Burnout among medicalstudents

Gulmetova Komola
12.21.2022

Contents:
1. Definition of the academic burn-out
2. Burn-out among medical students
3. The difference between burn-out and stress
4. Interesting facts about burn-out
5. Burn-out assessment instrument
6. Forms of the Maslach Burnout Inventory
7. Symptoms of Burn out
8. Why it is important?
9. Conclusions

Burnout
the state of being extremely tired or ill, either physically or mentally, because you
have worked too hard
the Oxford Advanced Learner's Dictionary

Academic Burnout
is defined as a three dimensional syndrome
which includes emotional exhaustion,
depersonalization, and reduced personal
accomplishment (Maslach and Jackson, 1981 ).
Maslach, C. and Jackson, S.E. (1981), The measurement of experienced burnout. J.
Organiz. Behav., 2: 99-113. https://doi.org/10.1002/job.4030020205

https://pin.it/6H78NX1

Burnout among medical students of a medicalcollege in Kathmandu 229 students

Shrestha, D. B., Katuwal, N., Tamang, A., Paudel, A., Gautam, A., Sharma, M., Bhusal, U., & Budhathoki, P. (2021). Burnout among medical students of amedical college in Kathmandu; a cross-sectional study. PLOS ONE, 16(6). https://doi.org/10.1371/journal.pone.0253808

Temporal Trends in Medical Student
BurnoutHansell, M. W., Ungerleider, R. M., Brooks, C. A., Knudson, M. P., Kirk, J. K., & Ungerleider, J. D. (2019). Temporal trends in medical student
burnout. Family Medicine, 51(5), 399–404. https://doi.org/10.22454/fammed.2019.270753

Medical student burnout and workplace/learning
environment
1, 2 year

Strongly
associated withthe perceived
level of support
from faculty
staff.

3, 4 year

Was most closely
linked toclerkshiporganization andexposure tocynical residents

Rotatingstudents

Possibly becauseof extended hours
spent at thehospital and theacuity of the cases
seen

Dyrbye LN, Thomas MR, Harper W, Massie FS Jr, Power DV, Eaker A, Szydlo DW, NovotnyPJ, Sloan JA, Shanafelt TD. The learning environment and medical student burnout: amulticentre study. Med Educ2009; 43: 274– 282.

No significant
relationship wasseen with thefrequency of call,number ofpatients seen,admissions orconsults

Why this is happening:• Medical school creates a demanding learning environment, where students areconstantly under pressure to absorb and retain a vast amount of information
within strict time constraints.
• Additionally, students encounter financial stressors like obtaining scholarships,
handling student loan repayments, and managing various expenses, further adding
to their workload.
• Furthermore, a lack of leisure time, limited opportunities to spend time withfamily and friends, preparing for residency programs, choosing a specialty, anddelayed income contribute to heightened stress levels among medical students.

Altannir, Y., Alnajjar, W., Ahmad, S. O., Altannir, M., Yousuf, F., Obeidat, A., & Al-Tannir, M. (2019). Assessment of burnout in medical undergraduate students in Riyadh,
Saudi Arabia. BMC Medical Education, 19(1). https://doi.org/10.1186/s12909-019-1468-3

Charkhabi, M., Azizi Abarghuei, M., & Hayati, D. (2013). The Association of Academic Burnout with self-efficacy and quality of learning experienceamong Iranian students. SpringerPlus, 2(1). https://doi.org/10.1186/2193-1801-2-677
Abdulghani, H. M., AlKanhal, A. A., Mahmoud, E. S., Ponnamperuma, G. G., & Alfaris, E. A. (2011). Stress and its effects on medical students: A cross-sectional study at aCollege of Medicine in Saudi Arabia. Journal of Health, Population and Nutrition, 29(5). https://doi.org/10.3329/jhpn.v29i5.8906

Generally, the prevalence of burnout is considerably dissimilar acrosscountries. The Middle East and Oceania countries have a higher
prevalence of burnout than other countries in other continents.

Frajerman, A., Morvan, Y., Krebs, M.-O., Gorwood, P., & Chaumette, B. (2019). Burnout in medical students before residency: A systematic review and meta-analysis. EuropeanPsychiatry, 55, 36–42. https://doi.org/10.1016/j.eurpsy.2018.08.006
Altannir, Y., Alnajjar, W., Ahmad, S. O., Altannir, M., Yousuf, F., Obeidat, A., & Al-Tannir, M. (2019). Assessment of burnout in medical undergraduate students in Riyadh, Saudi
Arabia. BMC Medical Education, 19(1). https://doi.org/10.1186/s12909-019-1468-3

Burn-out assessment instrument
The Maslach Burnout Inventory (MBI) is a psychological assessment
instrument comprising 22 symptom items pertaining to occupationnal
burnout.

Christina Maslach

Susan E. Jackson

Maslach, C.; Jackson, S.E.; Leiter, M.P. (1996–2016). Maslach Burnout Inventory Manual(Fourth ed.). Menlo Park, CA: Mind Garden, Inc.

Maslach Burnout Inventory Scales
Emotional
Exhaustion(EE)Professional
Efficacy

Depersonaliz
ation (DP)BURN-OUT
Personal
Accomplish
ment (PA)Cynicism

Maslach, C.; Jackson, S.E.; Leiter, M.P. (1996–2016). Maslach Burnout Inventory Manual(Fourth ed.).
Menlo Park, CA: Mind Garden, Inc.

