title: The learning environment and medical student burnout: a multicentre study.
abstract: OBJECTIVE
  Little is known about specific personal and professional factors influencing student distress. The authors conducted a comprehensive assessment of how learning environment, clinical rotation factors, workload, demographics and personal life events relate to student burnout.
  
  
  METHODS
  All medical students (n = 3080) at five medical schools were surveyed in the spring of 2006 using a validated instrument to assess burnout. Students were also asked about the aforementioned factors.
  
  
  RESULTS
  A total of 1701 medical students (response rate 55%) completed the survey. Learning climate factors were associated with student burnout on univariate analysis (odds ratio [OR] 1.36-2.07; all P < or = 0.02). Being on a hospital ward rotation or a rotation requiring overnight call was also associated with burnout (ORs 1.69 and 1.48, respectively; both P < or = 0.02). Other workload characteristics (e.g. number of admissions) had no relation to student burnout. Students who experienced a positive personal life event had a lower frequency of burnout (OR 0.70; P < or = 0.02), whereas those who experienced negative personal life events did not have a higher frequency of burnout than students who did not experience a negative personal life event. On multivariate analysis personal characteristics, learning environment and personal life events were all independently related to student burnout.
  
  
  CONCLUSIONS
  Although a complex array of personal and professional factors influence student well-being, student satisfaction with specific characteristics of the learning environment appears to be a critical factor. Studies determining how to create a learning environment that cultivates student well-being are needed.
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA. dyrbye.liselotte@mayo.edu
authors.forename: Liselotte N
authors.initials: LN
authors.lastname: Dyrbye
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Thomas
authors.forename: William
authors.initials: W
authors.lastname: Harper
authors.forename: F Stanford
authors.initials: FS
authors.lastname: Massie
authors.forename: David V
authors.initials: DV
authors.lastname: Power
authors.forename: Anne
authors.initials: A
authors.lastname: Eacker
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Szydlo
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Novotny
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Sloan
authors.forename: Tait D
authors.initials: TD
authors.lastname: Shanafelt
mesh_terms: D000328:Adult; D002055:Burnout, Professional; D003479:Curriculum; D003625:Data Collection; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D015999:Multivariate Analysis; D013337:Students, Medical / Q000523:psychology*; D016526:Workload; D055815:Young Adult