Training demands on clerk burnout: determining whether achievement goal motivation orientations matter

Abstract

BackgroundIn the education field, learning experiences are considered learners’ properties and are viewed as a key determinant in explaining learners’ learning processes, especially for training novices such as clerks with varying levels of commitment to the medical profession. This study explored whether clerks’ achievement goal motivation orientations might buffer the negative well-being to a certain extent, considering their training demands during clinical training.MethodsNinety-four clerks at a tertiary medical center were longitudinally traced during their 2-year clerkship spanning from September 2013 to April 2015. Web-based, validated, structured, self-administered questionnaires were used to evaluate the clerks’ properties of achievement goal motivation orientation and personal background at the beginning of the clerkship. Regular surveys were conducted to evaluate their perceptions of training demands and burnout at each specialty rotation. Overall, 2230 responses were analyzed, and linear mixed-effects models were used to examine the repeated measures of the clerks.ResultsThe results revealed that higher perceived psychological and physical demands of training were related to higher perceived burnout during the 2-year clerkship. Although both the clerks’ task and ego orientations were related to reduced burnout (direct effects), only task orientation was indicated to exert a buffering effect on their perception of physical demands on burnout in the 1st year of the clerkship.ConclusionsConsidering the negative effects of training demands (psychological and physical), we observed a limited effect of the task achievement motivation orientation of medical students; therefore, additional studies might focus on strategies to facilitate medical students in clerkships in addressing both the psychological and physical demands inherent in training workplaces to improve their learning experience and well-being.

Determinants and effects of medical students’ core self-evaluation tendencies on clinical competence and workplace well-being in clerkship

“…The study participants were medical students from 2 cohorts who were studying in the 7-year doctor of medicine (MD) program of a university medical school in Taiwan and who had commenced their 2-year clinical workplace training clerkship in September 2013 and September 2014. All the training courses (in various specialties, which are listed in S1 Appendix ) [ 31 ] of the 2-year clerkship were organized by the department of education of the university-affiliated medical center. Of a total of 258 medical students from the 2 cohorts, 154 students signed informed consent forms (participation rate: 60%).…”

“…ProQOL originally covered 2 major constructs, namely compassion satisfaction and compassion fatigue (which is further divided into 2 components, namely burnout and secondary traumatic stress) [ 42 ]. It has been increasingly employed in studies on physicians [ 43 – 45 ] and medical students [ 31 , 46 ]. Most phenomena linked to secondary traumatic stress were unsuitable for the learning content and contexts of clinical clerkships.…”

“…In this analysis, individual medical students were units of analysis, and their CSEs were dependent variables; all the preclinical academic performance indictors were independent variables, and their demographic characteristics (age and sex) were covariates. Pearson correlation with r > 0.7 and VIF > 5 served as the cutoff points for potential multicollinearity of the independent explanatory variables [ 31 , 50 ]. All analyses were performed using SPSS (IBM, Version 20.0).…”

Measuring achievement goal motivation, mindsets and cognitive load: validation of three instruments’ scores

“…Prior limited work in health professions education suggests associations between achievement goals (measured with various instruments) and academic performance, self-efficacy, burnout and frustration. [29][30][31][62][63][64][65][66] However, validity evidence for achievement goals assessments in the health professions has been sparsely reported.…”

Medical students’ resilience: a protective role on stress and quality of life in clerkship

“…Whether before or after graduation, undergoing clinical training is more challenging than studying at school and can trigger many physical and mental health conditions (particularly mental disorders and emotional exhaustion) in medical students [13]. Studies have also revealed that medical students can encounter stressful clinical events [14] and psychological and physical demands [15, 16] during their clinical training years. A review study covering the peer-reviewed, English-language articles in MEDLINE between 1990 and 2015 revealed a prevalence of burnout among trainees, including medical students, residents, and interns, to a much higher level than found among the general population [17].…”