Okay… big breath. This is not a post about the unappreciated genius of The Cure and Robert Smith. Rather, the Key Literature in Medical Education podcast tackles the important topic of burnout in residency education. The popular literature has tackled this topic with increasing attention over the last year. Checkout this link to see how your speciality ranks in a national self-report survey.
The study discussed a potential antidote to burnout. If you can’t handle that cliff hanger, checkout the abstract below. If you want all of the details, check out the podcast here.
– Jonathan (@sherbino)
KeyLIME Session 103 – Article under review:
View/download the abstract here.
Shapiro J, Zhang B, Warm EJ. Residency as a Social Network: Burnout, Loneliness, and Social Network Centrality. Journal of Graduate Medical Education. 2015 Dec;7(4):617-23
Reviewer: Jason R. Frank
Background
We live in an era where speakers give TED talks claiming that “we lose a medical school full of physicians every year to suicide“. Multiple studies document the hazards of medical training: needlesticks, intimidation, harassment, marital conflict, depression, MVCs post-nights, violence…And burnout. In study after study (usually as a self-report in a survey), residents are found to have a high degree of burnout as a population. The numbers range from ~20% to as high as ~80% scoring “positive” on standard instruments. Physician burnout itself is associated with other bad outcomes, including: depression, suicide, lesser altruism, impaired empathy, unprofessional behaviour, adverse events, and lower patient satisfaction.
Why do physicians have such scandalous stats? Is it the long hours, the social isolation, the sleeplessness, the hierarchy? How can we intervene to promote resilience and wellness in this critical next generation to enter our profession?
Purpose
The authors of this study (which includes a Pediatrics resident and Cincinnati meded guru Eric J Warm), set out to examine the relationship between “burnout” and “loneliness” or “social network centricity”.
Type of Paper
Research: Standardized testing using 3 psychological instruments
Key Outcomes
Response rate was 77% (95/124). 45% of residents in the study ruled in for burnout on the EE scores, 49% on the DP scores, 33% met both criteria. Burnout was associated with self-reported loneliness scores, with ORs of around 1.5, in a dose-dependent fashion. Males had greater depersonalization scores. Otherwise, no differences were noted with gender or marital status.
PA scores did not correlate with loneliness. On the other hand, higher PA scores were associated with greater social network measures, such as centrality.
With an n of only 95, some of the subgroup analysis gets to some pretty small subpopulations.
Key Conclusions
The authors conclude that burnout in residency correlates with loneliness, and a greater sense of personal accomplishment correlates with a stronger social network.
Spare Keys – other take home points for clinician educators
This is an interesting study, part of a new generation of papers using social network analysis in medical education. A few points of emphasis for CEs:
- Physician wellness is a major issue in our profession, and we as meded leaders need to seriously examine our enterprise to make it better in the 21st century
- Social network analysis is emerging as a new and powerful tool to ask questions in medical education
- Residents can publish cool studies too
Access KeyLIME podcast archives here
