Abstract

Burnout is an important occupational hazard and early detection is paramount in preventing negative sequelae in physicians, patients, and healthcare systems. Several screening tools have been developed to replace lengthy diagnostic tools for large-scale screening, however, comprehensive head–to–head evaluation for performance and accuracy are lacking. The primary objective of this study was to compare the diagnostic performance of five burnout screening tools, including a novel rapid burnout screening tool (RBST). This was a cross-sectional study involving 493 hospital staff (anaesthesiology and intensive care doctors, nurses, and ancillary staff) at the COVID-19 frontline across four hospitals in Singapore between December 2020 and April 2021. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) was used as the reference standard. Five burnout screening tools, the single-item MBI measure of burnout (SI-MBI), dual-item MBI (DI-MBI), abbreviated MBI (aMBI), Single Item Burnout Question (SIBOQ), and the RBST, were administered via a 36-item online survey. Tools were administered simultaneously and responses were anonymised. Burnout prevalence was 19.9%. The RBST and the SI-MBI had the two highest accuracies (87.8% and 81.9% respectively) and AUROC scores (0.86, 95% CI: 0.83–0.89 and 0.86, 95% CI: 0.82–0.89 respectively). However, the accuracy of the RBST was significantly higher than the SI-MBI (p < 0.0001), and it had the highest positive likelihood ratio (+LR = 7.59, 95% CI 5.65–10.21). Brief screening tools detect burnout albeit with a wide range of accuracy. This can strain support services and resources. The RBST is a free screening tool that can detect burnout with a high degree of accuracy.

Highlights

  • Burnout is an important occupational hazard that can adversely affect patients, physicians, and healthcare systems, if unaddressed [1,2,3,4,5,6,7]

  • This study found that the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), abbreviated MBI (aMBI), and rapid burnout screening tool (RBST) had acceptable reliability

  • All burnout screening tools demonstrated a high degree of validity

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Summary

Introduction

Burnout is an important occupational hazard that can adversely affect patients, physicians, and healthcare systems, if unaddressed [1,2,3,4,5,6,7] It is characterised by symptoms of emotional exhaustion, cynicism, and low professional efficacy [8,9]. The MBI-HSS, the most extensively validated and widely used tool to detect burnout in healthcare professionals [14], is proprietary and costly to administer in large populations [10], with both the survey and personal report costing up to USD 15 for an individual. This has led to the development of several burnout screening tools

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