Increased professionalization and lower burnout scores were associated with structured residency training program: results of a cross sectional survey

Figures & data

Table 1. Characteristics of the included ambulatory residents

Total sample (N, (%))		197	(100)
Gender: female (N,(%))		166	(84.3)
Age (M, (SD))		37.2	(7.0)
Participation in a regional RTN (N, (%))		41	(20.8)
Working hours per week (M, (SD))		32.5	(8.8)
Year of training
1.		6	(3.0)
2.		17	(8.6)
3.		29	(14.7)
4.		66	(33.5)
≥5.		73	(37.1)
Degree of burnout
Emotional Exhaustion (N, (%))
Low		107	(54.3)
Average		49	(24.9)
High		39	(19.8)
Depersonalization (N, (%))
Low		113	(57.4)
Average		43	(21.8)
High		40	(20.3)
Personal Accomplishment (N, (%))
Low		116	(58.9)
Average		48	(24.4)
High		23	(11.7)

M: mean; N: number; RTN: residents training network; SD: standard deviation.

Table 2. Burnout symptoms (mean values of emotional exhaustion, depersonalization, personal accomplishment), differentiated by gender, participation in a regional RTN, training phase, and year of training

	Emotional exhaustion			Depersonalization			Personal accomplishment
	N	M	(SD)	N	M	(SD)	N	M	(SD)
Total	195	18.7	(9.6)	196	6.0	(4.9)	187	40.2	(6.1)
Gender^a
Female	164	18.4	(9.5)	165	5.5	(4.6)	157	40.2	(6.0)
Male	29	20.0	(10.4)	29	8.4	(5.8)	28	39.6	(7.1)
		p = 0.375			p = 0.006			p = 0.887
Year of training^b
1.	5	28.8	(7.6)	6	8.3	(7.4)	4	36.5	(5.2)
2.	17	17.5	(8.0)	17	6.2	(5.1)	15	39.7	(5.4)
3.	29	17.1	(9.3)	29	5.9	(5.1)	28	40.1	(6.0)
4.	65	19.1	(9.6)	66	5.9	(4.5)	64	41.3	(4.9)
≥5.	73	18.8	(10.2)	72	5.7	(5.1)	71	39.4	(7.3)
		p = 0.129			p = 0.862			p = 0.351
Participation in a regional RTN^a
Yes	41	20.1	(12.1)	41	6.4	(5.7)	38	38.6	(7.0)
No	145	18.5	(8.9)	146	5.9	(4.7)	141	40.5	(6.0)
		p = 0.702			p = 0.932			p = 0.129

^aTest of significance: Mann–Whitney U-test; ^bTest of significance: Kruskal-Wallis-test; Level of significance: p < 0.05; M: mean; N: number; RTN: residents training network; SD: standard deviation. Cut-off values for ‘high’ burnout as suggested by Maslach et al. [22]: emotional exhaustion: ≥27; depersonalization: ≥10; personal accomplishment: ≤33.

Table 3. Degree of professionalism (sum score), differentiated by gender, participation in a regional network, and year of training

	Professionalism towards the patient			Professionalism towards other professionals			Professionalism towards society			Professionalism towards oneself
	N	M	(SD)	N	M	(SD)	N	M	(SD)	N	M	(SD)
Total	197	72.7	(5.55)	177	44.3	(5.27)	187	31.2	(4.17)	196	71.5	(6.77)
Participation in a regional RTN^a
Yes	41	74.5	(5.08)	38	46.1	(4.53)	40	32.7	(4.11)	41	72.5	(8.08)
No	147	72.4	(5.56)	131	43.8	(5.38)	138	30.7	(4.13)	146	71.3	(6.53)
		p = 0.031			p = 0.012			p = 0.007			p = 0.232
Gender^a
Female	166	73.1	(5.32)	149	44.4	(5.30)	158	31.1	(4.26)	165	71.8	(6.54)
Male	29	70.6	(6.51)	26	43.2	(5.23)	27	31.4	(3.82)	29	69.6	(8.02)
		p = 0.039			p = 0.259			p = 0.794			p = 0.255
Year of training
1.	6	68.1	(3.54)	5	41.4	(3.16)	5	30.9	(2.51)	5	64.4	(5.86)
2.	17	71.0	(5.19)	12	42.7	(5.60)	15	29.4	(5.48)	17	69.7	(5.97)
3.	29	71.9	(6.24)	28	43.7	(5.33)	27	30.5	(3.97)	29	72.4	(6.08)
4.	66	73.2	(5.15)	58	44.3	(5.38)	63	31.2	(4.10)	66	71.8	(6.73)
≥5.	73	73.8	(5.33)	68	45.4	(5.02)	71	32.0	(4.02)	73	72.2	(6.69)
		p = 0.040			p = 0.207			p = 0.369			p = 0.071

^aTest of significance: Mann–Whitney U-test; ^bTest of significance: Kruskal-Wallis-test; Level of significance: p < 0.05; M: mean; N: number; RTN: residents training network; SD: standard deviation

Table 4. Multivariable linear regression modelling of professionalism, years of training, and participation in a regional network. Outcome: Burnout sums up scores of emotional exhaustion, depersonalization, and personal accomplishment

Explanatory variable	Emotional exhaustion			Depersonalization			Personal accomplishment
	β	SD	p value	β	SD	p value	β	SD	p value
Constant	47.082	10.842		22.446	5.422		13.311	6.863
Professionalism towards the patient	−0.337	0.138	0.015	−0.207	0.069	0.003	0.319	0.087	0.000
Year of training	0.029	0.695	0.967	−0.018	0.345	0.958	−0.246	0.449	0.585
Participation in a regional RTN	−2.052	1.753	0.243	−0.708	0.881	0.423	2.492	1.116	0.027
Constant	35.825	8.310		14.330	4.186		24.032	5.310
Professionalism towards other professionals	−0.304	0.153	0.049	−0.153	0.077	0.048	0.272	0.096	0.005
Year of training	−0.113	0.757	0.882	−0.225	0.381	0.555	−0.282	0.488	0.565
Participation in a regional RTN	−1.688	1.883	0.372	−0.374	0.946	0.693	2.830	1.194	0.019
Constant	33.816	7.351		11.306	3.708		25.516	4.581
Professionalism towards society	−0.363	0.184	0.050	−0.125	0.093	0.180	0.349	0.114	0.003
Year of training	−0.052	0.720	0.943	−0.174	0.364	0.634	−0.301	0.464	0.518
Participation in a regional RTN	−1.968	1.816	0.280	−0.483	0.916	0.599	2.817	1.145	0.015
Constant	49.906	8.498		23.500	4.244		14.491	5.319
Professionalism towards oneself	−0.390	0.106	0.000	−0.224	0.053	0.000	0.315	0.066	0.000
Year of training	0.043	0.675	0.949	−0.148	0.338	0.663	−0.211	0.435	0.628
Participation in a regional RTN	−1.785	1.704	0.296	−0.499	0.852	0.559	2.148	1.079	0.048

RTN: residents training network; SD: standard deviation; Level of significance: p < 0.05; Note: Higher values in emotional exhaustion and depersonalization, but lower values in personal accomplishment indicate a higher degree of burnout symptoms.

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