Maslach Burnout Inventory-Human Services Survey Research Articles

Burnout among family and general practitioners

BackgroundJob burnout is an important syndrome that can deplete the emotional health aspects of physicians. Its impacts are reflected both on the physicians and their patients through undermining the performance of physicians and degrading the quality of the administered medical care leading to dissatisfaction of the patients about the medical service. ObjectivesThis study is formulated to compare the prevalence of high burnout among family physicians and general practitioners and reveal the predictors of high grades of burnout among physicians. Subjects and methodsA cross sectional study was carried out. Out of 378 physicians working in two health regions in Kuwait, 200 physicians returned a filled questionnaire, of these 105 were family physicians and the rest were primary health care physicians. Maslach Burnout Inventory–Human Service Survey tool was used to estimate high degree of burnout on three domains, namely emotional exhaustion, depersonalization and personal accomplishment. ResultsGeneral practitioners were more likely to suffer from high grades of emotional exhaustion (63.2%) than family physicians (19.0%). They also suffered from high grade of depersonalization (65.3%) compared with family physicians (27.6%). Those suffering from high grades of personal accomplishment burnout (inverse score) constituted 61.1% of primary health care physicians and 33.3% of family physicians. Those suffering from grades for the three burnout domain constituted more than one third of primary health care physicians (36.8%) compared with only 5.7% of family physicians. Type of physician job and marital status proved to be significant predictors of high grades of burnout. ConclusionBurnout is more common among primary care than family physicians. Searching for and eliminating all sources of stress in the primary health care centers in addition to training of these physicians on coping strategies to deal with stress at work seems to be an important step.

Staff outcomes from the Caring for Aged Dementia Care REsident Study (CADRES): A cluster randomised trial

BackgroundDementia care mapping and person centred care are well-accepted as processes for improving care and well-being for persons with dementia living in the residential setting. However, the impact of dementia care mapping and person centred care on staff has not been well researched. ObjectivesThe impact of person centred care and dementia care mapping compared to each other and to usual dementia care on staff outcomes was examined in terms of staff burnout, general well-being, attitudes and reactions towards resident behavioural disturbances, perceived managerial support, and quality of care interactions. DesignA cluster-randomised, controlled trial. SettingsThe study was conducted between 2005 and 2007 in 15 residential aged care sites in the Sydney metropolitan area, Australia, with comparable management structures, staffing mix and ratios, and standards of care. Participants194 consenting managers, nurses, therapists and nurse assistants working in the participating sites. MethodsIntervention care sites received training and support in either person centred care (n=5) or dementia care mapping (n=5); control sites continued with usual dementia care (n=5). Staff outcomes of those three groups were assessed before, directly after the four month intervention (post) and after a further four months (follow-up). The primary outcome measures were the Maslach Burnout Inventory-Human Services Survey and the 12-item General Health Questionnaire. Analysis involved repeated measures analyses of variance for each of the outcome measures and adjustment for potential confounders to limit bias. ResultsThe Maslach Burnout Inventory-Human Services Survey results showed that change over time in emotional exhaustion scores differed between the three groups. Post-hoc analyses for each group separately revealed that the only significant time effect was in the dementia care mapping group (p=0.006), with emotional exhaustion scores declining over time. At baseline, more perceived support from management was associated with less emotional exhaustion (rs=0.26, p=0.004, n=122) and less depersonalisation (rs=0.21, p=0.023, n=122), but not for any of the other outcome measures. ConclusionsThis study has shown that person centred approaches of care, in particular with dementia care mapping, may contribute to reducing staff job related burnout. The findings also highlight a potentially important role of managerial support and a whole of system approach.

Exposure to client aggression and burnout among community staff who support adults with intellectual disabilities in Ontario, Canada

Studies have shown that staff who support adults with intellectual disabilities (ID) are exposed to challenging behaviour in their work including client aggression. Exposure to aggressive behaviour has been associated with staff stress and burnout. Study samples have been small however, and there has been very little data exploring this issue among North American staff. A cross-sectional survey which included demographics, measures of frequency and severity (including perceived severity and a standardised severity score) of exposure to client aggression and the Maslach Burnout Inventory - Human Services Survey (MBI-HSS) was completed by 926 community staff who support adults with ID in Ontario, Canada. Relationships between demographic variables and exposure to aggression were examined with descriptive statistics. Pearson correlations were used to analyse exposure variables and MBI-HSS scores. Nearly all staff reported being exposed to client aggression in the prior 6 months. Mean MBI-HSS scores were comparable to previously published data in similar populations with the exception of a higher score in the personal accomplishment domain. All measures of exposure to aggression were significantly positively correlated with MBI-HSS scores in the emotional exhaustion and depersonalisation dimensions of burnout. The prevalence of burnout in this North American sample is comparable to what has been reported in similar populations in other locations, although these staff may have a higher sense of accomplishment with regard to their work. Findings from this large sample support the evidence that exposure to client aggression affects staff emotional well-being but is by no means the only important factor. Further study is needed to explore the differences and similarities reported here as well as other contributing factors which will guide the implementation of effective strategies to improve staff well-being.

