Burnout, Professional Fulfillment, Intention to Leave, and Sleep-Related Impairment among Radiology Trainees across the United States (US): A Multisite Epidemiologic Study

Higgins, Mikhail C.S.S.; Siddiqui, Ali A.; Kosowsky, Tova; Unan, Lizz; Rowe, Susannah; Marchalik, Daniel

doi:10.1016/j.acra.2022.01.022

Cited by 17 publications

(11 citation statements)

References 61 publications

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“…With an increasing number of part-time physicians and younger physicians prioritizing work-life balance [28], practice leaders require effective strategies for recruitment and retention of talented clinicians. Currently, practice leaders still rely on self-reported data (through physician surveys) to identify physician burnout, job satisfaction, and intention to leave [7,11,15,[29][30][31]. Given limitations of self-report, including response fatigue and bias [32], more accurate and reliable tools for identification of physicians at-risk for departure are needed such that timely, targeted, and appropriate interventions can alter their course and prevent departure.…”

Section: Introductionmentioning

confidence: 99%

Predicting physician departure with machine learning on EHR use patterns: A longitudinal cohort from a large multi-specialty ambulatory practice

Lopez

Paek

et al. 2023

PLoS ONE

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Physician turnover places a heavy burden on the healthcare industry, patients, physicians, and their families. Having a mechanism in place to identify physicians at risk for departure could help target appropriate interventions that prevent departure. We have collected physician characteristics, electronic health record (EHR) use patterns, and clinical productivity data from a large ambulatory based practice of non-teaching physicians to build a predictive model. We use several techniques to identify possible intervenable variables. Specifically, we used gradient boosted trees to predict the probability of a physician departing within an interval of 6 months. Several variables significantly contributed to predicting physician departure including tenure (time since hiring date), panel complexity, physician demand, physician age, inbox, and documentation time. These variables were identified by training, validating, and testing the model followed by computing SHAP (SHapley Additive exPlanation) values to investigate which variables influence the model’s prediction the most. We found these top variables to have large interactions with other variables indicating their importance. Since these variables may be predictive of physician departure, they could prove useful to identify at risk physicians such who would benefit from targeted interventions.

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Section: Introductionmentioning

confidence: 99%

Predicting physician departure with machine learning on EHR use patterns: A longitudinal cohort from a large multi-specialty ambulatory practice

Lopez

Paek

et al. 2023

PLoS ONE

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“…Data suggests that protected time away from work can lead to restoration of sleep quality and reduced longterm stress 17 . Work hour limitations have generally been reported to have positive effects on resident well-being 13,16 , but interventions including night oat, reduced shift length, and protected sleep time on call have not consistently produced improvements in resident wellness, patient care, or resident education 15 . In our case, while we found signi cant improvement of emotional exhaustion and stress, we found no signi cant difference among cohorts in depression, anxiety, depersonalization, or personal accomplishment scores.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple duty hour reforms have been implemented by the ACGME to address sleep deprivation, fatigue, and burnout among residents in the past two decades, and several studies have examined the effect of duty hour restrictions on resident well-being and sleep with mixed results [7][8][9][10][11][12] . Self-reported sleep deprivation has been shown to be associated with higher prevalence of moderate depression and clinical burnout among residents 10,13,14 . However, several studies have not found a signi cant association between burnout and sleep in resident physicians when sleep is measured through wrist actigraphy rather than subjective "sleepiness" 8,9 .…”

mentioning

confidence: 99%

The Effect of Mandatory Post-call Relief on Sleep and Wellness in Ophthalmology Residents

Feng

Davis

Chowdhary

et al. 2023

Preprint

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Background Multiple duty hour reforms have been implemented to optimize resident wellness through increasing opportunities for sleep recovery, but few studies have recorded objectively measured sleep or shown direct sleep and wellness benefits from such interventions. This study seeks to determine whether mandatory post-call relief policies with a partial night float system improved resident sleep, activity, and burnout among ophthalmology residents taking home call. Methods We conducted a two-group cohort study of ophthalmology residents at the University Washington comparing post graduate year-2 (PGY-2) resident sleep, activity, and burnout between the optional post-call relief group from July 1, 2017 to June 30, 2019 to the mandatory post-call relief group from July 1, 2019 to June 30, 2021. Results The mandatory post-call relief group recorded longer total sleep on call than the optional post-call relief group (p < 0.001). There was no difference in overnight sleep recorded on call (median 3.4 hours), but residents recorded more time napping in the mandatory post-call relief cohort (p < 0.001). There was no significant difference between cohorts in amount of sleep while not on call. Residents in the mandatory post-call relief cohort recorded higher average daily steps, higher exercise time, and lower sedentary time than residents in the optional post-call relief cohort (p < 0.001). They also recorded lower median emotional exhaustion on the Maslach Burnout Inventory and lower stress in the Depression and Anxiety Stress Scale in the mandatory post-call relief cohort (p = 0.008). Conclusions Implementation of mandatory post-call relief policies with a partial night-float system among PGY-2 residents resulted in more post-call naps with more overall physical activity, lower emotional exhaustion scores, and lower stress scores, despite no changes to overnight sleep on call or total sleep.

