The sociotechnical factors associated with burnout in residents in surgical specialties

34836841 2022 05 04 2022 06 06 1878-7452 79 3 2022 May-Jun Journal of surgical education J Surg Educ The Sociotechnical Factors Associated With Burnout in Residents in Surgical Specialties: A Qualitative Systematic Review. 614 623 614-623 10.1016/j.jsurg.2021.11.006 S1931-7204(21)00323-8 The consequences of burnout remain prevalent within general surgery training programs, yet there is no comprehensive description of the factors associated with burnout. Using sociotechnical systems theory, this review aims to qualitatively evaluate the factors associated with burnout in surgical residents. A systematic review of the literature was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review was conducted using PubMed, Web of Science, Scopus, and Embase. Two reviewers independently selected studies, extracted data, and assessed quality, with a third reviewer acting as a moderator to resolve conflicts. The Systems Engineering Initiative for Patient Safety framework was utilized to categorize factors as either contributing to or mitigating burnout. The study was registered with PROSPERO (CRD42021237448). Included studies were conducted within the United States and published prior to November 11, 2020. Included studies were peer-reviewed primary data, that were written in English and evaluated the sociotechnical factors associated with burnout in surgical residents. A total of 4387 articles were identified and after review, 15 studies were included for analysis. Reported burnout rates ranged from 17 to 94%, with a total mean rate of 57%. Factors found to contribute to burnout include financial stress, work-life imbalance, excessive charting, insufficient job resources, poor social support, and mistreatment. Mitigating factors include having time away from work, increased didactics, supportive faculty, attending social events, and the presence of program-based wellness initiatives. Consequences of burnout include depression, substance abuse, and decreased job satisfaction. Reported burnout rates among surgical residents are high. A complex number of sociotechnical factors were found to contribute to burnout, yet many factors are also shown to mitigate burnout. Surgical residencies may address burnout by making changes based on the presence or absence of these factors within their program. Copyright © 2021 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved. Kratzke Ian M IM Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: Ian.Kratzke@unchealth.unc.edu. Woods Lindsay C LC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Adapa Karthik K Division of Health Engineering, Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Kapadia Muneera R MR Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Mazur Lukasz L Division of Health Engineering, Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. eng Journal Article Systematic Review 2021 11 24 United States J Surg Educ 101303204 1878-7452 IM Burnout, Professional epidemiology Burnout, Psychological Humans Internship and Residency Job Satisfaction Specialties, Surgical United States burnout residency systems theory training programs 2021 6 28 2021 9 14 2021 11 7 2021 11 28 6 0 2022 5 6 6 0 2021 11 27 5 32 ppublish 34836841 10.1016/j.jsurg.2021.11.006 S1931-7204(21)00323-8