Adaptation and validation of the Maslach Burnout Inventory-Human Services Survey in Cali, Colombia

Objective: The objective of this study was to establish the psychometric properties of reliability and validity of the «Maslach Burnout Inventory-Human Services Survey» (MBI-HSS). Methods: The work was conducted by a process of translation and back-translation of the original instrument, instrument adaptation, translation and adaptation of the application manual, pilot study, and implementation of the adapted version of the instrument with 314 health professionals in Cali, according to the guidelines of the International Test Commission (ITC). Results: The results showed that the scale has good internal consistency (a=0.767); however, the dimension of «depersonalization» has the lowest internal consistency (a=0.518). Regarding validity, in comparing between the factor structure of the modified scale with the original version, we identified that the size of the validated version largely coincides with that of the original version; in the dimension of emotional fatigue, item 6 is excluded because it will be part of the depersonalization scale, items 15 and 21 were also excluded given their poor discriminatory ability. Conclusion: It is necessary to overcome the stability problems of the MBI-HSS depersonalization subscale in health professionals and reformulate the response options to make them more understandable for professionals within the Colombian context.

Anesthesiology residency program director burnout

Study Objective To evaluate work-related stress as well as personal factors associated with professional burnout in program directors of anesthesiology. Design Survey instrument. Setting Academic anesthesiology department. Subjects Anesthesiology residency program directors (n = 132). Measurements A 5-part structured, open-ended questionnaire evaluating program and respondents' demographic information, work-related stressors, assessment of control of respondent's personal life using the modified efficiency scale, the Maslach Burnout Inventory-Human Services survey (MBI-HSS), and assessment of spousal/significant relationship support. Main Results 100 program directors (76%) responded to the survey. Twenty respondents met the criteria for high burnout risk, and an additional 30 were at risk of developing burnout. Twenty-two directors reported the high likelihood that they would step down in one to two years. Forty-three percent who reported the high likelihood of stepping down stated they were significantly affected by job-related stressors compared with 18% who reported a lower likelihood of stepping down ( P = 0.03). Program directors who scored in the high burnout risk category were more likely to report lower current job satisfaction ( P < 0.005) and an increased likelihood of stepping down in the next two years ( P = 0.009). Logistic regression analysis identified compliance issues, self-assessment of effectiveness, family/significant other support, perceived impact of stressful factors, and current job satisfaction as predictors of high burnout. The model had a sensitivity (95% CI) of 0.55 (0.34 to 0.74) and specificity of 0.99 (0.92 to 1.0) for predicting high burnout risk. Conclusions Fifty-two percent of anesthesiology program directors are at high risk for developing burnout syndrome. Job-related stress, especially with administrative duties regarding compliance, was predictive of burnout among program directors.

Risk of Burnout in Perioperative Clinicians

Burnout can lead to health and psychologic problems and is apparently increasing in physicians and nurses. Previous studies have not evaluated all healthcare workers within a single work unit. This study evaluates the risk of burnout in all medical personnel in one perioperative unit. We developed an online survey that included demographics, a modified version of the Maslach Burnout Inventory-Human Services Survey, and the Social Support and Personal Coping Survey. Survey constructs (e.g., depersonalization and health) and a global score were calculated. Larger construct and global values were associated with higher risk of burnout. These were separately regressed on role, age, and sex. The global score was then regressed on each of the survey constructs. Of the 145 responses, 46.2% were physicians (22.8% residents), 43.4% were nurses or nurse anesthetists, and 10.3% were other personnel. After adjusting for sex and age, residents scored higher than other physicians on the following (expected change [95% confidence interval]): global score (1.12 [0.43-1.82]), emotional exhaustion (1.54 [0.44-2.60]), and depersonalization (1.09 [0.23-1.95]). Compared with nonphysicians, residents were 1 U or more higher on these items (P < 0.05 in all cases). Residents had higher health (1.49 [0.48-2.50]) and workload (1.23 [0.07-2.40]) values compared with physicians. Better health, personal support, and work satisfaction scores were related to decreased global scores (P < 0.05). Physicians (particularly residents) had the largest global burnout scores, implying increased risk of burnout. Improving overall health, increasing personal support, and improving work satisfaction may decrease burnout among perioperative team members.

