Resident Physician Well-Being and Assessments of Their Knowledge and Clinical Performance
Open Access
- 24 September 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of General Internal Medicine
- Vol. 27 (3), 325-330
- https://doi.org/10.1007/s11606-011-1891-6
Abstract
Medical knowledge and clinical performance ratings are major criteria for assessing the competence of resident physicians. However, these assessments may be influenced by residents’ mental health. The relationship between residents’ well-being and empathy and assessments of their global performance remains unclear. To determine whether resident well-being and empathy are associated with assessments of their medical knowledge and clinical performance. We studied 730 clinical performance assessments completed by peers, supervising residents, and allied health professionals; 193 mini-clinical evaluation exercise (mini-CEX) evaluations; and 260 in-training examinations (ITE) of Mayo Clinic internal medicine residents between January 2009 and August 2010. Multivariate generalized estimating equations were used to evaluate associations between residents’ well-being and empathy and assessments of their knowledge and clinical performance. Independent variables were empathy using the Interpersonal Reactivity Index (IRI), burnout using the Maslach Burnout Inventory, depression using a standardized two-question screening instrument, and quality of life using a Linear Analog Self-Assessment item and the Medical Outcomes Study Short Form (SF-8). Dependent variables were mini-CEX, ITE, and the validated six-item Mayo clinical performance assessment. 202 residents (64.7%) provided both well-being and at least one category of assessment data. In multivariate models, residents’ scores on the IRI empathy measure of “the tendency to adopt the psychological view of others” were associated with higher peer ratings on “desirability as a physician for a family member” (beta = 0.023, 95% CI = 0.007–0.039, p = 0.004). Additionally, burnout was associated with higher supervisor ratings of communication (beta = 0.309, 95% CI = 0.100–0.517, p = 0.004). There were no observed associations between ITE or mini-CEX scores and resident quality of life, burnout, fatigue, depression, or empathy. Most dimensions of resident well-being were not associated with residents’ knowledge scores and assessments of their clinical performance by other members of the health care team, which supports the trustworthiness of these measures. Nonetheless, correlations of resident empathy and burnout with assessments completed by peers and supervising residents suggest that some ratings of residents may be influenced by interpersonal factors.Keywords
This publication has 57 references indexed in Scilit:
- Internal structure of mini-CEX scores for internal medicine residents: factor analysis and generalizabilityAdvances in Health Sciences Education, 2010
- Impact of Resident Well-Being and Empathy on Assessments of Faculty PhysiciansJournal of General Internal Medicine, 2009
- Proposal for a Collaborative Approach to Clinical TeachingMayo Clinic Proceedings, 2009
- Does scale length matter? A comparison of nine- versus five-point rating scales for the mini-CEXAdvances in Health Sciences Education, 2008
- Factors Associated with Medical Knowledge Acquisition During Internal Medicine ResidencyJournal of General Internal Medicine, 2007
- Association of Perceived Medical Errors With Resident Distress and EmpathyJAMA, 2006
- The Interdependence of Social Identification and LearningAmerican Educational Research Journal, 2004
- Toward a Measurement Model of the Affect Intensity Measure: A Three-Factor StructureJournal of Research in Personality, 1996
- Assessing physician empathy using the interpersonal reactivity index: A measurement model and cross-sectional analysisPsychology, Health & Medicine, 1996
- Measuring the quality of life of cancer patientsJournal of Chronic Diseases, 1981