Burnout and well-being of medical and surgical residents in relation to emotional intelligence: A 3-year study.

BACKGROUND: This study aims to examine the relationship of emotional intelligence to physician burnout and well-being and compare these changes between medical and surgical residents during training. METHODS: The longitudinal study used survey data, collecting measures on burnout and emotional intelligence in residents. Postgraduate year 1 residents at a community-based Michigan hospital completed the following surveys: Maslach Burnout Inventory, Physician Wellness Inventory, and Trait Emotional Intelligence Questionnaire-Short Form survey. These measures were given quarterly in postgraduate year 1 and once during subsequent years. RESULTS: Seventy-seven residents completed measurements during their first 3 years. Forty-two (54.5%) were in the medical resident group; the remaining 35 (45.5%) were in the surgical resident group. Significant increases in measured burnout during the first year improved in subsequent years but did not return to baseline (P < .01). Emotional exhaustion (Maslach Burnout Inventory-Emotional Exhaustion) increased a relative 44% the first year (P = .000) and decreased 23% by the third year (P < .01). The Physician Wellness Inventory subscales also had significant decreases (P = .01) but less than the Maslach Burnout Inventory subscales (improvement ≤25%). Both medical and surgical groups had similar decreases in the Physician Wellness Inventory subscales (-25%) in their first year. The emotional intelligence score significantly correlated with exhaustion (Maslach Burnout Inventory-Emotional Exhaustion: r = -0.243; P = .002) and distress (Physician Wellness Inventory-Distress: r = -0.197; P = .014). CONCLUSION: The risk for burnout increased sharply at the beginning of training for this hospital resident participant group and remained high throughout residency. Emotional intelligence is an important factor associated with less emotional exhaustion during residency.

Development and Evaluation of a Health Behavior Change Clinic in Primary Care: An Interdisciplinary Partnership.

Providing effective healthy behavior change interventions within primary care presents numerous challenges. Obesity, tobacco use, and sedentary lifestyle negatively impact the health quality of numerous medical patients, particularly in underserved patient populations with limited resources. Primary Care Behavioral Health (PCBH) models, which incorporate a Behavioral Health Consultant (BHC), can offer point-of-contact psychological consultation, treatment, and also provide opportunities for interdisciplinary psychologist-physician clinical partnerships to pair a BHC's health behavior change expertise with the physician's medical care. Such models can also enhance medical training programs by providing resident physicians with live, case-based learning opportunities when partnered with a BHC to address patient health behaviors. We will describe the development, implementation, and preliminary outcomes of a PCBH psychologist-physician interdisciplinary health behavior change clinic within a Family Medicine residency program. Patient outcomes revealed significant reductions (p < .01) in weight, BMI, and tobacco use. Implications and future directions are discussed.

Longitudinal Study of Emotional Intelligence, Well-being, and Burnout of Surgical and Medical Residents.

INTRODUCTION: Emotional intelligence (EI) as a concept is becoming increasingly relevant in the healthcare industry. In order to examine the relationship between EI, burnout, and wellness, we administered these measures quarterly in resident physicians and analyzed the variables in each subset to gain insights and understanding of their relationship. METHODS: In 2017 and 2018, all residents entering the training programs in year one (PGY-1) were administered The Emotional Intelligence Questionnaire - Short Form (TEIQue-SF), The Maslach Burnout Inventory (MBI), and The Physician Wellness Inventory (PWI). The questionnaires were completed quarterly. Statistical analysis included ANOVA and ANCOVA. RESULTS: The overall combined PGY-1 resident year (n = 80) had an EI global trait mean score of 5.47 (SD: 0.59) at the beginning of their first year. The domains of burnout and physician wellness were examined across four different time points during the resident's first year. Domain scores changed significantly over the four time points during the first year. There was a relative 46% increase in exhaustion (P < .001), 48% increase in depersonalization (P < .001), and an 11% decrease in personal achievement (P < .001). Physician wellness domains also changed significantly between time 1 and the end of the year (time 4). There was a relative 12% decrease in career purpose (P < .001), a 30% increase in distress (P < .001), and 6% decrease in cognitive flexibility (P < .001). Each burnout domain and physician wellness domain were highly correlated with emotional quotient (EQ). Emotional quotient was independently assessed with each domain at baseline and with changes overtime. The lowest EQ group reported their distress increased significantly over time (P = .003) and a decline in career purpose (P < .001) and cognitive flexibility (P = .04). The response rate was 100%. CONCLUSION: Emotional intelligence is associated with well-being and burnout in individual residents; therefore, it is important to identify those who require increased support during residency in order to succeed.

