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  • Jane C. Johnson
Published/Copyright: June 1, 2018
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 118 Issue 6

I appreciate the opportunity to discuss our study1 examining the factor structure of the Medical Education Hassles Scale-R (MEHS-R) by addressing the questions presented by Kendall and Castro-Alves.2 Kendall and Castro-Alves2 identified 3 questions for which they requested clarification and additional information: (1) potential survey response fatigue caused by the length of the MEHS-R, (2) the effect of program leadership on burnout, and (3) other factors that may lead to burnout in medical students.

Regarding the first question, survey response fatigue can occur from the number of items on a survey or from the number of surveys given within a short period. Wolf et al3 included the item “filling out forms” as 1 of the 101 items on the MEHS-R. In recognition of the potential for survey response fatigue, we examined the frequency of endorsement as a hassle and variability of responses to the 101 items of the MEHS-R (unpublished data). Almost 50 items had responses with infrequent endorsement as a hassle and low variability of responses, indicating they could potentially be eliminated from the scale. Factor analysis of the modified 53-item MEHS-R identified 5 subscales with adequate Cronbach α, and the fit indices for the confirmatory factor analyses conducted were marginally higher than those of the 101-item MEHS-R analysis. However, the elimination of some items may have resulted from the rural location of the medical schools included in the study. Additional testing at a larger variety of medical schools would improve the validity of the process. Even with the elimination of almost 50 items to form the modified MEHS-R, information on many different potential hassles is necessary to identify the types of stress that predict burnout to develop effectively targeted wellness interventions. As such, the need to obtain more specific information about the stress experienced by medical students may outweigh the risk of potential survey response fatigue.

The other 2 questions of Kendall and Castro-Alves2 both relate to factors that potentially affect medical student burnout apart from the types of stress identified by our study.1 Learning environment, including support from program leadership and clerkship organization, and some medical student workplace factors such as overnight call are significant predictors of burnout in medical students, while other factors, such as number of patients seen, are not.4,5 Future studies could examine whether the types of stress experienced by medical students moderate the relationship of learning environment and workplace factors with burnout. Results of such studies could further aid in the development of targeted wellness interventions to reduce or prevent burnout in medical students.

A.T. Still Research Institute, A.T. Still University, Kirksville, Missouri

References

1. Johnson JC , DegenhardtBF, SmithCK, WolfTM, PetersonDF. Tool for predicting medical student burnout from sustained stress levels: factor analysis of the Medical Education Hassles Scale-R. J Am Osteopath Assoc. 2018;118(3):170-180. doi:10.7556/jaoa.2018.036Search in Google Scholar PubMed

2. Kendall MC , Castro-AlvesLJ. Instrument development to evaluate student burnout and stress [letter]. J Am Osteopath Assoc. 2018;118(6):364-365.Search in Google Scholar

3. Wolf TM , von AlmenTK, FaucettJM, RandallHM, FranklinFA. Psychosocial changes during the first year of medical school. Med Educ. 1991;25(3):174-181.10.1111/j.1365-2923.1991.tb00049.xSearch in Google Scholar PubMed

4. Dyrbye LN , ThomasMR, HarperW, et al. The learning environment and medical student burnout: a multicentre study. Med Educ. 2009;43(3):274-282. doi:10.1111/j.1365-2923.2008.03282.xSearch in Google Scholar PubMed

5. IsHak W , NikraveshR, LedererS, PerryR, OgunyemiD, BernsteinC. Burnout in medical students: a systematic review. Clin Teach. 2013;10(4):242-245. doi:10.1111/tct.12014Search in Google Scholar PubMed

Published Online: 2018-06-01
Published in Print: 2018-06-01

© 2018 American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Articles in the same Issue

