Abstract
OBJECTIVE: Although well-established metrics exist to measure workplace burnout, researchers disagree about how to categorize individuals based on assessed symptoms. Using a person-centered approach, this study identifies classes of burnout symptomatology in a large sample of general surgery residents in the United States. DESIGN, SETTING, PARTICIPANTS: A survey was administered following the 2018 American Board of Surgery In-Training Examination (ABSITE) to study wellness among U.S. general surgery residents. Latent class models identified distinct classes of residents based on their responses to the emotional exhaustion and depersonalization questions of the modified abbreviated Maslach Burnout Inventory (aMBI). Classes were assigned representative names, and the characteristics of their members and residency programs were compared. RESULTS: The survey was completed by 7415 surgery residents from 263 residency programs nationwide (99.3% response rate). Five burnout classes were found: Burned Out (unfavorable score on all six items, 9.8% of total), Fully Engaged (favorable score on all six items, 23.1%), Fatigued (favorable on all items except frequent fatigue, 32.2%), Overextended (frequent fatigue and burnout from work, 16.7%), and Disengaged (weekly symptoms of fatigue and callousness, 18.1%). Within the more symptomatic classes (Burned Out, Overextended, and Disengaged), men manifested more depersonalization symptoms, whereas women reported more emotional exhaustion symptoms. Burned Out residents were characterized by reports of mistreatment (abuse, sexual harassment, and gender-, racial-, or pregnancy and/or childcare-based discrimination), duty hour violations, dissatisfaction with duty hour regulations or time for rest, and low ABSITE scores. CONCLUSIONS: Burnout is multifaceted, with complex and variable presentations. Latent class modeling categorizes general surgery residents based on their burnout symptomatology. Organizations should tailor their efforts to address the unique manifestations of each class as well as shared drivers.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1814-1824 |
| Number of pages | 11 |
| Journal | Journal of Surgical Education |
| Volume | 78 |
| Issue number | 6 |
| DOIs | |
| State | Published - Nov 1 2021 |
Funding
This work was funded by American College of Surgeons (ACS) and Accreditation Council for Graduate Medical Education (ACGME). Dr. Hewitt was supported by a postdoctoral research fellowship (Agency for Healthcare Research and Quality [AHRQ] 5T32HS000078). Dr. Cheung was supported by National Science Foundation ([NSF] #1714952). The American Board of Surgery (ABS) provided the data collection platform. None of the funding sources had involvement in the study design, analysis, or interpretation of data; in the writing of the report; or in the decision to submit the article for publication. Disclosure: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This work was funded by American College of Surgeons (ACS) and Accreditation Council for Graduate Medical Education (ACGME). Dr. Hewitt was supported by a postdoctoral research fellowship ( Agency for Healthcare Research and Quality [AHRQ] 5T32HS000078 ). Dr. Cheung was supported by National Science Foundation ([NSF] #1714952 ). The American Board of Surgery (ABS) provided the data collection platform. None of the funding sources had involvement in the study design, analysis, or interpretation of data; in the writing of the report; or in the decision to submit the article for publication.
Keywords
- Burnout
- General Surgery
- Resident Wellness
- Surgical Education
ASJC Scopus subject areas
- Education
- Surgery