Emotional Intelligence, Burnout, and Wellbeing Among Residents as a Result of the COVID-19 Pandemic.

BACKGROUND: We previously reported the correlation between emotional intelligence (EI) with burnout/wellbeing in our PGY-1 residents, finding that EI moderated the development of burnout in the PGY-1 year. When COVID-19 arrived in early 2020, we were already collecting EI and burnout data for the 2019-2020 year. We elected to follow those residents throughout the year and compare them to the subsequent cohort to study the effect of the pandemic on their burnout and wellbeing and the influence of EI on this pattern. MATERIALS AND METHODS: All residents entering the training program (PGY-1) 2019-2020 (SURGE) & 2020-2021 (POST-SURGE) were administered the emotional intelligence questionnaire short form (TEIQue-SF), the Maslach burnout inventory, and the physician's wellness inventory. The questionnaires were completed quarterly. Statistical analysis included ANOVA. Institutional Review Board approval was obtained prior to the study. RESULTS: The overall combined PGY-1 residents year (n = 73) mean EI was 3.9 with no differences between academic year groups. The domains of burnout and physician wellbeing were examined across four different time points during the resident's first year. Domain scores changed over the four time periods during the first year. There was a relative decrease in achievement by 3.4 points, decrease in career purpose by 1.8 points, decrease in cognitive flexibility by .6 points and increase in distress by 4.1 points. Emotional exhaustion increased significantly more for the SURGE 2019-2020 group compared to the POST-SURGE 2020-2021 group (a relative 77% change). Emotional intelligence was independently assessed within each domain at baseline and for changes over time. DISCUSSION: Patterns of burnout and wellbeing were different with the COVID-19 SURGE group compared to the COVID-19 POST-SURGE group, perhaps because of differing expectations of the PGY-1 year participants but also perhaps due to the destabilizing effect of the first COVID-19 surge.

Reevaluating the evidence for a Hadean-Eoarchean dynamo.

The time of origin of the geodynamo has important implications for the thermal evolution of the planetary interior and the habitability of early Earth. It has been proposed that detrital zircon grains from Jack Hills, Western Australia, provide evidence for an active geodynamo as early as 4.2 billion years (Ga) ago. However, our combined paleomagnetic, geochemical, and mineralogical studies on Jack Hills zircons indicate that most have poor magnetic recording properties and secondary magnetization carriers that postdate the formation of the zircons. Therefore, the existence of the geodynamo before 3.5 Ga ago remains unknown.

Teaching ethics that honor the patient's and the provider's voice: The role of clinical integrity.

Medical ethics training is as variable as it is widespread. Previous research has indicated that medical learners find systematic approaches to ethical dilemmas to be helpful. This article describes a bioethics educational module. It includes an overview of common bioethical principles and presents a tool for organizing health-care providers' thinking and discussions about challenging ethical dilemmas. We discuss an area of bioethics that is often neglected, clinical integrity, and the role that a health-care provider's clinical integrity plays in ethical decision-making. We provide several hypothetical ethical vignettes for practice and discussion using the clinical integrity tool. The article also describes how this module has been implemented in one medical education setting and provides suggestions for educators.

Perspectives on Healthcare Provider Well-Being: Looking Back, Moving Forward.

