Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from Wales

Objectives Stress and burn-out among surgical trainees has been reported most prevalent in core surgical trainees (CST) and female trainees in particular. This study aimed to identify factors perceived by CSTs to be associated with stress and burnout in those at risk.Design An open-ended questionnai...

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Main Authors: Luke Hopkins, Oliver Luton, Richard J Egan, Wyn G Lewis, David Bryan Thomas Robinson, Osian Penri James, Arfon GMT Powell, Sarah Hemington-Gorse, Katie Mellor, Rhiannon L Harries
Format: Article
Language:English
Published: BMJ Publishing Group 2021-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/8/e045150.full
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author Luke Hopkins
Oliver Luton
Richard J Egan
Wyn G Lewis
David Bryan Thomas Robinson
Osian Penri James
Arfon GMT Powell
Sarah Hemington-Gorse
Katie Mellor
Rhiannon L Harries
author_facet Luke Hopkins
Oliver Luton
Richard J Egan
Wyn G Lewis
David Bryan Thomas Robinson
Osian Penri James
Arfon GMT Powell
Sarah Hemington-Gorse
Katie Mellor
Rhiannon L Harries
author_sort Luke Hopkins
collection DOAJ
description Objectives Stress and burn-out among surgical trainees has been reported most prevalent in core surgical trainees (CST) and female trainees in particular. This study aimed to identify factors perceived by CSTs to be associated with stress and burnout in those at risk.Design An open-ended questionnaire was distributed to 79 CSTs and two researchers categorised responses independently, according to Michie’s model of workplace stress.Setting A UK regional postgraduate medical region (Wales).Participants Sixty-three responses were received; 42 males, 21 females. The response rate was 79.7%.Results Inter-rater reliability was good (k=0.792 (79.2%), p<0.001). The most common theme of Michie’s model related to CST stress and burnout was career development, with most statements associated with curriculum, examination and academic demands required to attain a CST certificate of completion of training, and higher surgical national training number appointment. This was closely followed by those intrinsic to the job with recurrent discussion around the difficulties balancing work perceived to be service provision (ward work and on-calls), outpatient clinic and operative experience. Conversely, the most common themes relevant to stress and burnout among female trainees were associated with relationships at work (primarily the male-dominated nature of surgery), extraorganisational factors (family–work life balance) and individual characteristics (personality and physiological differences).Conclusion CSTs’ perceptions regarding the causes of National Health Service related stress and burnout are numerous, and these findings provide a basis for the development of targeted stressor counter-measures to improve training and well-being.
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spelling doaj-art-43f5e409cef244eebfd43fb764c8b9d82025-08-20T02:30:39ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2020-045150Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from WalesLuke Hopkins0Oliver Luton1Richard J Egan2Wyn G Lewis3David Bryan Thomas Robinson4Osian Penri James5Arfon GMT Powell6Sarah Hemington-Gorse7Katie Mellor8Rhiannon L Harries91 School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, Rhondda Cynon Taff, UK1 School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, UKSwansea University College of Medicine, Swansea, UK1 School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, UKSchool of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, Rhondda Cynon Taff, UKGeneral Surgery, Royal Gwent Hospital, Newport, UK1 School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, UK1 School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, UK1 School of Surgery, NHS Wales Health Education and Improvement Wales, Nantgarw, UKpresidentObjectives Stress and burn-out among surgical trainees has been reported most prevalent in core surgical trainees (CST) and female trainees in particular. This study aimed to identify factors perceived by CSTs to be associated with stress and burnout in those at risk.Design An open-ended questionnaire was distributed to 79 CSTs and two researchers categorised responses independently, according to Michie’s model of workplace stress.Setting A UK regional postgraduate medical region (Wales).Participants Sixty-three responses were received; 42 males, 21 females. The response rate was 79.7%.Results Inter-rater reliability was good (k=0.792 (79.2%), p<0.001). The most common theme of Michie’s model related to CST stress and burnout was career development, with most statements associated with curriculum, examination and academic demands required to attain a CST certificate of completion of training, and higher surgical national training number appointment. This was closely followed by those intrinsic to the job with recurrent discussion around the difficulties balancing work perceived to be service provision (ward work and on-calls), outpatient clinic and operative experience. Conversely, the most common themes relevant to stress and burnout among female trainees were associated with relationships at work (primarily the male-dominated nature of surgery), extraorganisational factors (family–work life balance) and individual characteristics (personality and physiological differences).Conclusion CSTs’ perceptions regarding the causes of National Health Service related stress and burnout are numerous, and these findings provide a basis for the development of targeted stressor counter-measures to improve training and well-being.https://bmjopen.bmj.com/content/11/8/e045150.full
spellingShingle Luke Hopkins
Oliver Luton
Richard J Egan
Wyn G Lewis
David Bryan Thomas Robinson
Osian Penri James
Arfon GMT Powell
Sarah Hemington-Gorse
Katie Mellor
Rhiannon L Harries
Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from Wales
BMJ Open
title Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from Wales
title_full Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from Wales
title_fullStr Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from Wales
title_full_unstemmed Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from Wales
title_short Trainee perspective of the causes of stress and burnout in surgical training: a qualitative study from Wales
title_sort trainee perspective of the causes of stress and burnout in surgical training a qualitative study from wales
url https://bmjopen.bmj.com/content/11/8/e045150.full
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