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Does burnout affect clinical reasoning? An observational study among residents in general practice

BACKGROUND: Burnout results from excessive demands at work. Caregivers suffering from burnout show a state of emotional exhaustion, leading them to distance themselves from their patients and to become less efficient in their work. While some studies have shown a negative impact of burnout on physic...

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Autores principales: Guillou, Philippe, Pelaccia, Thierry, Bacqué, Marie-Frédérique, Lorenzo, Mathieu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792007/
https://www.ncbi.nlm.nih.gov/pubmed/33413369
http://dx.doi.org/10.1186/s12909-020-02457-y
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author Guillou, Philippe
Pelaccia, Thierry
Bacqué, Marie-Frédérique
Lorenzo, Mathieu
author_facet Guillou, Philippe
Pelaccia, Thierry
Bacqué, Marie-Frédérique
Lorenzo, Mathieu
author_sort Guillou, Philippe
collection PubMed
description BACKGROUND: Burnout results from excessive demands at work. Caregivers suffering from burnout show a state of emotional exhaustion, leading them to distance themselves from their patients and to become less efficient in their work. While some studies have shown a negative impact of burnout on physicians’ clinical reasoning, others have failed to demonstrate any such impacts. To better understand the link between clinical reasoning and burnout, we carried out a study looking for an association between burnout and clinical reasoning in a population of general practice residents. METHODS: We conducted a cross-sectional observational study among residents in general practice in 2017 and 2019. Clinical reasoning performance was assessed using a script concordance test (SCT). The Maslach Burnout Inventory for Human Services Survey (MBI-HSS) was used to determine burnout status in both original standards of Maslach’s burnout inventory manual (conventional approach) and when individuals reported high emotional exhaustion in combination with high depersonalization or low personal accomplishment compared to a norm group (“emotional exhaustion +1” approach). RESULTS: One hundred ninety-nine residents were included. The participants’ mean SCT score was 76.44% (95% CI: 75.77–77.10). In the conventional approach, 126 residents (63.31%) had no burnout, 37 (18.59%) had mild burnout, 23 (11.56%) had moderate burnout, and 13 (6.53%) had severe burnout. In the “exhaustion + 1“ approach, 38 residents had a burnout status (19.10%). We found no significant correlation between burnout status and SCT scores either for conventional or “exhaustion + 1“ approaches. CONCLUSIONS: Our data seem to indicate that burnout status has no significant impact on clinical reasoning. However, one speculation is that SCT mostly examines the clinical reasoning process’s analytical dimension, whereas emotions are conventionally associated with the intuitive dimension. We think future research might aim to explore the impact of burnout on intuitive clinical reasoning processes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-020-02457-y.
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spelling pubmed-77920072021-01-11 Does burnout affect clinical reasoning? An observational study among residents in general practice Guillou, Philippe Pelaccia, Thierry Bacqué, Marie-Frédérique Lorenzo, Mathieu BMC Med Educ Research Article BACKGROUND: Burnout results from excessive demands at work. Caregivers suffering from burnout show a state of emotional exhaustion, leading them to distance themselves from their patients and to become less efficient in their work. While some studies have shown a negative impact of burnout on physicians’ clinical reasoning, others have failed to demonstrate any such impacts. To better understand the link between clinical reasoning and burnout, we carried out a study looking for an association between burnout and clinical reasoning in a population of general practice residents. METHODS: We conducted a cross-sectional observational study among residents in general practice in 2017 and 2019. Clinical reasoning performance was assessed using a script concordance test (SCT). The Maslach Burnout Inventory for Human Services Survey (MBI-HSS) was used to determine burnout status in both original standards of Maslach’s burnout inventory manual (conventional approach) and when individuals reported high emotional exhaustion in combination with high depersonalization or low personal accomplishment compared to a norm group (“emotional exhaustion +1” approach). RESULTS: One hundred ninety-nine residents were included. The participants’ mean SCT score was 76.44% (95% CI: 75.77–77.10). In the conventional approach, 126 residents (63.31%) had no burnout, 37 (18.59%) had mild burnout, 23 (11.56%) had moderate burnout, and 13 (6.53%) had severe burnout. In the “exhaustion + 1“ approach, 38 residents had a burnout status (19.10%). We found no significant correlation between burnout status and SCT scores either for conventional or “exhaustion + 1“ approaches. CONCLUSIONS: Our data seem to indicate that burnout status has no significant impact on clinical reasoning. However, one speculation is that SCT mostly examines the clinical reasoning process’s analytical dimension, whereas emotions are conventionally associated with the intuitive dimension. We think future research might aim to explore the impact of burnout on intuitive clinical reasoning processes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-020-02457-y. BioMed Central 2021-01-07 /pmc/articles/PMC7792007/ /pubmed/33413369 http://dx.doi.org/10.1186/s12909-020-02457-y Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Guillou, Philippe
Pelaccia, Thierry
Bacqué, Marie-Frédérique
Lorenzo, Mathieu
Does burnout affect clinical reasoning? An observational study among residents in general practice
title Does burnout affect clinical reasoning? An observational study among residents in general practice
title_full Does burnout affect clinical reasoning? An observational study among residents in general practice
title_fullStr Does burnout affect clinical reasoning? An observational study among residents in general practice
title_full_unstemmed Does burnout affect clinical reasoning? An observational study among residents in general practice
title_short Does burnout affect clinical reasoning? An observational study among residents in general practice
title_sort does burnout affect clinical reasoning? an observational study among residents in general practice
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792007/
https://www.ncbi.nlm.nih.gov/pubmed/33413369
http://dx.doi.org/10.1186/s12909-020-02457-y
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