Personality, Burnout, and Longevity among Professional Music Therapists

The purpose of this study was to examine possible relationships between personality, burnout level, longevity, and demographic variables among professional music therapists. The Sixteen Personality Factor Questionnaire (16PF) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were used to test personality and burnout. Subjects were 137 professional music therapists from all seven American Music Therapy Association (AMTA) regions with an overall average longevity of 17.85 years. The 16PF showed the personality traits that most describe music therapists are emotional sensitivity, reasoning, apprehension, warmth, openness to change, self-reliance, extraversion, anxiety, abstractedness, rule-consciousness, and self-control. Logistic regressions showed that the personality factor of anxiety (p < .007) significantly predicts the MBI-HSS subscale of emotional exhaustion and the personality factor of dominance (p < .01) significantly predicts the MBI-HSS subscale of personal accomplishment. While no personality factor significantly predicts the MBI-HSS subscales of depersonalization, social boldness (p < 0.07) and vigilance (p < .09) strongly contributed to this relationship. Logistic regressions also showed that highest degree earned is significantly (p < .000) predictive of longevity. Since the overall burnout level was in the average range, in essence this study described the profile of music therapists who are staying and thriving in the profession.

Prevalence of dietitian burnout

Burnout is the result of unmanaged stress that has been shown to affect those working in the healthcare professions. Although much research has been conducted on burnout among nurses, physicians and other health professionals, there is limited documentation on the phenomenon among dietitians. The purpose of this study was to establish the prevalence of burnout among dietitians in Ontario, Canada, determine the demographic variables associated with burnout, and compare these results with burnout data for other healthcare professionals. The Maslach Burnout Inventory-Human Services Survey and a demographic questionnaire were emailed to registered dietitians. The dietitians surveyed experienced a moderate amount of emotional exhaustion (mean = 19.96), a low level of depersonalisation (mean = 4.31) and a moderate sense of personal accomplishment (mean = 38.61). Statistically significant relationships were found between years as a dietitian and personal accomplishment (r = 0.16; P = 0.05), age and personal accomplishment (r = 0.15; P = 0.01), hours worked per week and emotional exhaustion (r = 0.17; P = 0.01) and hours worked per week and depersonalisation (r = 0.14; P = 0.01). There were no significant differences in mean burnout scores across the five areas of practice. Over 57% of dietitians had scores indicative of moderate to high levels of burnout overall. Although dietitians have lower levels of burnout compared to other healthcare professionals, moderate levels of emotional exhaustion and only moderate levels of personal accomplishment remain workplace issues for this professional group.

Prevalencia del síndrome de agotamiento profesional (burnout) en médicos familiares mexicanos: análisis de factores de riesgo

IntroductionBurn-out syndrome refers to a psycho-social problem that is common among physicians. ObjectiveTo determine its prevalence and risk factors in Mexican family physicians. MethodObservational, descriptive-cross-sectional study, by means of self-administration of the Maslach Burnout Inventory - Human Services Survey (MBI-HSS) in a random sample with proportional allocation of 240 physicians. The descriptive statistics and the inferential analysis were made with support of the SPSS 12.0 and Epi-info V 6.1. Results97.5% of the answers were obtained. We detected Burnout syndrome in 41.6% of the physicians. We found significant differences based on gender, age group, number of children, seniority, and type of job contract. ConclusionsBurn-out syndrome is frequent (41.6%) in family physicians, and its main risk factors are: Being a woman, 40 years-old or more, with children, with a minimum of 10 years at the workplace, and a long-term contract. Emotional exhaustion and depersonalization had a negative correlation, and lack of personal accomplishments at work had a positive correlation with the syndrome. It is necessary to establish preventive measures and interventions at the individual, social, and organizational levels to reduce its prevalence.

