Burnout and the Learning Environment of Anaesthetic Trainees

Abstract

Burnout has a high prevalence among healthcare workers and is increasingly recognised as an environmental problem rather than reflecting a personal inability to cope with work stress. We distributed an electronic survey, which included the Maslach Burnout Inventory Health Services Survey and a previously validated learning environment instrument, to 281 Victorian anaesthetic trainees. The response rate was 50%. We found significantly raised rates of burnout in two of three subscales. Ninety-one respondents (67%) displayed evidence of burnout in at least one domain, with 67 (49%) reporting high emotional exhaustion and 57 (42%) reporting high depersonalisation. The clinical learning environment tool demonstrated a significant negative correlation with burnout (r=-0.56, P <0.001). Burnout was significantly more common than when previously measured in Victoria in 2008 (62% versus 38%). Trainees rated examination preparation the most stressful aspect of the training program. There is a high prevalence of burnout among Victorian anaesthetic trainees. We have shown a significant correlation exists between the clinical learning environment measure and the presence of burnout. This correlation supports the development of interventions to improve the clinical learning environment, as a means to improve trainee wellbeing and address the high prevalence of burnout.

The Abbreviated Maslach Burnout Inventory Can Overestimate Burnout: A Study of Anesthesiology Residents

“…The MBI-HSS comprised 22 questions across 3 subscales; Emotional Exhaustion (EE)-9 questions, Depersonalization (DP)-5 questions, and self-perceived lack of Personal Accomplishment (PA)-8 questions. Responses were scored on a six-point Likert scale (ranging from 0 = never to 6 = everyday) for each subscale, and tabulated into three tiers (low, moderate or high) based on the reference ranges provided with the MBI-HSS: for EE, low (0-16), moderate (17)(18)(19)(20)(21)(22)(23)(24)(25)(26) and high (≥27); for DP, low (0-6), moderate (7)(8)(9)(10)(11)(12) and high (≥13), and finally, for PA, low (≤31), moderate (32)(33)(34)(35)(36)(37)(38) and high (≥39). Burnout was defined by the updated Maslach-recommended criteria of "high EE and high DP" or "high EE and low PA" [22].…”

“…Anesthesiology is a stressful specialty and a self-perceived lack of personal accomplishment may be more common because efforts for safe anesthesia are often not acknowledged [6][7][8]. Indeed, recent studies have suggested that burnout is common in anesthesiology residents and trainees [9][10][11]. In a national US study, the prevalence of burnout, distress and depression in 5295 anesthesiology residents were reported as 51%, 32% and 12%, respectively [9].…”

Burnout em residentes de anestesiologia – uma revisão da literatura

“…A prevalência de nos residentes de anestesiologia Encontrou-se uma alta prevalência de entre os residentes de anestesiologia australianos (n= 140) com 67% deles apresentando evidência desta síndrome em ao menos uma sub-escala EE (49%) e DP (42%), mas baixa de RP (26%), sendo que 10% o tinham nos três aspectos combinados. 6 Este estudo demonstrou um aumento na prevalência em entre os anos de 2008 e 2016, realizado na mesma população, passando de 38,2% (n=108) para 62%, se aproximando da prevalência encontrada em Hong Kong (n=62) em 2008, de 65,1%. 6,7 O maior estudo até o momento foi realizado por de Oliveira 4 , que avaliou através de questionários 54% dos residentes de anestesia americanos (1508 de um total de 2773, responderam a pesquisa).…”

“…Contempla, a exaustão emocional (EE) com 9 questões, a despersonalização (DP) com 5 itens e o baixo grau de realização pessoal (RP) com 8 questões, sendo possível apresentar alteração em qualquer aspecto isoladamente ou uma combinação destes. Uma dificuldade de interpretação dos resultados, está no fato de que o IBM foi extensamente modificado, a versão original foi aplicada na maioria estudos selecionados 6,7 , mas um desses utilizou uma versão sucinta 4…”

Understanding the Lives of Anaesthesia Trainees

“…In this edition of the journal, Castanelli and colleagues investigate the wellbeing of anaesthesia trainees in Victoria 1 . Their findings are deeply concerning-high rates of burnout with "emotional exhaustion" in half and high "depersonalisation" in 42 percent of the 140 trainees who completed the survey.…”