Date on Master's Thesis/Doctoral Dissertation

5-2019

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Educational Leadership, Evaluation and Organizational Development

Degree Program

Educational Leadership and Organizational Development, PhD

Author's Keywords

burnout; academic medicine; faculty; job demands-resources; qualitative

Abstract

This dissertation examines burnout in academic medical faculty. The medical literature reports 30-45% of physicians are burned out and presents a long list of potential drivers of burnout. Interventions have shown limited success at the individual level and greater success at the organizational level, but large-scale interventions are typically time- and cost-intensive. Using the Job Demands-Resources Model (JD-R) and interpretive phenomenological analysis (IPA), this study seeks to present the ways personal, interpersonal, and job characteristics are interpreted as demands or resources by faculty and how those demands and resources work together to drive or mitigate burnout. Over six chapters, this paper summarizes current literature; discusses assumptions, methodologies, and models; answers three research questions; and positions results within current theory, methods, and practice. Chapter 1 presents a brief overview of the study, including burnout and higher educational theory. The history and context of burnout research, including its growth in medical literature, are summarized in Chapter 2, along with a case for qualitative methodologies. IPA and study methodologies are discussed in additional detail in Chapter 3. Results are divided into two sections – Chapters 4 and 5 – to explore the depth and richness of each research question. Chapter 4 presents faculty definitions of burnout as well as their opinions about their own burnout. Additionally, academic medical faculty interpretations of personal, interpersonal, and job demands and resources are described. Chapter 5 examines the interplay of these demands and resources between practice settings, specialties, and job roles, in addition to comparison by self-reported burnout level. Using dominant themes and their informant characteristics, a model for the pathophysiology of burnout is proposed. The main themes in this model are expected to transfer between settings, though the unique sub-themes should differ based on context. Chapter 6 ties the main themes of the model to existing burnout, higher education, and JD-R literature, further making the argument for the validity of the proposed model. Four specific action areas are proposed – barriers to productivity, workload, and climate; collegial culture, leadership, and faculty support; recognition; and existing coping mechanisms – with specific recommendations from the literature.

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