Occupational stress, sense of coherence, coping, burnout and work engagement of registered nurses in South Africa

The aim of this study was to assess the relationship between the occupational stress, sense of coherence, coping, burnout and work engagement of registered nurses in South Africa. A cross-sectional survey design was used. The study population consisted of 818 registered nurses. The Nursing Stress Inventory, the Orientation to Life Questionnaire, the COPE, the Maslach Burnout Inventory-Human Services Survey, and the Utrecht Work Engagement Scale were administered. The results show that the experience of depletion of emotional resources and feelings of depersonalisation by registered nurses were associated with stress due to job demands and a lack of organisational support, focus on and ventilation of emotions as a coping strategy, and a weak sense of coherence. Work engagement was predicted by a strong sense of coherence and approach-coping strategies.

Effect of occupational commitment on job burnout of traditional Chinese medicine doctors

To investigate the status of job burnout in traditional Chinese medicine (TCM) doctors and explore the effect of occupational commitment on job burnout. A test of occupational commitment and job burnout was carried out in 507 TCM doctors with occupational commitment questionnaire and Maslach Burnout Inventory-Human Services Survey (MBI-HSS). The age group of < 30 years scored lowest (2.352 +/- 0.660) in personal accomplishment compared with 30 years old group and 40 years old group [(2.136 +/- 0.704) and (2.127 +/- 0.628) respectively] (P < 0.01). The score of emotional exhaustion and depersonalization increased with educational levels. There was significantly negative correlation between job burnout and occupational commitment (P < 0.01). Occupational commitment had significant effect on job burnout (P < 0.01). Occupational trouble commitment was a major predictor for emotional exhaustion (P < 0.01). Professional self-efficacy commitment was a major predictor for depersonalization (P < 0.01). Affective commitment was a major predictor for personal accomplishment (P < 0.01). Occupational commitment is a good predictor for job burnout. Improving occupational commitment is an important measure to prevent job burnout.

Personal and Environmental Characteristics Predicting Burnout Among Certified Athletic Trainers at National Collegiate Athletic Association Institutions

Recent research in the health care professions has shown that specific personal and environmental characteristics can predict burnout, which is a negative coping strategy related to stressful situations. Burnout has been shown to result in physiologic (eg, headaches, difficulty sleeping, poor appetite), psychological (eg, increased negative self-talk, depression, difficulty in interpersonal relationships), and behavioral (eg, diminished care, increased absenteeism, attrition) symptoms. To examine the relationship between selected personal and environmental characteristics and burnout among certified athletic trainers (ATs). Cross-sectional survey. A demographic survey that was designed for this study and the Maslach Burnout Inventory-Human Services Survey. A total of 206 ATs employed at National Collegiate Athletic Association (NCAA) institutions as clinical ATs volunteered. We assessed personal and environmental characteristics of ATs with the demographic survey and measured burnout using the Maslach Burnout Inventory-Human Services Survey. Multiple regression analyses were performed to examine relationships between specific personal and environmental characteristics and each of the 3 subscales of burnout (emotional exhaustion, depersonalization, personal accomplishment). Most ATs we surveyed experienced low to average levels of burnout. Personal characteristics predicted 45.5% of the variance in emotional exhaustion (P < .001), 21.5% of the variance in depersonalization (P < .001), and 24.8% of the variance in personal accomplishment (P < .001). Environmental characteristics predicted 16.7% of the variance in emotional exhaustion (P = .005), 14.4% of the variance in depersonalization (P = .024), and 10.4% of the variance in personal accomplishment (P = .209). Stress level and coaches' pressure to medically clear athletes predicted ratings on all 3 subscales of burnout. Our findings were similar to those of other studies of burnout among NCAA Division I ATs, coaches, and coach-teachers. The results also support the Cognitive-Affective Model of Athletic Burnout proposed by Smith. Finally, these results indicate new areas of concentration for burnout research and professional practice.

Monitoring stress levels in postgraduate medical training

The Accreditation Council for Graduate Medical Education (ACGME) mandates that residency Program Directors (PD) monitor resident well-being, including stress. Burnout, as a measure of work-related stress, is defined by a high degree of emotional exhaustion and depersonalization, and a low degree of personal accomplishment using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). The purpose of this study is to describe the use of the MBI-HSS as a method of monitoring stress levels in an academic otolaryngology residency training program and introduce this survey as a tool for wider use in meeting ACGME requirements. The MBI-HSS was administered to residents in an academic otolaryngology residency training program on three separate occasions: at the beginning, middle, and end of different academic years. In addition, at the time of the third administration, the MBI-HSS was completed by faculty and staff in the same department. Surveys were completed and collected anonymously. Responses were scored against normative data from the MBI-HSS overall sample and the medicine subscale. Low, average, and high levels of burnout were identified for the individual categories of emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA); average levels for each category were calculated. Twenty-two residents completed the first survey, taken near the end of an academic year; 19 completed the second administration in the middle of the following academic year; and 24 completed the third survey at the beginning of the subsequent academic year. Thirteen faculty and 23 staff also completed the third survey. We found that three, one, and one residents reported high levels of burnout on the first, second, and third surveys, respectively. These figures compare to one faculty member and no staff members in the same department reporting high levels of burnout. The MBI-HSS is an established and validated tool for identifying burnout in resident physicians. Residency PDs may find the MBI-HSS useful as an aid in monitoring resident well-being and stress. In our own department, we found levels of burnout comparable to those previously reported for residents and faculty in this specialty.

