Exploring medical resident engagement and burnout
Orrange, Susan Major
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Many studies have found high rates of burnout in residents, and psychological researchers have pursued job engagement as the positive opposite of burnout. This study was designed to determine how residents engage within their training programs, as both learners and employees, and the ways in which engagement relates to burnout for residents. Individual interviews were conducted with ten pediatrics and obstetrics-gynecology residents, using engagement concepts from higher education and psychology to inform the design of the questions. Interviews were audiotaped, transcribed, and analyzed using open coding, preliminary development of themes, focused coding, and final theme construction. This qualitative data analysis revealed several interconnected themes. Engagement in residents is characterized by: opportunities to embrace personal responsibility, develop autonomy, and mark achievements. The residency environment, recognized as both pervasive and hierarchical, promotes engagement by: emphasizing a supportive environment, preparing residents for the rapid shifts in responsibility throughout training progression, and utilizing the resident teaching role to promote further engagement. By gathering individual perspectives of residents, this research begins to establish a definition of engagement in residents that is more complex and nuanced than simply involvement or participation. Personal and environmental elements interact in a way that includes and extends elements of established models of student and work engagement, and also adds to the existing burnout literature. These findings will be helpful in developing effective pedagogical strategies to fully engage residents in their work and learning experiences.