Residency as a Social Network: Burnout, Loneliness, and Social Network Centrality

ABSTRACT Background Burnout is typically viewed as an individual condition, and no link has been identified between burnout and loneliness. Objective To investigate the association of burnout with loneliness and social network degree and centrality. Methods A survey containing the Maslach Burnout Inventory (MBI), a 3-question loneliness scale, and a social connectivity component was sent to residents in a large urban academic medical center internal medicine residency program. Results The response rate was 77% (95 of 124 residents). We defined significant burnout as MBI subscores of ≥ 27 for emotional exhaustion (EE), ≥ 10 for depersonalization (DP), or both. This was met by 43 (45%), 47 (49%), and 31 (33%) out of 95 respondents, respectively. Those with significant burnout had higher loneliness scores: 5.6 versus 4.5 for EE (P = .002; OR = 1.50; 95% CI 1.15–1.95); 5.4 versus 4.6 for DP (P = .024; OR = 1.33; 95% CI 1.03–1.71); and 5.8 versus 4.6 for both EE and DP (P = .001; OR = 1.54; 95% CI 1.17–2.02). Rating a larger number of coresidents as closer connections on a 5-point Likert scale was not associated with lower burnout scores. No measures of centrality were associated with burnout scores for EE and/or DP. High personal accomplishment subscores on the MBI did correlate significantly with several measures of centrality. Conclusions Burnout was associated with loneliness in a dose-dependent fashion. Greater sense of personal accomplishment was associated with greater network centrality.

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1949. Putting Out Fires: Assessing Burnout within an Infectious Diseases Fellowship at an Academic Medical Center

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz359.126 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S58-S59

Author(s):

Leslie-Ann Alexander ◽

Barbra M Blair ◽

Wendy Stead

Keyword(s):

Infectious Diseases ◽

Needs Assessment ◽

Medical Center ◽

Academic Medical Center ◽

Maslach Burnout Inventory ◽

Personal Accomplishment ◽

Medical Community ◽

Personal Factors ◽

Academic Medical ◽

Participant Understanding

Abstract Background Burnout, “a psychological syndrome of emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA),” is a well-described problem in the medical community. National surveys report 45% of practicing physicians and 60% of residents and fellows are burnt out. A longitudinal study of medical students and residents reported 45% burnout, as well as career choice regret in 14% of trainees. There are little data about burnout in Infectious Diseases (ID) physicians, including fellows. We sought to measure burnout prevalence in an academic ID Division, identify factors that modified the risk of burnout, and assess knowledge and attitudes about fellow and faculty burnout in the division. Methods The study population included 33 ID physicians (10 fellows, 23 faculties). Level of burnout was assessed via the Maslach Burnout Inventory (MBI), a validated 22-item tool. An additional survey was distributed as a needs assessment to determine participant understanding of “burnout” and “wellness,” ability to recognize burnout in colleagues, attitudes about the scope of the problem, and specific programmatic and personal factors felt to contribute to burnout. Results The MBI was completed by 10 fellows and 16 faculties (76%). A high score in ≥ 1 domain of burnout was reported in 50% of respondents, and 19% received a high score in both EE and DP. Fellows had moderate to high levels of EE (90%) and DP (70%), though all fellows reported at least a moderate sense of PA. The survey needs assessment was completed by 9 fellows and 17 faculties (79%). In a hypothetical case, 100% and 58% of participants correctly identified elements of DP and EE, respectively. Respondents identified several factors contributing to burnout risk, most commonly being lack of schedule autonomy (100%), increasing patient load (96%), and inability to attend teaching conferences (88%). Fellows felt burnt out when seeing ≥ 4 new consults per day and/or carrying a census of 10–11 patients. Conclusion ID fellows at an academic medical center recognize burnout and report levels on par with national data. Fellows and faculty can identify personal and programmatic factors that increase and decrease their risk of burnout. These data can guide programmatic and divisional interventions to improve trainee wellness. Disclosures All Authors: No reported Disclosures.

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Hyperoncotic Albumin Reduces Net Fluid Loss Associated With Hemodialysis

Hospital Pharmacy ◽

10.1177/0018578719828331 ◽

2019 ◽

Vol 55 (2) ◽

pp. 130-134

Author(s):

Mitchell S. Buckley ◽

Brian L. Erstad ◽

Jake M. Lansburg ◽

Sumit K. Agarwal

Keyword(s):

Medical Center ◽

Academic Medical Center ◽

Fluid Loss ◽

Fluid Removal ◽

Post Hoc Analysis ◽

Academic Medical ◽

The Mean ◽

Post Hoc ◽

Fluid Losses ◽

Dose Dependent

Purpose: The purpose of this study was to compare the volume of fluid removal associated with and without 25% albumin administration in conjunction with hemodialysis. Methods: This retrospective, cohort study was conducted at a large academic medical center over a 6-month period to compare the net fluid amount removed (mL) during hemodialysis between patients administered 25% albumin and those without albumin. Results: A total of 238 patients consisting of 973 unique hemodialysis sessions were evaluated. The mean overall net fluid removed by hemodialysis in the 25% albumin and no albumin groups were 1242 mL and 1899 mL, P < .001, respectively. No albumin group had significantly higher mean fluid losses compared with 25% albumin for a total dose of either 25 g ( P = .001) or 50 g ( P = .001). There were no significant differences in mean fluid loss between the no albumin group and patients receiving 75 g or 100 g of albumin. Post hoc analysis failed to demonstrate a dose-dependent response in those patients receiving 25% albumin and no albumin. Conclusion: Hyperoncotic albumin administered during hemodialysis sessions reduced net fluid loss associated with hemodialysis. The findings of this study do not support the routine use of 25% albumin to improve fluid removal during dialysis.

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