Ameliorating Work Burnout and Medical Residents
| Status: | Recruiting |
|---|---|
| Conditions: | Anxiety, Anxiety, Depression |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 25 - 50 |
| Updated: | 4/21/2016 |
| Start Date: | July 2015 |
| End Date: | February 2017 |
| Contact: | Marcos Sanchez-Gonzalez, MD PhD |
| Email: | masanchez@larkinhospital.com |
| Phone: | 305-284-7608 |
The Impact of Work Burnout on Sleep Quality and Negative Emotions in Medical Residents: An Intervention for Improving Wellbeing in Graduate Medical Education
Prior research has demonstrated that during residency years, in particular training to
obtain a medical specialty, work burnout is a very prevalent problem. Work burnout is
defined as a syndrome of dysfunction in three domains, emotional exhaustion,
depersonalization, and a reduced sense of personal accomplishment. (Maslach et. al., 1981).
Often, burnout has been associated with poor sleep quality and negative affectivity, such as
depression and anxiety. In fact, our preliminary data demonstrate that burnout in medical
residents affects sleep quality, and increases negative emotions. Strikingly, burnout in
medical residents negatively impacts working performance as well as patient-physician
interactions, and hence may affect the quality of health care. However, lacking are studies
aimed at understating how work burnout affects cognitive performance and decision making in
medical residents. The proposed study will provide essential groundwork in demonstrating the
link between burnout and impaired cognitive performance. In addition, the proposed study
will demonstrate feasibility for a future trial to test whether an intervention, emWave,
integrating a computer based stress management (resilience training), can have a positive
impact on residents with high burnout symptoms. The amelioration of psychological risk
factors in medical residents may lead to improved physician-patient relationships in the
service of improved quality of care.
obtain a medical specialty, work burnout is a very prevalent problem. Work burnout is
defined as a syndrome of dysfunction in three domains, emotional exhaustion,
depersonalization, and a reduced sense of personal accomplishment. (Maslach et. al., 1981).
Often, burnout has been associated with poor sleep quality and negative affectivity, such as
depression and anxiety. In fact, our preliminary data demonstrate that burnout in medical
residents affects sleep quality, and increases negative emotions. Strikingly, burnout in
medical residents negatively impacts working performance as well as patient-physician
interactions, and hence may affect the quality of health care. However, lacking are studies
aimed at understating how work burnout affects cognitive performance and decision making in
medical residents. The proposed study will provide essential groundwork in demonstrating the
link between burnout and impaired cognitive performance. In addition, the proposed study
will demonstrate feasibility for a future trial to test whether an intervention, emWave,
integrating a computer based stress management (resilience training), can have a positive
impact on residents with high burnout symptoms. The amelioration of psychological risk
factors in medical residents may lead to improved physician-patient relationships in the
service of improved quality of care.
Background: Burnout during residency years, in particular training to obtain a medical
specialty, has been well recognized. Often, burnout has been associated with poor sleep
quality and negative affectivity, such as depression. However, aspects of positive emotion
that have been linked to improved physical and mental health, such as trait forgiveness
(TF), have been poorly explored.
For instance, according to statistics, depression in residents is as high as twenty-five
percent, while residents' suffering from depression with resident burnout (defined as an
occupational related syndrome of emotional exhaustion and low sense of professional
accomplishment) is as high as seventy-six percent. In fact, first-year residents, with a
sense of high well-being, experience great level of burnout and depression by the end of
their first year. ( www.aafp.org, Yi M.S. et al. , 2007 ; Shanafelt T.D. et al. ,2002 ;
Richman J.A. et. al. , 1992)
There are two specific aims my collaborators and I are focusing on in in this two-phase
study:
Specific Aim 1: To explore the impact of work burnout on cognitive performance and
psychological functioning in medical residents. Mounting evidence points towards the
conclusion that work burnout can have a negative effect on psychological functioning in
medical residents. We will test the working hypothesis that work burnout will be associated
with poor cognitive performance, poor sleep quality, and high negative affectivity. Our
approach is to use self-reported cognitive impairment and cognitive performance tasks
designed to measure three basic processes underlying executive control: (i) updating, (ii)
inhibition, and (iii) switching. Negative affective symptoms will be measured using
validated psychometric scales for depression (Beck Depressive Inventory; BDI), anxiety
(State-Trait Anxiety Inventory; STAI), and anger (State-Trait Anger Expression Inventory-2;
STAEI-2). Sleep quality will be assessed via the Pittsburgh Sleep Quality Index (PSQI).
Specific Aim 2 - To examine the impact of an 8-week computer based resilience training
intervention on work burnout, cognitive performance, and affectivity in medical residents.
Our approach will be to test the impact of this intervention through a SmartPhone (e.g
Android Phone or Iphone) application, emWave software, which will be provided to all our
subjects. emWave is a tool that reduces stress by allowing individuals to be less reactive,
think clearly, and make good decisions, especially under pressure. Fifty medical residents
with high burnout symptoms will be randomized to receive an 8-week intervention (INT; n=25)
or sham control (CON; n=25).
specialty, has been well recognized. Often, burnout has been associated with poor sleep
quality and negative affectivity, such as depression. However, aspects of positive emotion
that have been linked to improved physical and mental health, such as trait forgiveness
(TF), have been poorly explored.
For instance, according to statistics, depression in residents is as high as twenty-five
percent, while residents' suffering from depression with resident burnout (defined as an
occupational related syndrome of emotional exhaustion and low sense of professional
accomplishment) is as high as seventy-six percent. In fact, first-year residents, with a
sense of high well-being, experience great level of burnout and depression by the end of
their first year. ( www.aafp.org, Yi M.S. et al. , 2007 ; Shanafelt T.D. et al. ,2002 ;
Richman J.A. et. al. , 1992)
There are two specific aims my collaborators and I are focusing on in in this two-phase
study:
Specific Aim 1: To explore the impact of work burnout on cognitive performance and
psychological functioning in medical residents. Mounting evidence points towards the
conclusion that work burnout can have a negative effect on psychological functioning in
medical residents. We will test the working hypothesis that work burnout will be associated
with poor cognitive performance, poor sleep quality, and high negative affectivity. Our
approach is to use self-reported cognitive impairment and cognitive performance tasks
designed to measure three basic processes underlying executive control: (i) updating, (ii)
inhibition, and (iii) switching. Negative affective symptoms will be measured using
validated psychometric scales for depression (Beck Depressive Inventory; BDI), anxiety
(State-Trait Anxiety Inventory; STAI), and anger (State-Trait Anger Expression Inventory-2;
STAEI-2). Sleep quality will be assessed via the Pittsburgh Sleep Quality Index (PSQI).
Specific Aim 2 - To examine the impact of an 8-week computer based resilience training
intervention on work burnout, cognitive performance, and affectivity in medical residents.
Our approach will be to test the impact of this intervention through a SmartPhone (e.g
Android Phone or Iphone) application, emWave software, which will be provided to all our
subjects. emWave is a tool that reduces stress by allowing individuals to be less reactive,
think clearly, and make good decisions, especially under pressure. Fifty medical residents
with high burnout symptoms will be randomized to receive an 8-week intervention (INT; n=25)
or sham control (CON; n=25).
Inclusion Criteria:
- Must be a medical resident attending a valid residency program from either Family
Medicine, Internal Medicine, Surgery or Psychiatry at Larkin Community Hospital
Exclusion Criteria:
We found this trial at
1
site
South Miami, Florida 33143
Principal Investigator: John S Samaan, MD, MPH
Phone: 305-284-7608
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