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What They Are Not Telling Us: Analysis of Nonresponders on a National Survey of Resident Well-Being
To characterize nonrespondents to a national survey about trainee well-being, examine response patterns to questions of sensitive nature, and assess how nonresponse biases prevalence estimates of mistreatment and well-being. BACKGROUND: Surgical trainees are at risk for burnout and mistreatment, whi...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health, Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782077/ https://www.ncbi.nlm.nih.gov/pubmed/36590893 http://dx.doi.org/10.1097/AS9.0000000000000228 |
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author | Cardell, Chelsea F. Yuce, Tarik K. Zhan, Tiannan Eng, Josh S. Cheung, Elaine O. Etkin, Caryn D. Amortegui, Daniela Jones, Andrew Buyske, Jo Bilimoria, Karl Y. Hu, Yue-Yung |
author_facet | Cardell, Chelsea F. Yuce, Tarik K. Zhan, Tiannan Eng, Josh S. Cheung, Elaine O. Etkin, Caryn D. Amortegui, Daniela Jones, Andrew Buyske, Jo Bilimoria, Karl Y. Hu, Yue-Yung |
author_sort | Cardell, Chelsea F. |
collection | PubMed |
description | To characterize nonrespondents to a national survey about trainee well-being, examine response patterns to questions of sensitive nature, and assess how nonresponse biases prevalence estimates of mistreatment and well-being. BACKGROUND: Surgical trainees are at risk for burnout and mistreatment, which are discernible only by self-report. Therefore, prevalence estimates may be biased by nonresponse. METHODS: A survey was administered with the 2018 and 2019 American Board of Surgery In-Training Examinations assessing demographics, dissatisfaction with education and career, mistreatment, burnout, thoughts of attrition, and suicidality. Responders in 2019 were characterized as survey “Completers,” “Discontinuers” (quit before the end), and “Selective Responders” (selectively answered questions throughout). Multivariable logistic regression assessed associations of respondent type with mistreatment and well-being outcomes, adjusting for individual and program characteristics. Longitudinal survey identifiers linked survey responses for eligible trainees between 2018 and 2019 surveys to further inform nonresponse patterns. RESULTS: In 2019, 6956 (85.6%) of 8129 eligible trainees initiated the survey, with 66.5% Completers, 17.5% Discontinuers, and 16.0% Selective Responders. Items with the highest response rates included dissatisfaction with education and career (93.2%), burnout (86.3%), thoughts of attrition (90.8%), and suicidality (94.4%). Discontinuers and Selective Responders were more often junior residents and racially/ethnically minoritized than Completers. No differences were seen in burnout and suicidality rates between Discontinuers, Selective Responders, and Completers. Non-White or Hispanic residents were more likely to skip questions about racial/ethnic discrimination than non-Hispanic White residents (21.2% vs 15.8%; odds ratio [OR], 1.35; 95% confidence interval [CI], 1.19–1.53), particularly when asked to identify the source. Women were not more likely to omit questions regarding gender/gender identity/sexual orientation discrimination (OR, 0.91; 95% CI, 0.79–1.04) or its sources (OR, 1.02; 95% CI, 0.89–1.16). Both Discontinuers and Selective Responders more frequently reported physical abuse (2.5% vs 1.1%; P = 0.001) and racial discrimination (18.3% vs 13.6%; P < 0.001) on the previous survey (2018) than Completers. CONCLUSIONS: Overall response rates are high for this survey. Prevalence estimates of burnout, suicidality, and gender discrimination are likely minimally impacted by nonresponse. Nonresponse to survey items about racial/ethnic discrimination by racially/ethnically minoritized residents likely results in underestimation of this type of mistreatment. |
format | Online Article Text |
