In Reply—Burnout Is Not Associated With Increased Medical Errors

Tawfik, Daniel S.; Profit, Jochen; Morgenthaler, Timothy I.; Satele, Daniel; Sinsky, Christine A.; Dyrbye, Liselotte N.; Tutty, Michael; West, Colin P.; Shanafelt, Tait D.

doi:10.1016/j.mayocp.2018.08.014

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…Burnout in physician trainees is a significant public health problem that decreases physician quality of life, affects patient safety, and has enormous economic consequences. 1,6,9 Importantly, although individual motivation for maintaining personal well-being is important, systemic organizational efforts to provide activities that enhance well-being have been identified as a critical aspect of counteracting physician burnout, 7,8,38 and our group is firmly committed to creating such programs. Efforts by healthcare institutions to mitigate physician burnout will require creativity, and the development of yoga-based activities to address this problem is one feasible approach.…”

Section: Discussionmentioning

confidence: 99%

“…Burnout in physicians and physician trainees has been called a "global crisis," 1 and prevalence of burnout in U.S. doctors is estimated to be at least 50%. [2][3][4][5][6][7][8] Physician burnout not only affects physicians' overall quality of life but also affects patient care and causes a high economic burden. 9 Because of the serious consequences of physician burnout, the Accreditation Council for Graduate Medical Education (ACGME) requires a focus on well-being for physician trainees at accredited institutions.…”

Section: Introductionmentioning

confidence: 99%

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Designing a Yoga Intervention Program to Improve Well-Being for Physician Trainees: Challenges and Lessons Learned

Hoffert

Kerr

Hegab

et al. 2020

International Journal of Yoga Therapy

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Well-being activities may help to counteract physician burnout. Yoga is known to enhance well-being, but there are few studies of yoga as an intervention for physicians in training. This prospective methodology-development study aimed to explore how to establish a yoga-based well-being intervention for physician trainees in a large urban training hospital. We aimed to identify factors that contribute to trainee participation and explore an instrument to measure changes in self-reported well-being after yoga. Cohorts included a required-attendance group, a voluntary-attendance group, and an unassigned walk-in yoga group. Weekly 1-hour yoga sessions were led by a qualified yoga instructor for 4 weeks. The seven-question Resident Physician Well-Being Index (RPWBI) was used to measure resident well-being before yoga, after 4 weeks of yoga, and 6 months post-yoga. Trainees attending each session ranged from 17 for required yoga to 0–2 for voluntary yoga, 2–9 for lunchtime walk-in yoga, and 1–7 for evening walk-in yoga. In the required-yoga group (n = 17), overall RPWBI mean scores did not change significantly across the three query times, and participation in the survey declined over time. The mean baseline RPWBI score for the required group before yoga was in the non-distressed range and answers to the seven individual questions varied. Requiring a yoga activity for medical trainees may be a good strategy for promoting participation in yoga. The RPWBI may have limited utility for measuring changes in overall group well-being after a yoga intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Designing a Yoga Intervention Program to Improve Well-Being for Physician Trainees: Challenges and Lessons Learned

Hoffert

Kerr

Hegab

et al. 2020

International Journal of Yoga Therapy

View full text Add to dashboard Cite

show abstract

“…Medical leaders have argued that these and other similar critiques are not relevant to current efforts to improve trainee and attending physician wellness ( Meeks, Jain, & Herzer, 2019 ; Tawfik et al, 2018 ). Yet many disability rights criticisms of wellness (e.g., its potential to “institutionalize disability bias” [ Basas, 2014 ;p.1035]) are ideological and not limited to a particular setting.…”

Section: Discussionmentioning

confidence: 99%

How is “stigma” conceived within the biomedical literature on trainee wellness? A directed content analysis