Summary of: Occupational burnout and work engagement: a national survey of dentists in the United Kingdom

Objective To determine the levels of burnout and work engagement among dentists in the United Kingdom. Study design Postal survey of 500 dentists selected at random from the General Dental Council register. Methods Respondents completed a questionnaire pack comprising the Utrecht Work Engagement Scale (UWES-17) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), together with questions on demographic characteristics. Results Approximately 8% of respondents had scores suggestive of burnout on all three scales of the MBI-HSS and a further 18.5% had high scores in two of the domains. Eighty-three percent of respondents had work engagement scores suggestive of moderate or high work engagement. Dentists with postgraduate qualifications and those who work in larger teams had lower burnout scores and more positive work engagement scores. Dentists who spend a greater proportion of their time in NHS practice showed lower work engagement and higher levels of burnout. Conclusions Burnout affects a small but significant proportion of dental practitioners in the United Kingdom. A larger proportion of practitioners show low work engagement, suggesting a negative attitude to their work. Higher burnout scores and lower work engagement scores were found in dentists without postgraduate qualifications, those in small teams and in those who spend a greater proportion of their time in NHS practice.

Burnout among hospital nurses in China

The aim of this study was to examine the level of burnout and factors that contribute to burnout in hospital nurses in the People's Republic of China. While burnout among hospital nurses has been widely researched in western countries, little research has investigated burnout among hospital nurses in China. A translated version of the Maslach Burnout Inventory-Human Services Survey was used to measure burnout in 249 randomly selected nurses from various wards of a large teaching hospital in Beijing, China. Questionnaire packs were sent to the hospital wards where selected nurses worked. One hundred and twenty-eight nurses returned the completed questionnaire. The response rate was 51%. The results showed moderate levels of Emotional Exhaustion and Personal Accomplishment, and low levels of Depersonalization. Age, years of experience and professional title had a significant positive relationship with Emotional Exhaustion and Personal Accomplishment. Older, married nurses with more personal responsibilities and in a more senior position experienced higher levels of Emotional Exhaustion. The findings suggest that burnout is a significant issue for nurses in China. The results of this study indicate that working environment factors such as relationships with coworkers and managers may contribute to or mitigate burnout. There is a need to address personal and professional support, life-work balance, personal accomplishment and educational programmes to reduce burnout in nurses working in China.

The Association between Leadership Behaviour and Burnout among Nursing Personnel in Health Care

The aim of the study was to explore the association between leadership behaviour and burnout among nursing personnel in health care. Surveys were sent to a random sample of 900 nurses and nurse managers in various health care organizations around Finland. Of these, 660 nurses responded (73%), 627 of whom were accepted for the final analysis. Leadership behaviour was measured with Multifactor Leadership Questionnaire (MLQ) and burnout with Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Correlations and one-way ANOVA were used for statistical analysis.Nursing leadership is both positively and negatively associated with burnout among nursing personnel. Idealized influence, inspirational motivation, intellectual stimulation, individualized consideration and contingent reward were positively associated with personal accomplishment and negatively with emotional exhaustion and depersonalization. Active management-by-exception behaviour of the nurse manager may increase personal accomplishment. Passiv...

Occupational burnout and work engagement: a national survey of dentists in the United Kingdom

To determine the levels of burnout and work engagement among dentists in the United Kingdom.Study design Postal survey of 500 dentists selected at random from the General Dental Council register. Respondents completed a questionnaire pack comprising the Utrecht Work Engagement Scale (UWES-17) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), together with questions on demographic characteristics. Approximately 8% of respondents had scores suggestive of burnout on all three scales of the MBI-HSS and a further 18.5% had high scores in two of the domains. Eighty-three percent of respondents had work engagement scores suggestive of moderate or high work engagement. Dentists with postgraduate qualifications and those who work in larger teams had lower burnout scores and more positive work engagement scores. Dentists who spend a greater proportion of their time in NHS practice showed lower work engagement and higher levels of burnout. Burnout affects a small but significant proportion of dental practitioners in the United Kingdom. A larger proportion of practitioners show low work engagement, suggesting a negative attitude to their work. Higher burnout scores and lower work engagement scores were found in dentists without postgraduate qualifications, those in small teams and in those who spend a greater proportion of their time in NHS practice.