id | pubmed-9782077 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Wolters Kluwer Health, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97820772022-12-28 What They Are Not Telling Us: Analysis of Nonresponders on a National Survey of Resident Well-Being Cardell, Chelsea F. Yuce, Tarik K. Zhan, Tiannan Eng, Josh S. Cheung, Elaine O. Etkin, Caryn D. Amortegui, Daniela Jones, Andrew Buyske, Jo Bilimoria, Karl Y. Hu, Yue-Yung Ann Surg Open Original Study To characterize nonrespondents to a national survey about trainee well-being, examine response patterns to questions of sensitive nature, and assess how nonresponse biases prevalence estimates of mistreatment and well-being. BACKGROUND: Surgical trainees are at risk for burnout and mistreatment, which are discernible only by self-report. Therefore, prevalence estimates may be biased by nonresponse. METHODS: A survey was administered with the 2018 and 2019 American Board of Surgery In-Training Examinations assessing demographics, dissatisfaction with education and career, mistreatment, burnout, thoughts of attrition, and suicidality. Responders in 2019 were characterized as survey “Completers,” “Discontinuers” (quit before the end), and “Selective Responders” (selectively answered questions throughout). Multivariable logistic regression assessed associations of respondent type with mistreatment and well-being outcomes, adjusting for individual and program characteristics. Longitudinal survey identifiers linked survey responses for eligible trainees between 2018 and 2019 surveys to further inform nonresponse patterns. RESULTS: In 2019, 6956 (85.6%) of 8129 eligible trainees initiated the survey, with 66.5% Completers, 17.5% Discontinuers, and 16.0% Selective Responders. Items with the highest response rates included dissatisfaction with education and career (93.2%), burnout (86.3%), thoughts of attrition (90.8%), and suicidality (94.4%). Discontinuers and Selective Responders were more often junior residents and racially/ethnically minoritized than Completers. No differences were seen in burnout and suicidality rates between Discontinuers, Selective Responders, and Completers. Non-White or Hispanic residents were more likely to skip questions about racial/ethnic discrimination than non-Hispanic White residents (21.2% vs 15.8%; odds ratio [OR], 1.35; 95% confidence interval [CI], 1.19–1.53), particularly when asked to identify the source. Women were not more likely to omit questions regarding gender/gender identity/sexual orientation discrimination (OR, 0.91; 95% CI, 0.79–1.04) or its sources (OR, 1.02; 95% CI, 0.89–1.16). Both Discontinuers and Selective Responders more frequently reported physical abuse (2.5% vs 1.1%; P = 0.001) and racial discrimination (18.3% vs 13.6%; P < 0.001) on the previous survey (2018) than Completers. CONCLUSIONS: Overall response rates are high for this survey. Prevalence estimates of burnout, suicidality, and gender discrimination are likely minimally impacted by nonresponse. Nonresponse to survey items about racial/ethnic discrimination by racially/ethnically minoritized residents likely results in underestimation of this type of mistreatment. Wolters Kluwer Health, Inc. 2022-12-12 /pmc/articles/PMC9782077/ /pubmed/36590893 http://dx.doi.org/10.1097/AS9.0000000000000228 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Study Cardell, Chelsea F. Yuce, Tarik K. Zhan, Tiannan Eng, Josh S. Cheung, Elaine O. Etkin, Caryn D. Amortegui, Daniela Jones, Andrew Buyske, Jo Bilimoria, Karl Y. Hu, Yue-Yung What They Are Not Telling Us: Analysis of Nonresponders on a National Survey of Resident Well-Being |
title | What They Are Not Telling Us: Analysis of Nonresponders on a National Survey of Resident Well-Being |
title_full | What They Are Not Telling Us: Analysis of Nonresponders on a National Survey of Resident Well-Being |
title_fullStr | What They Are Not Telling Us: Analysis of Nonresponders on a National Survey of Resident Well-Being |
title_full_unstemmed | What They Are Not Telling Us: Analysis of Nonresponders on a National Survey of Resident Well-Being |
title_short | What They Are Not Telling Us: Analysis of Nonresponders on a National Survey of Resident Well-Being |
title_sort | what they are not telling us: analysis of nonresponders on a national survey of resident well-being |
topic | Original Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782077/ https://www.ncbi.nlm.nih.gov/pubmed/36590893 http://dx.doi.org/10.1097/AS9.0000000000000228 |
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