Forms of the Maslach Burnout Inventory
Maslach Burnout Inventory - Human Services
Survey for Medical Personnel (MBI-HSS (MP))

Maslach Burnout Inventory - General Surveyfor Students (MBI-GS (S))[

Emotional
Exhaustion(EE)

Emotional
Exhaustion(EE)

Depersonaliz
ation (DP)Professional
Efficacy

BURN-OUT

Depersonaliz
ation (DP)Professional
Efficacy

Personal
Accomplish
ment (PA)Cynicism

BURN-OUT
Personal
Accomplish
ment (PA)Cynicism

Dimensions of academic burnout
Burnout typically manifests through three main
dimensions: profound exhaustion ("I can't handle
this anymore"), feelings of cynicism and detachment("I can't wait to get out of here"), and a sense ofinefficacy and failure ("Perhaps I'm not suited for
this; I'm just not competent enough"). If an
individual scores high in any one of these dimensions,
it often serves as an early indicator of burnout.

https://www.theladders.com/career-advice/the-3-earlywarning-signs-of-burnout-before-it-destroys-your-career-andrelationships

https://onlinelibrary.wiley.com/doi/full/10.1002/wps.2
0311

Symptoms of Overwhelming Exhaustion:
1. Excessive workload and fatigue.
2. Insomnia.
3. Increased occurrence of illness.

Symptoms of Cynicism:
1. Feelings of unfairness.
2. Loss of enjoyment.
3. Feeling undervalued.
4. Feeling unethical.
5. Isolation.
https://www.theladders.com/career-advice/the-3-early-warning-signs-of-burnout-before-itdestroys-your-career-and-relationships

Symptoms of Ineffectiveness:
1. Feelings of hopelessness.
2. Lack of focus and concentration.
3. Anxiety and panic attacks.
4. Increased irritability.

https://www.theladders.com/career-advice/the-3-earlywarning-signs-of-burnout-before-it-destroys-your-career-andrelationships

Six key domains of burn-out

Compson, J. (2015). The care heuristic for addressing burnout in Nurses. Journal of Nursing Educationand Practice, 5(7). https://doi.org/10.5430/jnep.v5n7p63
C. Maslach, M.P. Leiter, Chapter 43 - Burnout, Editor(s): George Fink, Stress: Concepts, Cognition, Emotion, and Behavior,
Academic Press, 2016, Pages 351-357, ISBN 9780128009512, https://doi.org/10.1016/B978-0-12-800951-2.00044-3.

An association with burnout
v An association between burnout in medicalstudents and suicidal ideation.
v Association with suicidal ideation andserious thoughts of dropping out of medicalschool
v Students who were single were significantly
more emotionally exhausted than theirclassmates in relationships.
IsHak, W., Nikravesh, R., Lederer, S., Perry, R., Ogunyemi, D., & Bernstein, C. (2013). Burnout in medical
students: A systematic review. The Clinical Teacher, 10(4), 242–245. https://doi.org/10.1111/tct.12014

Dyrbye LN, Thomas MR, Massie FS, Power DV, Eacker A, Harper W, Durning S, Moutier C, Szydlo
DW, Novotny PJ, Sloan JA, Shanafelt TD. Burnout and suicidal ideation among U.S. medicalstudents. Ann Intern Med2008; 149: 334– 341.

9Guthrie E, Black D, Bagalkote H, Shaw C, Campbell M, Creed F. Psychological stress and burnout inmedical students: a five year prospective longitudinal study. J R Soc Med1998; 91: 237– 243.

Dyrbye LN, Harper W, Durning SJ, Moutier C, Thomas MR, Massie FS Jr, Eacker A, Power
DV, Szydlo DW, Sloan JA, Shanafelt TD. Patterns of Distress in US Medical Students. Med
Teach2011; 33: 834– 839.

Under Pressure: Medical School Burnout. YouTube. (2020, April 3).
https://youtu.be/2ARXCT6K8K4

Conclusions
Medical schools have the opportunity to enhance students'
well-being by incorporating teachings on self-care skills,
implementing wellness interventions, and providing
education on burnout prevention and reduction. Strategies
such as restructuring medical student responsibilities,
conducting regular performance evaluations, andestablishing mentoring programs have proven effective in
reducing burnout among medical students. Moreover, theimplementation of structured mentoring programs can bebeneficial in mitigating student burnout. Peer support inhandling challenging cases can also be validating andstress-relieving for many students.

Peisah C, Latif E, Wilhelm K, Williams B. Secrets to psychological success: Why older doctors might
have lower psychological distress and burnout than younger doctors. Aging & Mental
Health2009; 13: 300– 307.
Dahlin ME, Runeson B. Burnout and psychiatric morbidity among medical students entering clinicaltraining: A three year prospective questionnaire and interview-based study. BMC Med Educ2007; 7: 6.

IsHak, W., Nikravesh, R., Lederer, S., Perry, R., Ogunyemi, D., & Bernstein, C. (2013).
Burnout in medical students: A systematic review. The Clinical Teacher, 10(4), 242–245.
https://doi.org/10.1111/tct.12014