Lawson¹,

Kalet²

2019

MedEdPublish

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Introduction: Institutional discrimination against trainees with suspected mental disorders has rarely been the focus of medical education research. This study explored whether such neglect might be related to the way in which stigma is conceived by academic medical researchers, and was informed by previous scholarship describing the disability models and stigma agendas believed to predominate within the medical field. The aim was to examine whether researchers might be focusing solely on the ways in which stigma prevents trainees from seeking mental health treatment, while neglecting to address mental health discrimination, as predicted by these scholars' descriptions. Methods: The authors searched PubMed and Medline for articles using combined terms wellness or wellbeing; medical student or resident or physician; and stigma and mental, published between September 12, 2011 and September 12, 2016. Directed content analysis of articles with a primary focus on mental health wellness provided counts of the words discrimination and treatment and evaluated authors' recommendations to either reduce discrimination or increase identification and mental health treatment. Results: Of the 25 articles meeting inclusion criteria, 23 used the word treatment (median = 7), while only 7 mentioned discrimination (median = 0). The authors of at least 20 articles recommended identification and treatment, but none provided any recommendations to reduce institutional discrimination. Three surveys also identified concerns about mental health discrimination that were not taken seriously by the authors of these studies. Conclusions: Current trainee wellness research appears to have largely ignored mental health discrimination as a negative influence. Such findings appear consistent with prior descriptions of a medical model of disability/services agenda to reducing stigma that has been criticized by proponents of a social model/rights agenda. Wellness researchers should take steps to reduce mental health discrimination against trainees and consider limitations of current conceptions of stigma within the medical field.

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“…Burnout and poor well-being have been recognized as common occupational hazards among physicians, nurses, and other healthcare professionals 1,2,3 . Nurse burnout and poor well-being are found to be associated with job turnover 4,5 , medical errors 6 , and poor patient care 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Impact of adverse event reporting system on burnout and job satisfaction of nurses in China: a nationwide cross-sectional study using a multilevel modeling approach

Chen

Wang

et al. 2022

Preprint

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IMPORTANCE Many organizational and personal factors may contribute to burnout and poor job satisfaction experienced by nurses. Adverse Event Reporting System (AERS) is a key component of organizational-level quality improvement system which impacts workplace wellness for nurses. However, little is known about the underlying influence and mechanism that AERS have on nurse' well-being. OBJECTIVE To explore the relationship between the implementation of AERS, burnout, and job satisfaction among psychiatric nurses in China. To uncover the mechanism through which AERS influences burnout and job satisfaction, while examining the mediating effect of workplace violence from patients. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used the multilevel linear regression analyses with a national sample of 9,744 psychiatric nurses from 41 psychiatric hospitals across 29 provinces in China. Data collection was performed in March 2019, and the analyses were conducted from May to July 2022. MAIN OUTCOMES AND MEASURES The main outcomes were self-reported burnout and job satisfaction. Burnout was measured by the Maslach Burnout Inventory and job satisfaction was measured using Minnesota Satisfaction Questionnaire. RESULTS Among 9,744 nurses (mean [SD] age, 34.7 [8.8] years) interviewed, 8064 (82.8%) were female. AERS was positively associated with job satisfaction (β=3.70; p<0.05), but negatively with burnout (β=-3.42; p<0.01) and workplace violence (β=-0.55; p<0.1). Workplace violence was positively associated with burnout (β=2.27; p< 0.01), while negatively associated with job satisfaction (β=-0.81; p<0.01). Mediation analysis indicated that the association between AERS, burnout, and job satisfaction was mediated by workplace violence. CONCLUSIONS AND RELEVANCE This study highlights that the implementation of AERS is associated with less workplace violence in hospitals, and it may also contribute to lower levels of burnout and higher levels of job satisfaction among psychiatric nurses.

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In Reply—Burnout Is Not Associated With Increased Medical Errors

Cited by 6 publications

References 9 publications

Designing a Yoga Intervention Program to Improve Well-Being for Physician Trainees: Challenges and Lessons Learned

Designing a Yoga Intervention Program to Improve Well-Being for Physician Trainees: Challenges and Lessons Learned

How is “stigma” conceived within the biomedical literature on trainee wellness? A directed content analysis

Impact of adverse event reporting system on burnout and job satisfaction of nurses in China: a nationwide cross-sectional study using a multilevel modeling approach

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