Objective
We aimed to identify job resources and job demands associated with measures of personal accomplishment (PA) in radiology residents in the United States.
Materials and Methods
A 34-item online survey was administered between May and June 2017 to U.S. radiology residents and included the 8 Likert-type PA questions from the Maslach Burnout Inventory-Human Services Survey, 19 visual analog scale job demands-resources questions, and 7 demographic questions. Multiple linear regression was calculated to predict PA based on job demands-resources. Effects of binomial demographic factors on PA scores were compared with independent-samples t tests. Effects of categorical demographic factors on PA scores were compared with one-way between-subjects analysis of variance tests. A linear regression was calculated to evaluate the relationship of age on PA scores.
Results
“The skills and knowledge that I am building are important and helpful to society” ( P = 2 × 10 −16 ), “I have good social support from my co-residents” ( P = 4 × 10 −5 ), and “I regularly receive adequate constructive feedback” ( P = 4 × 10 −6 ) all positively correlated with PA. PA scores were significantly lower for individuals who were single vs those married or partnered ( P = .01).
Conclusions
Radiology residents score higher in the PA domain of burnout when they receive adequate constructive feedback, have good co-resident social support, and feel that the skills and knowledge they are building are important to society. Improving constructive feedback mechanisms, enabling resident-only social time, and supporting opportunities that reinforce the importance of their contributions may therefore improve radiology residents’ sense of PA.
Introduction
A recent study of burnout in New England radiology residents identified a high degree of burnout in over one third of respondents. The surveyed radiology residents scored particularly poorly in the personal accomplishment (PA) domain relative to residents in other specialties . A recent study of burnout in musculoskeletal radiology fellows also identified a high degree of burnout with poor scores in PA as well as depersonalization . In this study, we report how job resources and job demands impact U.S. radiology residents’ sense of PA as identified in a new national survey.
Burnout can lead to decreased effectiveness and productivity, reduced job commitment, negative effects on home life , negative effects on personal health , and compromised patient safety . Burnout occurs when job demands exceed job resources . As per the job demands-resources (JD-R) theory of organizational psychology and behavior, job demands include role ambiguity, role conflict, job insecurity, and work overload, whereas job resources include autonomy, social support from colleagues, performance feedback, and supervisory coaching . Because low PA was the dominating burnout domain in previously surveyed radiology residents and because job resources and job demands impact burnout, understanding the effects of job resources and job demands on radiology residents’ sense of PA could help program directors and chief residents minimize the risk of burnout and establish effective burnout recovery solutions.
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Materials and Methods
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Survey
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TABLE 1
Demographics
PGY Level PGY 1 10 (3%) PGY 2 93 (30%) PGY 3 94 (30%) PGY 4 54 (17%) PGY 5 63 (20%) Average hours worked per week in last 6 mo 54.4 ± 8.9 h Age 31.1 ± 2.8 y Sex Male 217 (69%) Female 97 (31%) Married/Partnered Yes 220 (70%) No 94 (30%) Children Yes 89 (28%) No 225 (72%) Region New England (CT, MA, ME, NH, RI, VT) 35 (11%) Mid-Atlantic (NJ, NY, PA) 74 (24%) East North Central Midwest (IN, IL, MI, OH, WI) 41 (13%) West North Central Midwest (IA, KS, MN, MO, NE, ND, SD) 41 (13%) South Atlantic (DC, DE, FL, GA, MD, NC, SC, VA, WV) 45 (14%) East South Central (AL, KY, MS, TN) 6 (2%) West South Central (AR, LA, OK, TX) 20 (6%) Mountain (AZ, CO, ID, MN, NV, NM, UT, WY) 22 (7%) Pacific (AK, CA, HI, OR, WA) 30 (10%)
PGY, postgraduate year.
TABLE 2
Job Demands-resources Questions With Mean Visual Analog Scale Scores
Statement Mean Visual Analog Scale Score (Standard Deviation) The skills and knowledge that I am building are important and helpful to society. 79.6 (21.3) I am excited about my career when I think about my long-term impact as a radiologist. 74.4 (23.6) I spend most of my time performing important clinical work as opposed to trivial administrative/paper work. 65.6 (22.4) I have concerns about my job prospects after residency/fellowship. 53.0 (29.4) I am comfortable in my current role as a resident/fellow. 68.9 (24.5) I understand people’s expectations of me in the various aspects of my current job. 71.9 (21.8) People respect my role as an important part of the medical team. 60.3 (24.8) I have good social support from my co-residents. 74.1 (23.1) I can ask my co-residents for help if necessary. 82.0 (20.4) I feel that I am in competition with my co-residents. 38.7 (26.0) My attendings give me freedom and autonomy to make my own decisions. 68.1 (21.9) My attendings support my decisions. 69.5 (19.1) My attendings tend to make their own decisions and give me instructions on what to dictate. 50.4 (24.7) I receive excellent teaching from my attendings. 66.5 (22.9) I have the opportunity to attend excellent didactic learning sessions. 66.5 (24.9) I regularly receive adequate constructive feedback. 56.2 (25.3) I can ask my attendings for help if necessary. 79.5 (20.4) I have social support from my program directors, chief residents, and administrative staff. 73.0 (24.8) I have social support from my faculty. 66.8 (25.8)
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Subjects and Recruitment
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Statistical Analysis
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Results
Subjects, Recruitment, and Survey
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Statistical Analysis
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Conclusions
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