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Purpose <p>Burnout and thoughts of quitting residency are common among general surgery residents. Residency programs have utilized various methods to measure resident well-being including surveys, structured interviews, and townhall-style meetings. We sought to implement a resident-led exploration of burnout under a framework of participatory action research (PAR), utilizing a multiple-methods approach with an initial validated survey followed by semi-structured group interviews of each PGY class.</p> Methods <p>All categorical general surgery residents were invited to complete the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSS-MP). Group interviews of each PGY class were then performed, facilitated by the PGY5 class who functioned as peer-interviewers. Interviews were recorded and transcribed. The transcripts were assessed using an inductive open coding approach. Themes were identified, and thematic analysis performed.</p> Results <p>Eighteen of 19 (95%) categorical general surgery residents completed the MBI. Rates of burnout were higher than the general population as reported in the MBI score report, including in the areas of emotional exhaustion and depersonalization. Rates of personal accomplishment were similar to the general population. Themes identified from the resident-led group interviews included a perceived imbalance of service with residents’ personal goals. This imbalance was exhibited most notably on two rotations. As a result of imbalance, residents experienced feelings of guilt as well as a phenomenon of “trickle-down” burnout—where burnout of more senior individuals, both faculty and residents, had a negative impact on their peers and junior colleagues. Factors contributing to imbalance included systems and faculty factors. Finally, protective factors and ideas for improvement were also explored by residents.</p> Conclusions <p>A peer-led, PAR approach was used to identify resident burnout as a result of imbalanced service over personal goals, resulting in feelings of guilt and a trickle-down phenomenon. These findings provide a basis for a program-specific, resident-vetted approach to implement systems and institutional changes. This approach recognizes the role of residents as both researchers and stakeholders.</p>

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Rethinking burnout: a peer-led inductive approach to understanding resident well-being

  • 期刊论文

  • 发表日期：

    2025年4月10日

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  • Mary C. Brandt,
  • S. P. O’Malley,
  • M. E. Welborn,
  • N. Roberts,
  • E. C. Sturm

摘要

Purpose

Burnout and thoughts of quitting residency are common among general surgery residents. Residency programs have utilized various methods to measure resident well-being including surveys, structured interviews, and townhall-style meetings. We sought to implement a resident-led exploration of burnout under a framework of participatory action research (PAR), utilizing a multiple-methods approach with an initial validated survey followed by semi-structured group interviews of each PGY class.

Methods

All categorical general surgery residents were invited to complete the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSS-MP). Group interviews of each PGY class were then performed, facilitated by the PGY5 class who functioned as peer-interviewers. Interviews were recorded and transcribed. The transcripts were assessed using an inductive open coding approach. Themes were identified, and thematic analysis performed.

Results

Eighteen of 19 (95%) categorical general surgery residents completed the MBI. Rates of burnout were higher than the general population as reported in the MBI score report, including in the areas of emotional exhaustion and depersonalization. Rates of personal accomplishment were similar to the general population. Themes identified from the resident-led group interviews included a perceived imbalance of service with residents’ personal goals. This imbalance was exhibited most notably on two rotations. As a result of imbalance, residents experienced feelings of guilt as well as a phenomenon of “trickle-down” burnout—where burnout of more senior individuals, both faculty and residents, had a negative impact on their peers and junior colleagues. Factors contributing to imbalance included systems and faculty factors. Finally, protective factors and ideas for improvement were also explored by residents.

Conclusions

A peer-led, PAR approach was used to identify resident burnout as a result of imbalanced service over personal goals, resulting in feelings of guilt and a trickle-down phenomenon. These findings provide a basis for a program-specific, resident-vetted approach to implement systems and institutional changes. This approach recognizes the role of residents as both researchers and stakeholders.