BackgroundPhysicians increasingly show symptoms of burnout due to the high job demands they face, posing a risk for the quality and safety of care. Job and personal resources as well as support... Show moreBackgroundPhysicians increasingly show symptoms of burnout due to the high job demands they face, posing a risk for the quality and safety of care. Job and personal resources as well as support interventions may function as protective factors when demands are high, specifically in times of crisis such as the COVID-19 pandemic. Based on the Job Demands-Resources theory, this longitudinal study investigated how monthly fluctuations in job demands and job and personal resources relate to exhaustion and work engagement and how support interventions are associated with these outcomes over time. MethodsA longitudinal survey consisting of eight monthly measures in the period 2020-2021, completed by medical specialists and residents in the Netherlands. We used validated questionnaires to assess job demands (i.e., workload), job resources (e.g., job control), personal resources (e.g., psychological capital), emotional exhaustion, and work engagement. Additionally, we measured the use of specific support interventions (e.g., professional support). Multilevel modeling and longitudinal growth curve modeling were used to analyze the data. Results378 medical specialists and residents were included in the analysis (response rate: 79.08%). Workload was associated with exhaustion (gamma = .383, p < .001). All job resources, as well as the personal resources psychological capital and self-judgement were associated with work engagement (gamma s ranging from -.093 to .345, all ps < .05). Job control and psychological capital attenuated the workload-exhaustion relationship while positive feedback and peer support strengthened it (all ps < .05). The use of professional support interventions (from a mental health expert or coach) was related to higher work engagement (estimate = .168, p = .032) over time. Participation in organized supportive group meetings was associated with higher exhaustion over time (estimate = .274, p = .006). ConclusionsJob and personal resources can safeguard work engagement and mitigate the risk of emotional exhaustion. Professional support programs are associated with higher work engagement over time, whereas organized group support meetings are associated with higher exhaustion. Our results stress the importance of professional individual-level interventions to counteract a loss of work engagement in times of crisis. Show less
Fris, D.A.H.; Vianen, A.E.M. van; Koen, J.; Hoog, M. de; Pagter, A.P.J. de 2022
Objectives: Many medical students experience career decision-making stress in the final phase of training. Yet, the factors that induce or reduce career decision-making stress and how progression... Show moreObjectives: Many medical students experience career decision-making stress in the final phase of training. Yet, the factors that induce or reduce career decision-making stress and how progression in their clerkships relates to these factors are unknown. This knowledge gap limits the possibilities for medical schools to develop and implement interventions targeting students' career decision-making stress. This study explores content, process, and context factors that may affect career decision-making stress. Methods: Using cross-sectional survey data from medical master students (n = 507), we assessed content (future work self), process (choice irreversibility, time pressure, career decision-making self-efficacy), and context (supervisory support, medical school support, study load, competition) factors and their relationships with career decision-making stress. The hypothesized relationships were tested with structural equation modelling. Results: A clearer future work self and higher career decision self-efficacy were associated with lower career decision-making stress, while experienced time pressure, competition, and study load were associated with higher career decision-making stress. Choice-irreversibility beliefs, supervisory support, and medical school support were unrelated to career decision-making stress. As students' clerkships progressed, they gained a clearer future work self, but also experienced more time pressure. Discussion: Clinical clerkships help students to form a clearer future work self, which can diminish career decision-making stress. Yet, students also experience more time pressure as the period of clerkships lengthens, which can increase career decision-making stress. A school climate of high competition and study load seems to foster career decision-making stress, while school support hardly seems effective in diminishing this stress. Show less
Solms, L.; Koen, J.; Vianen, A.E.M. van; Theeboom, T.; Beersma, B.; Pagter, A.P.J. de; Hoog, M. de 2022
Coaching is a systematic and goal-oriented one-on-one intervention by a coach aimed to guide clients in their professional and personal development. Previous research on coaching has demonstrated... Show moreCoaching is a systematic and goal-oriented one-on-one intervention by a coach aimed to guide clients in their professional and personal development. Previous research on coaching has demonstrated effects on a number of positive outcomes, including well-being and performance, yet little is known about the processes that underlie these outcomes, such as the type of questions coaches use. Here, we focus on three different types of coaching questions, and aim to uncover their immediate and sustained effects for affect, self-efficacy, and goal-directed outcomes, using a between-subjects experiment. One hundred and eighty-three medical residents and PhD students from various medical centers and healthcare organizations in the Netherlands were recruited to participate in a self-coaching writing exercise, where they followed written instructions rather than interacting with a real coach. All participants were randomly allocated to one of three conditions: either one of two solution-focused coaching conditions (i.e., the success or miracle condition) or a problem-focused coaching condition. Self-report questionnaires were used to measure key outcomes of coaching, that is positive and negative affect, self-efficacy, goal orientation, action planning (i.e., quantity and quality) and goal attainment. Two follow-up measurements assessed if the effects of the self-coaching exercise led to problem-solving actions within an initial follow-up period of 14 days and a subsequent follow-up period of 10 days. Findings showed that participants experienced more positive affect, less negative affect, and higher approach goal orientation after the solution-focused coaching exercise compared to the problem-focused coaching exercise. In all conditions, goal attainment increased as a consequence of the self-coaching intervention. We discuss the implications of our findings for the science and practice of contemporary coaching. Show less
