Examining resident burnout through the lens of self-determination theory: The role of general causality orientations

Adam Neufeld, Greg Malin, Oksana Babenko, Cesar Orsini

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Abstract

Background: Burnout continues to plague graduate medical education, but theory-informed approaches are lacking for effectively tackling this problem. Studies on personal factors that explain physician burnout have also neglected the role of self-determination. In self-determination theory (SDT), general causality orientations—autonomy, control, and impersonal—represent individual differences in self-determination that can be socialized and primed within environments, each relating to different motivation, behaviour, and well-being outcomes. Objective: This study therefore investigates how each general causality orientation relates to resident burnout, the hypothesis being that the autonomy orientation will negatively correlate, while the control and impersonal orientations will positively correlate. Methods: Surveys containing demographic questions and two scales—the Causality Orientations at Work Scale (COWS) and Oldenburg Burnout Inventory (OLBI)—were sent in 2023 to a sample of Canadian residents across three institutions. Correlation and multiple regression analyses were performed, controlling for significant demographic factors. Results: A total of 243/1,200 residents (20.2%) completed the survey. The three general causality orientations accounted for 31.5% of the variance in resident burnout, autonomy correlating negatively (B = -.24, p < .001, CI, -.37 to -.11) and control (B = .20, p = .003, CI, .07 to .33) and impersonal (B = .28, p < .001, CI, .13 to .42) correlating positively. Conclusions: Resident burnout is positively associated with the control and impersonal causality orientations, and negatively associated with the autonomy causality orientation.
Original languageEnglish
JournalJournal of Graduate Medical Education
Publication statusAccepted/In press - 19 Dec 2024

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