![]() Moreover, we are not aware of any previous study examining concurrent validity of the self-defined and MBI responses with related, validated work environment measures. However, no comparison to our knowledge has described sensitivity and specificity for the self-defined burnout measure and MBI subscales. These results suggest that the single-item self-defined burnout measure and MBI subscales have strong agreement. 21 Compared to the self-defined burnout single-item, the MBI emotional exhaustion single-item had a high correlation ( r = 0.79) and sensitivity and specificity over 80%. A correlation of 0.61–0.72 was found for the MBI cynicism single-item vs. A correlation of 0.76–0.83 was found for the MBI emotional exhaustion single-item vs. Prior studies have also analyzed sensitivity and specificity for MBI single-item measures (one item from each MBI subscale’s five items). ![]() The self-defined burnout measure significantly predicted high emotional exhaustion but did not predict low emotional exhaustion or any category of cynicism. That study, a survey of rural physicians and advance practice clinicians, examined whether the self-defined burnout measure predicted high and low MBI subscale burnout categories using multivariate linear mixed models. 19 Only one study used an analytic approach other than correlations. 18 A second study of Australian oncology workers also found the self-defined burnout measure and MBI emotional exhaustion subscale strongly correlated ( r = 0.68, p < 0.0001). One physician survey found the self-defined burnout measure strongly correlated with the MBI emotional exhaustion subscale ( r = 0.64, p < 0.0001) the cynicism subscale was less strongly correlated ( r = 0.324, p value not reported). Published Comparisons of Burnout Measuresįew studies directly compare how the MBI and self-defined burnout measures perform in the same sample of physicians. 10 The item originated from a study of burnout in HMOs 11 and has subsequently been included in several major studies. The self-defined burnout measure is one of the ten survey questions on the “Mini-Z” work experience instrument developed by Linzer and colleagues. 9 MBI instruments require a license fee to administer. The 16-item General MBI survey uses the terms cynicism and personal accomplishment while the 22-item Health Services Personnel survey uses the analogous terms depersonalization and professional efficacy, with results consistent across survey versions. It is composed of three dimensions: emotional exhaustion, cynicism (or depersonalization), and personal accomplishment (or professional efficacy). The MBI, considered an industry standard, has been fielded across large samples of diverse occupations in multiple countries. Two common measures are the Maslach Burnout Inventory (MBI) and a five-choice, single item based on self-defined burnout. Within this context of heightened attention to clinician and staff well-being, greater understanding of the instruments used to measure burnout is essential. 6 The American Board of Family Medicine added work experience questions to its 2016 recertification registration to better understand and track burnout, 7 and CEOs of leading healthcare organizations have issued a call to action that argues for regular measurement of physician well-being. 5 The Society for General Internal Medicine made burnout a theme of its 2017 Annual Meeting. 4 The American Medical Association’s “STEPS Forward” modules offer guidance on practice transformation and clinician and trainee well-being. Several burnout-related initiatives aim to support the “quadruple aim” of a sustainable clinician and staff work experience in addition to improved patient experience, quality, and lower costs. A burntout workforce may adversely affect clinical quality, patient experience, and costs of care. High levels of burnout are concerning not only for clinician and staff well-being. The National Academy of Medicine 1 and Agency for Healthcare Quality and Research 2, 3 have spotlighted concerning levels of burnout among clinicians and healthcare staff, particularly in primary care.
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