Recognizing the impact of healthcare professional (HCP) burnout has led to vigorous interest from organizations and individuals regarding how to most effectively promote HCP well-being. The present paper reviews the literature on HCP well-being and describes factors that impact well-being at various levels (i.e., system, institution, program, interpersonal, and individual). We propose that change must occur at all levels to have the greatest impact. Further, we highlight opportunities to advance research on HCP well-being (e.g., being more inclusive regarding study populations and designing longitudinal intervention studies).

The Problems With Burnout Research.

Burnout among physicians and physicians-in-training is well established as a potential threat to the health and well-being of health care providers and patients. However, there are myriad problems with current burnout research and its ongoing measurement that threaten the validity of the conclusions. For example, researchers have used differing ways of defining and measuring burnout. Those who have used the Maslach Burnout Inventory vary in recommended use of the instrument and cutoff scores. As a result, the authors suggest that the term "burnout" may be misused and recommend some reconsideration of the meaning of burnout. The measurement and discussion of burnout have strong implications for interventions and policy alike. In this article, the authors review the problems with burnout research and ask important questions about the future directions of research efforts. The authors recommend a consistent measurement approach and perhaps moving toward a focus on physician wellness from a positive psychology perspective.

Self-Report Study of Predictors of Physician Wellness, Burnout, and Quality of Patient Care.

OBJECTIVE: The goal of this self-report study was to examine the relation of work variables, self-rated health and mental health status, and perceived social support to physician wellness, physician burnout, and quality of patient care. METHODS: We administered a demographics questionnaire, the Physician Wellness Inventory, the Maslach Burnout Inventory, and the Patient Care Scale to a random sample of full physician members of the American Academy of Family Physicians. We performed regression analyses on self-reported health status, work variables, and social support data as predictor variables and the subscales from the Physician Wellness Inventory, Maslach Burnout Inventory, and Patient Care Scale as the outcome variables. RESULTS: The response rate was 22%. Self-reported mental health status significantly predicted all of the wellness scales, the burnout scales, and the quality of patient care. The ability to manage the workload was the second strongest predictor of multiple scales. CONCLUSIONS: More work should be done to explore the factors related to physicians' self-ratings of mental health status and what that means to them. Also, it is important to study whether self-rated mental health status is related to objective patient care quality measures.

Relation Between Physicians' Work Lives and Happiness.

OBJECTIVES: Although we know much about work-related physician burnout and the subsequent negative effects, we do not fully understand work-related physician wellness. Likewise, the relation of wellness and burnout to physician happiness is unclear. The purpose of this study was to examine how physician burnout and wellness contribute to happiness. METHODS: We sampled 2000 full-time physician members of the American Academy of Family Physicians. Respondents completed a demographics questionnaire, questions about workload, the Physician Wellness Inventory, the Maslach Burnout Inventory, and the Subjective Happiness Scale. We performed a hierarchical regression analysis with the burnout and wellness subscales as predictor variables and physician happiness as the outcome variable. RESULTS: Our response rate was 22%. Career purpose, personal accomplishment, and perception of workload manageability had significant positive correlations with physician happiness. Distress had a significant negative correlation with physician happiness. CONCLUSIONS: A sense of career meaning and accomplishment, along with a lack of distress, are important factors in determining physician happiness. The number of hours a physician works is not related to happiness, but the perceived ability to manage workload was significantly related to happiness. Wellness-promotion efforts could focus on assisting physicians with skills to manage the workload by eliminating unnecessary tasks or sharing workload among team members, improving feelings of work accomplishment, improving career satisfaction and meaning, and managing distress related to patient care.

Post-traumatic stress disorder: theory and treatment update.

Post-traumatic stress disorder (PTSD) is one of the few mental disorders in which the cause is readily identifiable. In this article, we review the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria, prevalence, and presentation of patients with PTSD in primary care. The purpose of this article is to review current literature regarding theory, etiology, and treatment effectiveness. Key findings in terms of neurobiological underpinnings with implications for future treatment are discussed. Recommendations regarding effective psychotherapy and pharmacotherapy, emerging treatment, and management issues in primary care settings are offered.