The Effect of Burnout on Medical Errors and Professionalism in First-Year Internal Medicine Residents 

This month’s journal club was written by Jenny MacDowell, M’17, with reference to the following article: The Effect of Burnout on Medical Errors and Professionalism in First-Year Internal Medicine Residents by Kwah, MD, Weintraub, MD, Fallar, PhD, and Ripp, MD, MPH. 

The relationship between resident burnout, professionalism, and medical errors is unclear.   This cohort study aimed to determine whether burnout correlated with objective measures of medical errors and professionalism such as medication prescription errors.  Burnout was measured using the Maslach Burnout inventory following three domains: emotional exhaustion, depersonalization, and sense of personal accomplishment.  Medication prescription error rate was the chosen medical error metric measured.  Professionalism was measured by examining discharge summaries completed within 48 hours, outpatient charts completed within 72 hours, and the average time to review outpatient laboratory results.

The study found that residents with burnout at the end of the year had a lower rate of medication prescription errors (0.553 vs. 0.780, p=0.007).  The professionalism metrics had no significant difference between residents with or without burnout.

Discussion questions:

  • How do the results of this study conflict with the concept of the Yerkes-Dodson curve?http://sourcesofinsight.com/yerkes-dodson-human-performance-curve/
  • Are you surprised by the results of this study and why?
  • What could be the underlying reason residents with burnout had a decrease in medical error?
  • Are the results clinically significant?

References:

Kwah, Jason, Jennifer Weintraub, Robert Fallar, and Jonathan Ripp. “The Effect of Burnout on Medical Errors and Professionalism in First-Year Internal Medicine Residents.” Journal of Graduate Medical Education 8.4 (2016): 597-600.

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