Trainee burnout: when does the fire start?

Robinson, David Bryan Thomas, James, Osian Penri, Hopkins, Luke, Brown, Chris, Powell, Arfon ORCID: https://orcid.org/0000-0002-3740-8275, Abdelrahman, Tarig, Egan, Richard John and Lewis, Wyn 2022. Trainee burnout: when does the fire start? Postgraduate Medical Journal 98 , pp. 124-130. 10.1136/postgradmedj-2020-137839

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Abstract

Purpose of the study Burnout is an increasingly recognised phenomenon in acute healthcare specialities and associated with depersonalisation, ill health and training programme attrition. This study aimed to quantify contributory physiological variables that may indicate stress in newly qualified doctors. Study design Post Graduate Year 1 doctors (n=13, 7 f, 6 m) were fitted with a VivaLNK wellness device during four prior induction days, followed by their first 14 days work as qualified doctors. Minute-by-minute Heart Rate (HR), Respiratory Rate (RR), and Stress Index (SI) data were correlated with Maslach Burnout Inventories, Short Grit Scales (SGS) and clinical rota duties: Induction vs Normal Working-Day (NWD) versus On-call shift. Results In a total 125 recorded shift episodes, on comparing Induction versus NWD versus On-call shift work, no variation was observed in HR above baseline (25.47 vs 27.14 vs 24.34, p=0.240), RR above baseline (2.21 vs 1.86 vs 1.54, p=0.126) or SI (32.98 vs 38.02 vs 35.47, p=0.449). However, analysis of participant-specific temporal SIs correlated with shift-related clinical duties; that is, study participants who were most stressed during a NWD, were also more stressed during Induction (R2 0.442, p=0.026), and also during On-call shifts (R2 0.564, p=0.012). Higher SGS scores were inversely related to lower SIs (coefficient −32.52, 95% CI −45.881 to 19.154, p=0.001). Conclusion Stress and burnout stimulus appear to start on day one of induction for susceptible PGY1 doctors, and continues into front-line clinical work irrespective of shift pattern. Short Grit Scale questionnaires appear an effective tool to facilitate targeted stress countermeasures.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	BMJ Publishing Group
ISSN:	1469-0756
Date of First Compliant Deposit:	7 October 2022
Date of Acceptance:	11 October 2020
Last Modified:	10 Jun 2023 01:58
URI:	https://orca.cardiff.ac.uk/id/eprint/153152

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