Solms, L.; Vianen, A. van; Koen, J.; Theeboom, T.; Pagter, A.P.J. de; Hoog, M. de; Challenge Support Res Network 2021
Objectives Physician burn-out is increasing, starting already among residents. The consequences of burn-out are not limited to physicians' well-being, they also pose a threat to patient care and... Show moreObjectives Physician burn-out is increasing, starting already among residents. The consequences of burn-out are not limited to physicians' well-being, they also pose a threat to patient care and safety. This study investigated the effectiveness of a professional coaching intervention to reduce burn-out symptoms and foster personal resources in residents and specialists.Design In a controlled field experiment, medical residents and specialists received six coaching sessions, while a control group did not undergo any treatment. The authors assessed burn-out symptoms of exhaustion and cynicism, the personal resources psychological capital, psychological flexibility and self-compassion, as well as job demands and job resources with validated questionnaires (January 2017 until August 2018). The authors conducted repeated measures analyses of variance procedures to examine changes over time for the intervention and the control group.Setting Four academic hospitals in the Netherlands.Participants A final sample of 57 residents and specialists volunteered in an individual coaching programme. A control group of 57 physicians did not undergo any treatment.Intervention Coaching was provided by professional coaches during a period of approximately 10 months aiming at personal development and growth.Results The coaching group (response rate 68%, 57 physicians, 47 women) reported a reduction in burn-out symptoms and an increase in personal resources after the coaching intervention, while no such changes occurred in the control group (response rate 35%, 42 women), as indicated by significant time x group interactions, all p<0.01. Specifically, physicians increased their psychological capital (eta(2)(p)=0.139), their self-compassion (eta(2)(p)=0.083), and reported significantly less exhaustion (eta(2)(p)=0.126), the main component of the burn-out syndrome.Conclusion This study suggests that individual coaching is a promising route to reduce burn-out symptoms in both residents and specialists. Moreover, it strengthens personal resources that play a crucial role in the prevention of burn-out. Show less
Baas, M.; Nijstad, B. A.; Koen, J.; Boot, N. C.; De Dreu, C. K. W. 2020
Existing findings on the intriguing link between vulnerability to psychopathology and creativity are scattered and inconclusive. Here we report 3 studies (total N = 826) that tested a 2-step... Show moreExisting findings on the intriguing link between vulnerability to psychopathology and creativity are scattered and inconclusive. Here we report 3 studies (total N = 826) that tested a 2-step solution to the possible relationship between vulnerability to psychopathology and creativity. First, we propose that inclinations toward psychopathologies that are linked to the avoidance system (anxiety, depressive mood, negative schizotypy) can be clustered and distinguished from another cluster of psychopathologies that are linked to the approach system (hypomania, positive schizotypy). Second, we propose that inclinations toward avoidance-related (approach-related) psychopathologies associate with reduced (increased) creativity. Consistent with our first step, confirmatory factor analyses showed that trait anxiety, depressive mood, and negative schizotypy load on an avoidance-based vulnerability factor, whereas hypomania and positive schizotypy load on an approach-based vulnerability factor. Partial support for the second step was obtained: Whereas avoidance-based vulnerability to psychopathology was not related to creativity, approach-based vulnerability was associated with increased creativity. Finally, results showed that approach rather than avoidance-based vulnerability to psychopathology positively predicts creativity because it associates with stronger approach sensitivity toward novelty. However, based on the cross-sectional nature of our research design no conclusions regarding causality can be drawn. Show less
Solms, L.; Vianen, A.E.M. van; Theeboom, T.; Koen, J.; Pagter, A.P.J. de; Hoog, M. de; ... ; Challenge Support Res Network 2019
Objectives The high prevalence of burnout among medical residents and specialists raises concerns about the stressful demands in healthcare. This study investigated which job demands and job... Show moreObjectives The high prevalence of burnout among medical residents and specialists raises concerns about the stressful demands in healthcare. This study investigated which job demands and job resources and personal resources are associated with work engagement and burnout and whether the effects of these demands and resources differ for medical residents and specialists.Design In a survey study among residents and specialists, we assessed job demands, job resources, personal resources, work engagement and burnout symptoms using validated questionnaires (January to December 2017). Results were analysed using multivariate generalised linear model, ordinary least squares regression analyses and path analyses.Setting Five academic and general hospitals in the Netherlands.Participants A total number of 124 residents and 69 specialists participated in this study. Participants worked in the fields of pediatrics, internal medicine and neurology.Results The associations of job and personal resources with burnout and work engagement differed for residents and specialists. Psychological capital was associated with burnout only for specialists (b=-0.58, p<0.001), whereas psychological flexibility was associated with burnout only for residents (b=-0.31, p<0.001). Colleague support (b=0.49, p<0.001) and self-compassion (b=-0.33, p=0.004) were associated with work engagement only for specialists.Conclusion This study suggests that particularly personal resources safeguard the work engagement and lessen the risk of burnout of residents and specialists. Both residents and specialists benefit from psychological capital to maintain optimal functioning. In addition, residents benefit from psychological flexibility, while specialists benefit from colleague support. Personal resources seem important protective factors for physicians' work engagement and well-being. When promoting physician well-being, a one-size-fits-all approach might not be effective but, instead, interventions should be tailored to the specific needs of specialists and residents. Show less
