| Popis: |
Introduction: Addressing physician wellbeing is an increasing trend in both literature and policymaking (1). Despite recognition that occupational burnout is widespread within all healthcare systems, neither a collective understanding of burnout in medical training nor an understanding of burnout recovery strategies has been established globally (2). Thus, a narrative literature review aiming to synthesise the current state of burnout in global medical training was employed, focusing uniquely on how drivers of burnout interact with how clinicians recover from the phenomenon. Methods: Three medical databases (EMBASE, MEDLINE, HMIC) were searched using a scoping approach with keywords from 2013 to March 2023. Grey literature was additionally included. Reviewers screened titles and abstracts prior to full text review of selected articles. Broad eligibility criteria were applied, and subsequently articles were critically appraised alongside formal risk-of-bias assessment. Only burnout-focused papers published in English were included. Outcomes: 536 articles were identified, and after full-text screening, 84 articles met the inclusion criteria. The review provided a rich overview of prevalence by personality, speciality, and training stage as well as both intrinsic and extrinsic contributing factors to burnout and the corresponding impact on work. Existing interventions for burnout recovery were categorised into three domains comprising wellness, individual and institutional-level strategies – the latter two comprised resilience and mindfulness training, self-awareness, mentorship, culture, working conditions, discussion facilitation and screening. Importantly, burnout was consistently found to have negative impacts on patients, the institution, and clinicians. Discussion: Despite the well-evidenced negative effects of burnout (three), this review highlighted significant homogeneity in factors facilitating burnout. Contrastingly, burnout recovery strategies were mostly individual-specific with strong basis surrounding giving protected time to clinicians, promoting wellness approaches over respite and personal engagement. The influence of organisation-level changes, such as those made by the NHS, remain poorly considered within burnout and warrants tailored research given the heterogeneity of the evidence base. |