Burnout in European family doctors: the EGPRN study

The aim of this study was to determine the prevalence of burnout, and of associated factors, amongst family doctors (FDs) in European countries. Methodology. A cross-sectional survey of FDs was conducted using a custom-designed and validated questionnaire which incorporated the Maslach Burnout Inventory Human Services Survey (MBI-HSS) as well as questions about demographic factors, working experience, health, lifestyle and job satisfaction. MBI-HSS scores were analysed in the three dimensions of emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). Almost 3500 questionnaires were distributed in 12 European countries, and 1393 were returned to give a response rate of 41%. In terms of burnout, 43% of respondents scored high for EE burnout, 35% for DP and 32% for PA, with 12% scoring high burnout in all three dimensions. Just over one-third of doctors did not score high for burnout in any dimension. High burnout was found to be strongly associated with several of the variables under study, especially those relative to respondents' country of residence and European region, job satisfaction, intention to change job, sick leave utilization, the (ab)use of alcohol, tobacco and psychotropic medication, younger age and male sex. Burnout seems to be a common problem in FDs across Europe and is associated with personal and workload indicators, and especially job satisfaction, intention to change job and the (ab)use of alcohol, tobacco and medication. The study questionnaire appears to be a valid tool to measure burnout in FDs. Recommendations for employment conditions of FDs and future research are made, and suggestions for improving the instrument are listed.

Measuring Resident Well-Being: Impostorism and Burnout Syndrome in Residency

Assessing resident well-being is becoming increasingly important from a programmatic standpoint. Two measures that have been used to assess this are the Clance Impostor Scale (CIS) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). However, little is known about the relationship between the two phenomena. To explore the prevalence and association between impostorism and burnout syndrome in a sample of internal medicine residents. Anonymous, cross-sectional postal survey. Forty-eight internal medicine residents (postgraduate year [PGY] 1-3) at the Schulich School of Medicine & Dentistry (62.3% response rate). Short demographic questionnaire, CIS and MBI-HSS. Impostorism and burnout syndrome were identified in 43.8% and 12.5% of residents, respectively. With the exception of a negative correlation between CIS scores and the MBI's personal accomplishment subscale (r = -.30; 95% CI -.54 to -.02), no other significant relations were identified. Foreign-trained residents were more likely to score as impostors (odds ratio [OR] 10.7; 95% CI 1.2 to 98.2) while senior residents were more likely to experience burnout syndrome (OR 16.5 95% CI 1.6 to 168.5). Both impostorism and burnout syndrome appear to be threats to resident well-being in our program. The lack of relationship between the two would suggest that programs and researchers wishing to address the issue of resident distress should consider using both measures. The finding that foreign-trained residents appear to be more susceptible to impostorism warrants further study.

Burnout in Medical School Deans: An Uncommon Problem

To assess the burnout level among U.S. and Canadian medical school deans and to study how burnout relates to certain characteristics including hours worked, effectiveness, and support from family and colleagues. Questionnaires were sent in September 2006 to 100 deans who had served at least one year. The questionnaire included 13 questions from the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which measures three subcomponents of burnout: emotional exhaustion, depersonalization, and personal accomplishment. The response rate was 90%. The median age of participants was 60; the median length of service at the current institution was four years; the median number of hours worked per week was 70.0. Deans most frequently identified school budget deficits, loss of funding, and departure of key faculty as stressors. Whereas only 11% reported being dissatisfied with their positions, 33% reported it was likely they would step down within the next two years. The predominant pattern of MBI-HSS subscale scores in participating deans was moderate emotional exhaustion, moderate depersonalization, and high personal accomplishment. Only 2% of respondents satisfied all three subscale scores for high burnout. Emotional exhaustion was significantly directly associated with work week length and number of weekend days worked and was inversely associated with spousal support, length of service, and age. Despite having an "extreme" job, only 2% of deans exhibited high levels of burnout. A high sense of control and self-efficacy, a supportive family, increasing length of service, and increasing age may be factors which reduce burnout in deans.