Demographics, Activities, and Environmental Factors Impact Burnout in a National Survey of Emergency Medicine Residents

Introduction: Burnout in emergency medicine and in residency training has been well-described. The impact of demographic, individual, and programmatic factors on burnout have not previously been determined in a national survey of emergency medicine residents. This study aimed to identify personal and environmental factors impacting resident burnout in a national sample of emergency medicine residents. Methods: A prospective Emergency Medicine Resident Wellness Survey was administered in 2017. We surveyed respondents on demographic, personal, and environmental factors; each respondent also completed the Maslach Burnout Inventory - Human Services Survey. Linear regressions were used to identify variables associated with the Maslach Burnout Inventory’s subscales of burnout (depersonalization, emotional exhaustion, and personal achievement). Results: The survey was completed by 1,522 of 7,186 (21.2%) eligible EM residents. Respondents represented 193 of 247 (78.1%) Emergency Medicine residency programs. Increased levels of depersonalization were associated with graduation from a US medical school, female gender, and increase in respondent age. Trainees who were parents and who graduated from an osteopathic (vs. allopathic) medical school were found to have decreased levels of depersonalization. Emotional exhaustion was decreased in respondents who took breaks while on shift and who engaged in regular studying. Conclusion: While some individual characteristics impact burnout, environmental factors also play a significant role, and should be a target of system-level interventions to improve trainee well-being

Factor Structure and Measurement Invariance of the Maslach Burnout Inventory in Emergency Medicine Residents

Introduction: Emergency medicine residents suffer from high rates of occupational burnout. Recent research has focused on identifying risk and protective factors for burnout as well as targets for intervention. This research has primarily employed the Maslach Burnout Inventory to evaluate burnout in this population. Factor analytic work has identified three underlying factors measured by the Maslach Burnout Inventory: Emotional Exhaustion, Depersonalization, and Personal Accomplishment. However, this three-factor structure has not been evaluated in emergency medicine residents. Furthermore, its structural equivalence has not been demonstrated across commonly-studied risk factors, such as gender and year of post-graduate training. In the present study, we evaluated the structure of the Maslach Burnout Inventory in emergency medicine residents as well as its measurement invariance across gender and post-graduate year. Methods: 1522 emergency medicine residents (21.1% of all US residents from 78.1% of US residency programs) were recruited as part of the 2017 National EM Resident Wellness Survey and completed the Maslach Burnout Inventory – Human Services Survey. The factor structure and measurement invariance across both respondent gender and post-graduate year were evaluated using a series of confirmatory factor analyses. Exploratory analyses evaluated whether burnout scores differed across men/women and post-graduate years 1, 2, and 3+ using a structural equation model. Results: The three-factor structure was observed after minor modifications which replicated in cross-validation. This structure was invariant across both gender and post-graduate year at the configural, metric, and scalar levels. Emotional exhaustion scores were higher for female residents and scores on all of the MBI scales indicated greater burnout for more advanced residents. Conclusions: These results indicate the Maslach Burnout Inventory is fully structurally equivalent across gender and post-graduate year and further validates its use in this population. Secondary evaluations of the latent means revealed that female residents tend to have higher scores on Emotional Exhaustion and that scores on all factors tend to worsen as trainees progress through their residency

Optimist Prime- Emergency Medicine Residents are an Optimistic Group

Introduction: No study before has been conducted looking at the level of optimism and pessimism in emergency medicine residents and how it may be linked to resident burnout. This is the first national- level assessment of these personality factors. Methods: This was a prospective survey study leveraging data obtained through the 2017 National Emergency Medicine Resident Wellness Survey, which included the Life Orientation Test-Revised (LOT-R). The Life Orientation Test-Revised (LOT-R) is a 10-item tool that measures levels of optimism versus pessimism. Results: We found that the majority of our resident respondents scored in the moderate category of the LOT-R. Additionally, 12.4% fell into the more optimistic category. Conclusion: The results indicate that emergency medicine residents are not generally pessimistic and a pessimistic outlook is unlikely to affect resident levels of fatigue, burnout or emotional distress

The Space Infrared Interferometric Telescope (SPIRIT): High-resolution imaging and spectroscopy in the far-infrared

We report results of a recently-completed pre-Formulation Phase study of SPIRIT, a candidate NASA Origins Probe mission. SPIRIT is a spatial and spectral interferometer with an operating wavelength range 25 - 400 microns. SPIRIT will provide sub-arcsecond resolution images and spectra with resolution R = 3000 in a 1 arcmin field of view to accomplish three primary scientific objectives: (1) Learn how planetary systems form from protostellar disks, and how they acquire their inhomogeneous composition; (2) characterize the family of extrasolar planetary systems by imaging the structure in debris disks to understand how and where planets of different types form; and (3) learn how high-redshift galaxies formed and merged to form the present-day population of galaxies. Observations with SPIRIT will be complementary to those of the James Webb Space Telescope and the ground-based Atacama Large Millimeter Array. All three observatories could be operational contemporaneously.Comment: 20 pages, 12 figures, accepted for publication in J. Adv. Space Res. on 26 May 200