Factors Associated with Burnout among Medical Students: Roles of Grit, Resilience, and the Educational Environment.

บทคัดย่อ

Abstract:

Objective: The rigorous nature of medical education often contributes to various mental health concerns, including burnout syndrome. Students who possess strong grit and resilience attributes, coupled with a supportive educational environment, are less likely to experience burnout. This study investigates the association among grit, resilience, and the educational environment on burnout syndrome among clinical medical students.

Material and Methods: A cross-sectional study was conducted involving 103 (97.17%) fourth-to sixth-year medical students in a Chonburi Hospital, Thailand in the academic year 2023. Participants completed self-administered questionnaires including: demographic information (sex, level, GPAX, rotation and intend to study medicine), Maslach Burnout Inventory, 8-item Short Grit Scale, Davidson Resilience Scale 10 and Dundee Ready Education Environment Measure (DREEM). Data were analyzed using descriptive statistics, linear regression analysis, and binary logistic regression with statistical significance p<0.05. Ethical approval was obtained from the Chonburi Hospital Research Ethics Committee (31/67/S/q).

Results: Of the 103 participants, 61 (59.2%) were female, 70.9% had GPAX ≥ 3.0, and 68.0% were rotating in major departments. The prevalence of burnout was 53.4% (EE; Emotional exhaustion or DP; Depersonalization high level). High resilience and grit were observed in 48.5% and 20.4% of students, respectively. Significant negative correlations were found between burnout dimensions (EE, DP) and grit (β = –0.31, p = 0.049), resilience (β = –0.27, p = 0.032), and several DREEM subscales consisted of academic self-perception (β = –0.905, p < 0.001) and social self-perception (β = –0.639, p = 0.004). Multivariable logistic regression revealed that low perception of atmosphere (OR = 12.84, 95%CI 1.54–106.91, p = 0.018) and low social self-perception (OR = 9.44, 95%CI 1.92–46.46, p = 0.006) were significantly associated with burnout. The model yielded an AUC of 0.77.

Conclusion:
Grit, resilience, self-confidence, and strong peer support are key protective factors against burnout among medical students. Academic and social self-perceptions are strong predictors of burnout risk. Interventions to strengthen resilience and peer support, and to improve the educational climate, may effectively reduce burnout in clinical training.

Keywords: burnout, grit, resilience, educational environment, medical students