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Factors That Influence Burnout of Clinical and Research Faculty: New Insights of Data from a United States Cancer Center Using CART Analysis
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DOI：10.3390/healthcare14070926.png)
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Highlights What are the main findings? In analysis of data from faculty at a U.S. academic cancer center employed in both 2019 and 2021, specific aspects of faculty engagement with the institution, its leadership, and faculty perceptions of work-life quality and control over their work were associated with report of burnout in 2021, revealing opportunities for institutional intervention. While prior burnout was predominantly associated with future burnout, it alone did not doom all faculty to future burnout as other factors were also independently associated with future burnout, including for those not reporting burnout earlier. What are the implications of the main findings? Individual-level interventions to prevent and ameliorate burnout are important as others report, but our work revealed that faculty perception and experience of institutional-level factors may also be key to addressing faculty burnout at similar academic health science centers. Strategies to promote inclusive institutional climate and autonomy over work may play critical roles in preventing and managing risk of faculty burnout at academic health science centers.Highlights What are the main findings? In analysis of data from faculty at a U.S. academic cancer center employed in both 2019 and 2021, specific aspects of faculty engagement with the institution, its leadership, and faculty perceptions of work-life quality and control over their work were associated with report of burnout in 2021, revealing opportunities for institutional intervention. While prior burnout was predominantly associated with future burnout, it alone did not doom all faculty to future burnout as other factors were also independently associated with future burnout, including for those not reporting burnout earlier. What are the implications of the main findings? Individual-level interventions to prevent and ameliorate burnout are important as others report, but our work revealed that faculty perception and experience of institutional-level factors may also be key to addressing faculty burnout at similar academic health science centers. Strategies to promote inclusive institutional climate and autonomy over work may play critical roles in preventing and managing risk of faculty burnout at academic health science centers.Abstract Background/Objectives: Burnout among academic health professionals affects well-being and performance of critical responsibilities-clinical, research, administrative, and teaching. Despite growing attention, study limitations hinder understanding the mechanisms of burnout among health professionals fully. This study identifies individual and institutional factors associated with faculty burnout at a U.S. academic cancer center. Methods: From 2019 to 2021, all faculty at a large research hospital, regardless of rank, were invited to complete employee surveys, which assessed institutional support, work-life balance, and job demands. Burnout in 2021 served as the primary outcome, measured using a validated single-item scale with five response options: 1-2 were classified as not burned out and 3-5 as burned out. Using classification and regression tree (CART) analysis, a flexible, non-parametric approach that does not require distributional assumptions of the outcome variable and is well-suited for handling complex, non-linear relationships and interactions among multiple predictors, we explored without a priori hypotheses factors contributing to burnout status in 2021, using prior burnout experience and institutional factors assessed in both years as predictors. Results: This cross-sectional analysis revealed both report of burnout in 2019 and perceptions of low institutional inclusion linked to burnout in 2021, while higher report of job accomplishment and of empowerment was associated with lower burnout in 2021. Past burnout did not doom faculty to future burnout when they felt a strong sense of institutional inclusion and support in adapting to institutional change, indicating that burnout can be mitigated, even after a pandemic. Conclusions: Patterns of burnout were related to faculty engagement with the institution and leadership and their perceptions of work-life quality and control over their work, revealing opportunities for intervention. Strengthening support systems, promoting strategies for managing professional and personal demands better, and optimizing workloads may mitigate risk for faculty in academic health centers.
Keywords:
faculty burnout
health professionals
classification and regression tree (CART)
institutional support
leadership
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