{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T09:41:02Z","timestamp":1775727662275,"version":"3.50.1"},"reference-count":42,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T00:00:00Z","timestamp":1663545600000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","award":["NMRC\/CG\/004\/2013"],"award-info":[{"award-number":["NMRC\/CG\/004\/2013"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,9,2]]},"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Recent research suggests that burn-out is high and appears to be rooted in system-level factors including the local learning environment (LE). While most studies on this topic have been cross-sectional, our aim was to explore the relationship between burn-out and the LE over time within psychiatry residents. We hypothesised that burn-out is a significant predictor of learner perception of overall and all subdomains of LE within residents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a repeated measures questionnaire study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We surveyed psychiatry residents in Singapore between January 2016 and December 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The Oldenburg Burnout Inventory and the Postgraduate Hospital Education Environment Measure (PHEEM) were used to assess burn-out and resident perception of the LE, respectively. Linear mixed modelling was used to examine changes in PHEEM scores over time while taking into account burn-out status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Overall, 93 residents (response rate 89.4%) took part.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average difference between initial PHEEM total scores for residents with and without burn-out was significant (p&lt;0.001). Burn-out status was a significant predictor of lower overall and all subdomain PHEEM scores at baseline (all p&lt;0.001). PHEEM Teaching scores showed a significant increase over time for all residents regardless of burn-out status (p&lt;0.05). However, PHEEM Total, Role Autonomy, Social Support scores did not change significantly over time or change significantly between residents with or without burn-out.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Perceptions of LE among psychiatry residents at baseline are inversely associated with burn-out status. That only the Teaching subdomain score increased over time could be accounted for by the fact that it is a more tangible and visible aspect of the LE compared with perceived role autonomy or social support subdomains. Our findings underscore the importance of attending to the well-being and improving the LE of our residents so as to optimise learning during training.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-060148","type":"journal-article","created":{"date-parts":[[2022,9,19]],"date-time":"2022-09-19T13:07:29Z","timestamp":1663592849000},"page":"e060148","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Burn-out and relationship with the learning environment among psychiatry residents: a longitudinal study"],"prefix":"10.1136","volume":"12","author":[{"given":"Qian Hui","family":"Chew","sequence":"first","affiliation":[{"name":"Research Division, Woodbridge Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Cleland","sequence":"additional","affiliation":[{"name":"Medical Education Research and Scholarship Unit, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3209-9626","authenticated-orcid":false,"given":"Kang","family":"Sim","sequence":"additional","affiliation":[{"name":"West Region, Woodbridge Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,9,19]]},"reference":[{"key":"2025120601065839000_12.9.e060148.1","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1007\/s40596-018-0939-x","article-title":"Exploring the association between electronic health record use and burnout among psychiatry residents and faculty: a pilot survey study","volume":"42","author":"Domaney","year":"2018","journal-title":"Acad Psychiatry"},{"key":"2025120601065839000_12.9.e060148.2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1001\/jamainternmed.2016.7674","article-title":"Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis","volume":"177","author":"Panagioti","year":"2017","journal-title":"JAMA Intern Med"},{"key":"2025120601065839000_12.9.e060148.3","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1097\/ACM.0000000000003094","article-title":"Redesigning the learning environment to promote learner well-being and professional development","volume":"95","author":"Dyrbye","year":"2020","journal-title":"Acad Med"},{"key":"2025120601065839000_12.9.e060148.4","unstructured":"National Academies of Sciences, Engineering and Medicine . 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