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Lack of association between resident doctors' well‐being and medical knowledge
Author(s) -
West Colin P,
Shanafelt Tait D,
Cook David A
Publication year - 2010
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/j.1365-2923.2010.03803.x
Subject(s) - empathy , burnout , accreditation , interpersonal reactivity index , medicine , graduate medical education , family medicine , mental health , medline , test (biology) , association (psychology) , cross sectional study , psychology , clinical psychology , psychiatry , medical education , perspective taking , paleontology , political science , law , biology , psychotherapist , pathology
Medical Education 2010: 44 : 1224–1231Objectives Resident doctors' (residents) well‐being impacts on the medical care they provide. Despite the high prevalence of resident doctors' distress, the relationship between their well‐being and the specific competencies defined by the Accreditation Council for Graduate Medical Education is poorly understood. We evaluated the association of resident well‐being with medical knowledge as assessed on both a standardised test of general medical knowledge and at the end of web‐based courses on a series of focused topics. Methods We conducted a repeated cross‐sectional study of associations between well‐being and medical knowledge scores over time for internal medicine residents from July 2004 to June 2007. Well‐being measures included linear analogue self‐assessment (LASA) scales measuring quality of life (including overall quality of life, mental, physical and emotional well‐being, and fatigue), the Medical Outcome Study Eight‐Item Short Form Health Survey (SF‐8) assessment of mental and physical well‐being, the Maslach Burnout Inventory and the PRIME‐MD two‐item depression screen. We also measured empathy using the perspective taking and empathic concern subscales of the Interpersonal Reactivity Index. Medical knowledge measures included scores on web‐based learning module post‐tests and scores on the national Internal Medicine In‐Training Examination (IM‐ITE). As data for each association were available for at least 126 residents, this study was powered to detect a small‐to‐moderate effect size of 0.3 standard deviations. Results No statistically significant associations were observed between well‐being and either web‐based learning module post‐test score or IM‐ITE score. Parameter estimates of the association of well‐being variables with knowledge scores were uniformly small. For all well‐being metrics, meaningful differences were associated with knowledge score difference estimates of < 1 percentage point. Conclusions Resident well‐being appears to have limited association with competence in medical knowledge as assessed following web‐based courses on specific topics or using standardised general medical examinations.