  1. SPECIAL COMMUNICATION
  2. Insights on the Nationwide Project in Osteopathic Medical Education and Empathy (POMEE)
  3. SURF
  4. Perceptions of and Attitudes Toward Diabetes Among Chinese Americans
  5. OMT MINUTE
  6. Osteopathic Cranial Manipulative Medicine in the Setting of Concussion
  7. LETTERS TO THE EDITOR
  8. Patient Engagement in Coauthored Medical Records
  9. Response
  10. Tool for Predicting Medical Student Burnout From Sustained Stress Levels
  11. Response
  12. AOA COMMUNICATION (REPRINT)
  13. Official Call: 2018 Annual Business Meeting of the American Osteopathic Association
  14. AOA COMMUNICATION
  15. Proposed Amendments to the AOA Constitution, Bylaws, and Code of Ethics
  16. ORIGINAL CONTRIBUTION
  17. Reducing Health Disparities: Understanding the Unintended Effects of Health Care Professional and Patient Characteristics on Treatment
  18. Practice Area Intentions of Graduates of Colleges of Osteopathic Medicine: What Role Does Debt Play?
  19. BRIEF REPORT
  20. First-Year Osteopathic Medical Students’ Knowledge of and Attitudes Toward Physical Activity
  21. Osteopathic Manipulative Therapy Potentiates Motor Cortical Plasticity
  22. Safety of Osteopathic Cranial Manipulative Medicine as an Adjunct to Conventional Postconcussion Symptom Management: A Pilot Study
  23. JAOA/AACOM MEDICAL EDUCATION
  24. Use of a Clinical Pathologic Conference to Demonstrate Residents’ ACGME Emergency Medicine Milestones, Aid in Faculty Development, and Increase Academic Output
  25. CASE REPORT
  26. Primary Lung Signet Ring Cell Carcinoma Presenting as a Cavitary Pancoast Tumor in a 32-Year-Old Man
  27. CLINICAL IMAGES
  28. Constrictive Pericarditis
  29. IN YOUR WORDS
  30. Anastamosis
https://doi.org/10.7556/jaoa.2018.080
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. SPECIAL COMMUNICATION
  2. Insights on the Nationwide Project in Osteopathic Medical Education and Empathy (POMEE)
  3. SURF
  4. Perceptions of and Attitudes Toward Diabetes Among Chinese Americans
  5. OMT MINUTE
  6. Osteopathic Cranial Manipulative Medicine in the Setting of Concussion
  7. LETTERS TO THE EDITOR
  8. Patient Engagement in Coauthored Medical Records
  9. Response
  10. Tool for Predicting Medical Student Burnout From Sustained Stress Levels
  11. Response
  12. AOA COMMUNICATION (REPRINT)
  13. Official Call: 2018 Annual Business Meeting of the American Osteopathic Association
  14. AOA COMMUNICATION
  15. Proposed Amendments to the AOA Constitution, Bylaws, and Code of Ethics
  16. ORIGINAL CONTRIBUTION
  17. Reducing Health Disparities: Understanding the Unintended Effects of Health Care Professional and Patient Characteristics on Treatment
  18. Practice Area Intentions of Graduates of Colleges of Osteopathic Medicine: What Role Does Debt Play?
  19. BRIEF REPORT
  20. First-Year Osteopathic Medical Students’ Knowledge of and Attitudes Toward Physical Activity
  21. Osteopathic Manipulative Therapy Potentiates Motor Cortical Plasticity
  22. Safety of Osteopathic Cranial Manipulative Medicine as an Adjunct to Conventional Postconcussion Symptom Management: A Pilot Study
  23. JAOA/AACOM MEDICAL EDUCATION
  24. Use of a Clinical Pathologic Conference to Demonstrate Residents’ ACGME Emergency Medicine Milestones, Aid in Faculty Development, and Increase Academic Output
  25. CASE REPORT
  26. Primary Lung Signet Ring Cell Carcinoma Presenting as a Cavitary Pancoast Tumor in a 32-Year-Old Man
  27. CLINICAL IMAGES
  28. Constrictive Pericarditis
  29. IN YOUR WORDS
  30. Anastamosis
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