The median respondent age was 29 years (IQR, 28–31 years). Of 334 EM residents, 261 (78%) responded. Analysis was performed using a statistical package program (R version 3.3.2, The R Foundation, Vienna, Austria). Data were analyzed using Spearman correlation (for nonnormally distributed continuous variables), χ 2, or Student's t test as appropriate for continuous or categorical variables. Continuous variables are displayed as means with SD for normally distributed variables or as median values with interquartile ranges (IQRs) for nonnormally distributed variables. Descriptive statistics are presented as total number (n) and percentages for categorical variables. We also obtained basic demographic information (age, sex, and PGY level). 22 Work-life balance was assessed with the question, “Does my work schedule leave me enough time for my personal/family life?” Responses of strongly agree and agree were categorized as positive for work-life balance. Career satisfaction was assessed by the question: “If given the opportunity to revisit your career choice, would you choose to become a physician again?” Responses of likely and very likely were categorized as positive for career satisfaction. We administered 2 questions, previously published by Shanafelt et al, 22, 23 to assess career satisfaction and work-life balance. 21 When compared with clinical interviews, a positive response on the 2-item instrument had a sensitivity of 96% and a specificity of 57% for detecting depression and performed similarly to longer case-finding instruments. 27ĭepression was screened using the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire 2 question screen (PRIME-MD PHQ-2): “During the past month, have you often been bothered by feeling down, depressed, or hopeless?” and “During the past month, have you often been bothered by little interest or pleasure in doing things?” 21 A yes response to either question is considered a positive screen for depression. 20 One study compared the validity, reliability, and responsiveness of a single-item quality-of-life VAS to multi-item scales, including the Medical Outcomes Study 20-Item Short Form (MOS SF-20) and the Rotterdam Symptom Checklist (RSCL), showing that the VAS demonstrated high correlations with the MOS SF-20 health perceptions scale and moderate to high correlation with all other subscales of the MOS SF-20 and RSCL. Visual analog scales (VASs) have been used since the 1970s to measure quality of life, with the assessment consisting of a single-item linear analog scale assessment: “How would you rate your overall quality of life during the past week?” with the score treated as a continuous variable. Additional categorizations are available as online supplemental material. 1, 24 Consistent with the Maslach definition, burnout was defined by both high emotional exhaustion (> 26) and high depersonalization (> 12). We also measured the levels of burnout and positive depression screens in a cohort of emergency medicine (EM) residents.īurnout was assessed using the 22-question MBI, which has validity evidence for use in health- and service-related occupations. We hypothesized that these tools can be used to perform alternative assessments of resident well-being. We sought to compare the MBI to 4 published well-being instruments 20 – 23 to determine to what degree scores correlate with the MBI. Correlating the MBI with other measures also can provide validity evidence for these tools. Use of other instruments also may reduce the potential for survey fatigue from repeated use of the MBI. 17, 18 Identifying additional psychometric variables that correlate with the MBI may assist in identifying and addressing underlying attributes that manifest as burnout. 1 While the MBI provides valuable information, critiques include its proprietary nature, the lack of an established level of burnout that correlates with negative outcomes, and the observation that the 3 categories measured do not translate into target areas for interventions. The Maslach Burnout Inventory (MBI) is a 22-item instrument that is considered the “gold standard” for assessing burnout. 2 – 4 Burnout has negative implications for the physical and mental health of physicians, 5 – 8 career satisfaction, 9, 10 and patient care, 11 – 15 and may have deleterious effects on patient care. 1 The prevalence of burnout continues to rise, and it affects medical students, residents, and more than half of all practicing physicians. Occupational burnout develops due to long-term, unresolvable job stress, and is defined as a triad of emotional exhaustion, depersonalization, and low personal achievement.
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