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“…Data suggests that protected time away from work can lead to restoration of sleep quality and reduced long-term stress [ 16 ]. Work hour limitations have generally been reported to have positive effects on resident well-being [ 13 , 17 ], but interventions including night float, reduced shift length, and protected sleep time on call have not consistently produced improvements in resident wellness, patient care, or resident education [ 15 ]. In our case, while we found significant improvement of emotional exhaustion and stress, we found no significant difference among cohorts in depression, anxiety, depersonalization, or personal accomplishment scores.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple duty hour reforms have been implemented by the ACGME to address sleep deprivation, fatigue, and burnout among residents in the past two decades, and several studies have examined the effect of duty hour restrictions on resident well-being and sleep with mixed results [ 7 – 12 ]. Self-reported sleep deprivation has been shown to be associated with higher prevalence of moderate depression and clinical burnout among residents [ 10 , 13 , 14 ]. However, several studies have not found a significant association between burnout and sleep in resident physicians when sleep is measured through wrist actigraphy rather than subjective “sleepiness” [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of mandatory post-call relief on sleep and wellness in ophthalmology residents

Feng,

Davis,

Chowdhary

et al. 2023

BMC Med Educ

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Background Multiple duty hour reforms have been implemented to optimize resident wellness through increasing opportunities for sleep recovery, but few studies have recorded objectively measured sleep or shown direct sleep and wellness benefits from such interventions. This study seeks to determine whether mandatory post-call relief policies with a partial night float system improved resident sleep, activity, and burnout among ophthalmology residents taking home call. Methods We conducted a two group cohort study of ophthalmology residents at the University Washington comparing post graduate year-2 (PGY-2) resident sleep, activity, and burnout between the optional post-call relief group from July 1, 2017 to June 30, 2019 to the mandatory post-call relief group from July 1, 2019 to June 30, 2021. Results Of twenty total residents participating in the survey portion, 18 residents participated in the sleep and activity tracking portion of the study, 9 in in the optional post-call relief cohort, and 9 in the mandatory post-call relief cohort. The mandatory post-call relief group recorded longer total sleep on call than the optional post-call relief group (p < 0.001). There was no difference in overnight sleep recorded on call (median 3.4 h), but residents recorded more time napping in the mandatory post-call relief cohort (p < 0.001). There was no significant difference between cohorts in amount of sleep while not on call. Residents in the mandatory post-call relief cohort recorded higher average daily steps, higher exercise time, and lower sedentary time than residents in the optional post-call relief cohort (p < 0.001). They also recorded lower median emotional exhaustion on the Maslach Burnout Inventory and lower stress in the Depression and Anxiety Stress Scale in the mandatory post-call relief cohort (p = 0.008). Conclusions Implementation of mandatory post-call relief policies with a partial night-float system among PGY-2 residents was associated with more post-call naps with more overall physical activity, lower emotional exhaustion scores, and lower stress scores, despite no changes to overnight sleep on call or total sleep. Although sample size limits interpretation of data, implementation of mandatory post call relief could be considered to improve post-call sleep in programs with home call.

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Burnout, Professional Fulfillment, Intention to Leave, and Sleep-Related Impairment among Radiology Trainees across the United States (US): A Multisite Epidemiologic Study

Cited by 17 publications

References 61 publications

Predicting physician departure with machine learning on EHR use patterns: A longitudinal cohort from a large multi-specialty ambulatory practice

Predicting physician departure with machine learning on EHR use patterns: A longitudinal cohort from a large multi-specialty ambulatory practice

The Effect of Mandatory Post-call Relief on Sleep and Wellness in Ophthalmology Residents

The effect of mandatory post-call relief on sleep and wellness in ophthalmology residents

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