Skip to main content
Log in

Concurrent Validity of Single-Item Measures of Emotional Exhaustion and Depersonalization in Burnout Assessment

Journal of General Internal Medicine Aims and scope Submit manuscript

ABSTRACT

BACKGROUND

Burnout is a common problem among physicians and physicians-in-training. The Maslach Burnout Inventory (MBI) is the gold standard for burnout assessment, but the length of this well-validated 22-item instrument can limit its feasibility for survey research.

OBJECTIVE

To evaluate the concurrent validity of two questions relative to the full MBI for measuring the association of burnout with published outcomes.

DESIGN, PARTICIPANTS, AND MAIN MEASURES

The single questions “I feel burned out from my work” and “I have become more callous toward people since I took this job,” representing the emotional exhaustion and depersonalization domains of burnout, respectively, were evaluated in published studies of medical students, internal medicine residents, and practicing surgeons. We compared predictive models for the association of each question, versus the full MBI, using longitudinal data on burnout and suicidality from 2006 and 2007 for 858 medical students at five United States medical schools, cross-sectional data on burnout and serious thoughts of dropping out of medical school from 2007 for 2222 medical students at seven United States medical schools, and cross-sectional data on burnout and unprofessional attitudes and behaviors from 2009 for 2566 medical students at seven United States medical schools. We also assessed results for longitudinal data on burnout and perceived major medical errors from 2003 to 2009 for 321 Mayo Clinic Rochester internal medicine residents and cross-sectional data on burnout and both perceived major medical errors and suicidality from 2008 for 7,905 respondents to a national survey of members of the American College of Surgeons.

KEY RESULTS

Point estimates of effect for models based on the single-item measures were uniformly consistent with those reported for models based on the full MBI. The single-item measures of emotional exhaustion and depersonalization exhibited strong associations with each published outcome (all p ≤0.008). No conclusion regarding the relationship between burnout and any outcome variable was altered by the use of the single-item measures rather than the full MBI.

CONCLUSIONS

Relative to the full MBI, single-item measures of emotional exhaustion and depersonalization exhibit strong and consistent associations with key outcomes in medical students, internal medicine residents, and practicing surgeons.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1.
Figure 2.

References

  1. Haas JS, Cook EF, Puopolo AL, Burstin HR, Cleary PD, Brennan TA. Is the professional satisfaction of general internists associated with patient satisfaction? J Gen Intern Med. 2000;15:122–8.

    Article  PubMed  CAS  Google Scholar 

  2. Shanafelt TD, Bradley KA, Wipf JE, Back AL. Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med. 2002;136:358–67.

    PubMed  Google Scholar 

  3. West CP, Huschka MM, Novotny PJ, et al. Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA. 2006;296:1071–8.

    Article  PubMed  CAS  Google Scholar 

  4. Dyrbye LN, Thomas MR, Massie FS, et al. Burnout and suicidal ideation among U.S. medical students. Ann Intern Med. 2008;149:334–41.

    PubMed  Google Scholar 

  5. West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302:1294–1300.

    Article  PubMed  CAS  Google Scholar 

  6. Dyrbye LN, Thomas MR, Power DV, et al. Burnout and serious thoughts of dropping out of medical school: a multi-institutional study. Acad Med. 2010;85:94–102.

    Article  PubMed  Google Scholar 

  7. Dyrbye LN, Massie FS Jr, Eacker A, et al. Relationship between burnout and professional conduct and attitudes among US medical students. JAMA. 2010;304:1173–80.

    Article  PubMed  CAS  Google Scholar 

  8. Shanafelt TD, Balch CM, Bechamps G, et al. Burnout and medical errors among American surgeons. Ann Surg. 2010;251:995–1000.

    Article  PubMed  Google Scholar 

  9. Shanafelt TD, Balch CM, Dyrbye L, et al. Suicidal ideation among American surgeons. Arch Surg. 2011;146:54–62.

    Article  PubMed  Google Scholar 

  10. West CP, Shanafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306:952–60.

    Article  PubMed  CAS  Google Scholar 

  11. Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto, CA: Consulting Psychologists Press; 1996.

    Google Scholar 

  12. Rafferty JP, Lemkau JP, Purdy RR, Rudisill JR. Validity of the Maslach Burnout Inventory for family practice physicians. J Clin Psychol. 1986;42:488–492.

    Article  PubMed  CAS  Google Scholar 

  13. Thomas NK. Resident burnout. JAMA. 2004;292:2880–9.

    Article  PubMed  CAS  Google Scholar 

  14. West CP, Dyrbye LN, Sloan JA, Shanafelt TD. Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med. 2009;24:1318–21.

    Article  PubMed  Google Scholar 

  15. Rohland BM, Kruse GR, Rohrer JE. Validation of a single-item measure of burnout against the Maslach Burnout Inventory among physicians. Stress Health. 2004;20:75–9.

    Article  Google Scholar 

  16. Hansen V, Girgis A. Can a single question effectively screen for burnout in Australian cancer care workers? BMC Health Serv Res. 2010;10:341.

    Article  PubMed  Google Scholar 

  17. Maslach C, Jackson SE. The measurement of experienced burnout. J Occup Behav. 1981;2:99–113.

    Article  Google Scholar 

Download references

Acknowledgments

This work was supported by the Mayo Clinic Department of Medicine Program on Physician Well-Being The authors wish to acknowledge the participation of the American College of Surgeons and the site leaders for each medical school, Steven J. Durning, MD (Uniformed Services University of the Health Sciences), Anne M. Eacker, MD (University of Washington School of Medicine), William Harper, MD (University of Chicago Pritzker School of Medicine), F. Stanford Massie, MD (University of Alabama School of Medicine), Christine Y. Moutier, MD (University of California, San Diego), David V Power, MD (University of Minnesota Medical School), and Matthew R. Thomas, MD (Mayo Clinic).

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Colin P. West MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

West, C.P., Dyrbye, L.N., Satele, D.V. et al. Concurrent Validity of Single-Item Measures of Emotional Exhaustion and Depersonalization in Burnout Assessment. J GEN INTERN MED 27, 1445–1452 (2012). https://doi.org/10.1007/s11606-012-2015-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-012-2015-7

KEY WORDS

Navigation