Burnout and engagement in health profession students and early career health professionals: exploring the role of demands and resources

Abstract

There are ongoing concerns about the general and occupational wellbeing of early career health professionals and health profession students. The overall aims of this research project were to explore burnout and engagement using theory driven hypotheses and to increase understanding of how to reduce burnout and increase engagement in these populations. Three studies explored the direct and indirect relationships of burnout and engagement with different potential antecedents and consequences using a three wave longitudinal data set. The fourth study assessed a pilot intervention aimed at reducing burnout and distress and increasing engagement and wellbeing. The first study explored burnout and engagement in a sample of 260 health profession students using a cross-sectional design. Direct relationships of study demands and resources and personal resources with burnout and engagement were explored as well as the indirect role personal resources might play in relation to burnout and engagement. The role of personal resources was found to be important in explaining burnout and less important in explaining engagement. Demands and resources mediated the relationship between personal resources and burnout and engagement. The second study aimed to explore the relationships of neuroticism, extraversion and conscientiousness with the exhaustion component of burnout and total engagement using the first two waves of the longitudinal study. Participants included a mixed sample of 100 students or employees. The relationships between personality and burnout and engagement were not as strong as previous cross-sectional research indicated when measured longitudinally and controlling for the outcome at time one. Demands and resources mediated some of the relationships between personality and burnout and engagement. The third study used all three waves of the longitudinal study and explored the transition from study into the workplace. Participants were 86 health profession students at time one, 86 employees at time two and 57 employees at time three, the majority of employed participants worked in the health sector. The study found that participants had higher levels of burnout in study than in work and that student burnout predicted employee burnout even when controlling for mental health and neuroticism. The final study evaluated a modified Dialectical Behaviour Therapy (DBT) skills training group teaching mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness skills. Participants were Master level psychology students (intervention group, n = 17; non-randomised control group, n = 57). At follow-up the intervention group had significantly more change in all measures than the control group. It was considered that there was preliminary evidence for the effectiveness, acceptability and feasibility of the intervention for reducing burnout and overall psychological distress, as well as for increasing positive states, including engagement. Overall, this study found support for demands and resources as important predictors of student burnout and engagement and tested some of the interaction relationships suggested by current burnout theory which have not been tested in this population. Additionally, this study found preliminary evidence that the impact of personality on burnout and engagement may be mediated by demands and resources. Finally, this study found initial support for the effectiveness of an intervention group based on DBT skills for decreasing burnout and increasing engagement.