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Associations between job demands, job resources and patient-related burnout among physicians: results from a multicentre observational study
Objectives To investigate associations of job demands
and resources with patient-related burnout among
physicians.
Design Multicentre observational study.
Setting Fifty medical departments at 14 (academic and
non-academic) hospitals in the Netherlands.
Participants Four hundred sixty-five physicians
(71.6% response rate), comprising 385 (82.8%) medical
specialists and 80 (17.2%) residents.
Main outcome measures Job demands (workload and
bureaucratic demands), job resources (participation in
decision making, development opportunities, leader’s
inspiration, relationships with colleagues and patients)—
measured with the validated Questionnaire of Experience
and Evaluation of Work and Physician Worklife Survey—
and patient-related burnout, measured using the validated
Copenhagen Burnout Inventory.
Results Patient-related burnout was positively associated
with workload (b=0.36; 95% CI, 0.25 to 0.48; p<0.001)
and negatively associated with development opportunities
(b=–0.18; 95% CI, –0.27 to –0.08; p<0.001) and
relationships with patients (b=–0.12; 95% CI, –0.22 to
–0.03; p=0.01). Relationships with patients moderated
the association between bureaucratic demands and
patient-related burnout (b=–0.15; 95% CI, –0.27 to –0.04;
p=0.01).
Conclusions Physicians with high workloads and few
development opportunities reported higher levels of
patient-related burnout. Those with positive patient
relationships were less likely to experience patient-related
burnout, even in the presence of excessive bureaucracy.
Therefore, positive physician–patient relationships may be
supported to reduce the likelihood of physicians’ patientrelated burnout. Howeve
Exploring nurses' role in guiding residents' workplace learning: A mixed-method study.
INTRODUCTION: Understanding residents' workplace learning could be optimized by not only considering attending physicians' role but also the role of nurses. While previous studies described nurses' role during discrete activities (e.g. feedback), a more profound understanding of how nurses contribute to residents' learning remains warranted. Therefore, we used the educational concept of guidance and explored the extent to which residents' and nurses' perceptions align regarding nurses' guiding role and which reasons they provide for their perceptions. METHODS: This mixed-method study was conducted at four Dutch university medical centres in 2021. We simultaneously collected quantitative and qualitative data from 103 residents and 401 nurses through a theory-informed questionnaire with a Likert-scale and open-ended questions. We analyzed quantitative data to explore respondents' perceptions of nurses' guiding role by using anova. The thematically analyzed qualitative open comments explored respondents' reasons for their perceptions. RESULTS: Nurses indicated to provide significantly more support (p = .01) and guidance on learning from patient care (p < .01) than perceived by residents. Moreover, nurses indicated that attending physicians did not always involve them in guiding residents, whereas residents perceived nurses were being involved (p < .001). Themes suggest that nurses and residents could be divided into two groups: (i) respondents who felt that guiding was inextricably linked to good interprofessional collaboration and patient care and (ii) respondents who saw the guiding role as limited and emphasised the distinct fields of expertise between nurses and physicians. CONCLUSIONS: Residents and nurses felt that nurses played an important role in guiding residents' workplace learning. However, some residents did not always perceive to be guided. To further capitalise on nurses' guiding role, we suggest that residents can be encouraged to engage in the learning opportunities nurses provide to achieve optimal team-based patient care