title: Risk and Resilience Factors Associated with Resident Burnout.
abstract: OBJECTIVE
  We investigated hypothesized risk and resilience factors and their association with burnout in first year medicine and psychiatry residents at an urban teaching hospital in order to help guide the development of interventions targeted at reducing burnout.
  
  
  METHODS
  We administered the Maslach Burnout Inventory (MBI), Perceived Stress Scale-10, Functional Assessment of Chronic Illness Therapy-Fatigue Scale, Penn State Worry Questionnaire, Patient Health Questionnaire-9 (depression symptoms), Revised Life Orientation Test (optimism), Self-Efficacy Questionnaire, Cognitive and Affective Mindfulness Scale, Interpersonal Reactivity Index Perspective-Taking Scale (empathy), and Measure of Current Status-Part A to first year medicine and psychiatry residents prior to initiation of clinical rotations in June.
  
  
  RESULTS
  The response rate was 91 % (68 of 75 residents). Nineteen respondents (28 %) met criteria for burnout as measured by the MBI. Residents with burnout scored higher on self-report measures assessing perceived stress (Cohen's d = 0.97; p = 0.004), fatigue (d = 0.79; p = 0.018), worry (d = 0.88; p = 0.0009), and depression symptoms (d = 0.84; p = 0.035) and scored lower on questionnaires assessing mindfulness (d = -0.63; p = 0.029) and coping ability (d = -0.79; p = 0.003).
  
  
  CONCLUSIONS
  In a cross-sectional assessment using self-report measures, we found that nearly a third of first year residents prior to starting their internships experience burnout. They exhibit lower levels of mindfulness and coping skills and higher levels of depression symptoms, fatigue, worry, and stress. These preliminary findings should encourage programs to initiate and study curricula that combine mindfulness and self-awareness coping strategies to enhance or protect against burnout as well as cognitive behavioral coaching strategies to offset symptoms of burnout when present.
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA. dchaukos@partners.org.
authors.forename: Deanna
authors.identifier: http://orcid.org/0000-0001-5813-697X
authors.initials: D
authors.lastname: Chaukos
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Emma
authors.initials: E
authors.lastname: Chad-Friedman
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Darshan H
authors.initials: DH
authors.lastname: Mehta
authors.affiliation: University of California San Francisco, San Francisco, CA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Byerly
authors.affiliation: University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Alper
authors.initials: A
authors.lastname: Celik
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: McCoy
authors.affiliation: Massachusetts General Hospital, Boston, MA, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: Denninger
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000706:statistics & numerical data; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D011570:Psychiatry / Q000193:education* / Q000706:statistics & numerical data; D055500:Resilience, Psychological; D012306:Risk
keywords: Resident burnout; Resident wellness; Residents: professional development; Resiliency