Purpose of the study Burnout is an increasingly recognised phenomenon in acute healthcare specialities and associated with depersonalisation, ill health and training programme attrition. This study aimed to quantify contributory physiological variables that may indicate stress in newly qualified doctors.
Study design Post Graduate Year 1 doctors (n=13, 7 f, 6 m) were fitted with a VivaLNK wellness device during four prior induction days, followed by their first 14 days work as qualified doctors. Minute-by-minute Heart Rate (HR), Respiratory Rate (RR), and Stress Index (SI) data were correlated with Maslach Burnout Inventories, Short Grit Scales (SGS) and clinical rota duties: Induction vs Normal Working-Day (NWD) versus On-call shift.
Results In a total 125 recorded shift episodes, on comparing Induction versus NWD versus On-call shift work, no variation was observed in HR above baseline (25.47 vs 27.14 vs 24.34, p=0.240), RR above baseline (2.21 vs 1.86 vs 1.54, p=0.126) or SI (32.98 vs 38.02 vs 35.47, p=0.449). However, analysis of participant-specific temporal SIs correlated with shift-related clinical duties; that is, study participants who were most stressed during a NWD, were also more stressed during Induction (R2 0.442, p=0.026), and also during On-call shifts (R2 0.564, p=0.012). Higher SGS scores were inversely related to lower SIs (coefficient −32.52, 95% CI −45.881 to 19.154, p=0.001).
Conclusion Stress and burnout stimulus appear to start on day one of induction for susceptible PGY1 doctors, and continues into front-line clinical work irrespective of shift pattern. Short Grit Scale questionnaires appear an effective tool to facilitate targeted stress countermeasures.
- Education & training (see Medical Education & Training)
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Collaborators Welsh Surgical Research Initiative Collaborators, Claire-Marie Hughes, Robyn Hackett, Tom Meredith, Robert Parker, Andrew Forrester, Annie, Hoather, Dominic Hayes, Emma Watson-Jones, Francesca Mitchell, Gareth Price, James Cochrane, Oliver Purnell, Patrick Colhoun, Charlotte Sanders.
Contributors DR – concept design, data acquisition and analysis, drafting, final approval and submission; OJ – data interpretation, drafting and final approval; LH – data interpretation, drafting and final approval; CB – data interpretation, critical revision and final approval; AP – data interpretation, critical revision and final approval; TA – data interpretation, critical revision and final approval; RE – concept design, data interpretation, critical revision and final approval; WGL – concept design, drafting, final approval prior to submission, content guarantor; Welsh Surgical Research Initiative – data collection. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding OPJ was supported by a Joint Surgical Research Fellowship from the Royal College of Surgeons England and Health Education and Improvement Wale.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Ethical approval was granted by the NHS Research Authority and Health and Care Research Wales (IRAS 254658).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.
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