从业年限、担任PD的年限、学术职称或PD角色的工作投入百分比无关。
尽管神经科住院医师培训项目主任从事的是一个职业倦怠程度较高的领域,但研究发现他们的职业倦怠程度低于此前报告的水平。94%的PD表示在其角色中感到受到重视,这与较低的个人和工作相关职业倦怠相关,可能是未来反思和职业倦怠干预的一个关键目标。