INSPIRED but Tired: How Medical Faculty's Job Demands and Resources Lead to Engagement, Work-Life Conflict, and Burnout.

BACKGROUND: Past research shows that physicians experience high ill-being (i.e., work-life conflict, stress, burnout) but also high well-being (i.e., job satisfaction, engagement). OBJECTIVE: To shed light on how medical faculty's experiences of their job demands and job resources might differentially affect their ill-being and their well-being with special attention to the role that the work-life interface plays in these processes. METHODS: Qualitative thematic analysis was used to analyze interviews from 30 medical faculty (19 women, 11 men, average tenure 13.36 years) at a top research hospital in Canada. FINDINGS: Medical faculty's experiences of work-life conflict were severe. Faculty's job demands had coalescing (i.e., interactive) effects on their stress, work-life conflict, and exhaustion. Although supportive job resources (e.g., coworker support) helped to mitigate the negative effects of job demands, stimulating job resources (e.g., challenging work) contributed to greater work-life conflict, stress, and exhaustion. Thus, for these medical faculty job resources play a dual-role for work-life conflict. Moreover, although faculty experienced high emotional exhaustion, they did not experience the other components of burnout (i.e., reduced self-efficacy, and depersonalization). Some faculty engaged in cognitive reappraisal strategies to mitigate their experiences of work-life conflict and its harmful consequences. CONCLUSION: This study suggests that the precise nature and effects of job demands and job resources may be more complex than current research suggests. Hospital leadership should work to lessen unnecessary job demands, increase supportive job resources, recognize all aspects of job performance, and, given faculty's high levels of work engagement, encourage a climate that fosters work-life balance.

Validating MMI scores: are we measuring multiple attributes?

The multiple mini-interview (MMI) used in health professional schools' admission processes is reported to assess multiple non-cognitive constructs such as ethical reasoning, oral communication, or problem evaluation. Though validation studies have been performed with total MMI scores, there is a paucity of information regarding how well MMI scores differentiate the constructs being measured, the relationship between MMI scores (construct or total) and personality characteristics, and how well MMI scores (construct or total) predict future performance in practice. Results from these studies could assist with MMI station development, rater training, score interpretation, and resource allocation. The purpose of this study was to investigate the validity of MMI construct scores (oral communication and problem evaluation), and their relationship to personality measures (emotionality and extraversion) and specific scores from standardized clinical communications interviews (building the relationship and explaining and planning). Confirmatory factor analysis results support a two factor MMI model, however the correlation between these factors was .87. Oral communication MMI scores significantly correlated with extraversion (r c = .25, p < .05), but MMI scores were not related to emotionality. Scores for building a relationship were significantly related to MMI oral communication scores, (r c = .46, p < .001) and problem evaluation scores (r c = .43, p < .001); scores for explaining and planning were significantly related to MMI problem evaluation scores (r c = .36, p < .01). The results provide validity evidence for assessing multiple non-cognitive attributes during the MMI process and reinforce the importance of developing MMI stations and scoring rubrics for attributes identified as important for future success in school and practice.