"Necessary Compromises": A Qualitative Exploration of the Influence of Burnout on Resident Education

Dave W. Lu, Department of Emergency Medicine University of Washington School of Medicine Seattle WA USA.
Carl A. Germann, Department of Emergency Medicine University of Washington School of Medicine Seattle WA USA.
Sara W. Nelson, Department of Emergency Medicine University of Washington School of Medicine Seattle WA USA.
Joshua Jauregui, Department of Emergency Medicine Tufts University School of Medicine - Maine Medical Center Portland ME USA.
Tania D. Strout, Department of Emergency Medicine University of Washington School of Medicine Seattle WA USA.

Abstract

OBJECTIVE: Burnout is prevalent among resident physicians and has a negative impact on their well-being and effectiveness at work. How burnout shapes residents' educational experiences, attitudes, habits, and practices is not well understood. There is also a lack of research regarding self-identified mitigation strategies for residents. The authors qualitatively explored burnout's role in the educational experiences of resident physicians. METHODS: Qualitative data were generated from a sample of 29 emergency medicine residents through four semistructured focus groups across four institutions in January and February 2019. The authors employed a constructivist approach to thematic analysis. Transcripts were coded and organized into major and minor themes. RESULTS: Residents reported that a misalignment of their individual versus institutional priorities and a lack of agency were significant contributors to their burnout. Residents described how burnout affected multiple aspects of their education, including their motivation and curiosity to learn, engagement in scholarly activity, and teaching of others. Residents identified several ways of building a sense of community that they explained was most useful in mitigating their experiences with burnout. CONCLUSION: Burnout had a negative influence on many facets of residents' educational experiences during training. Program directors and educators can take resident-identified steps to moderate its detrimental role on trainee education.