6/17/2023 0 Comments Depersonalization symptomsFrom this dataset, we excluded physicians who were not in practice in the US or retired at the time of the survey. Further sampling design details are published in Shanafelt et al. Participants were sampled via email from the American Medical Association Physician Master File. (2015) to monitor the national prevalence of physician burnout. This study used secondary survey data on the 22-item MBI from the 2014 wave of the anonymous, cross-sectional study conducted by Shanafelt et al. As a secondary aim, we evaluated the precision bandwidth of each MBI subscale relative to where US physicians’ scores are distributed on each metric. We produced a crosswalk mapping raw (total) MBI subscale scores to scaled (IRT-based) scores and associated response profiles. Our primary aim was to create response profiles describing the probability of burnout symptoms across standardized MBI subscale scores in US physicians. In this study, we leveraged the content-referenced and norm-referenced score interpretation of IRT-calibrated (estimated) models to better understand the meaning of MBI subscale scores in a national US physician sample. However, no studies have applied IRT methods to evaluate the MBI in a national sample of US physicians. IRT analyses are routinely used in health outcome measurement and are part of the NIH Patient Reported Outcome Measurement Information System (PROMIS) scientific standards for health outcome measurement development and validation. Using IRT to estimate physicians’ probability of endorsing MBI subscale items across different burnout symptom severity levels, scores can be interpreted based on how likely a physician is to endorse a particular item (e.g., “I feel burned out from my work”) at a particular frequency (e.g., “once a week” or more) and relative to the mean score of the sample (i.e., content-referenced and norm-referenced scoring, respectively). The use of item response theory (IRT) measurement methods can facilitate an enhanced understanding of subscale scores over traditional methods. Traditional measurement methods do not permit users to directly compare subscale scores with the content of items to interpret their meaning. One contributor to the observed inconsistencies in defining dichotomous burnout outcomes on the MBI may be the lack of clarity regarding the meaning of subscale scores. ![]() ![]() While the MBI is the most widely used physician burnout outcome assessment, a recent systematic review found a lack of consistency in cut-points used to define dichotomous burnout outcomes on each continuous MBI subscale, contributing to a marked heterogeneity in reported burnout prevalences across studies. Our results can be used to better understand the meaning and precision of MBI scores in US physicians compare individual/group MBI scores against a reference population of US physicians and inform the selection of subscale cut-points for defining categorical physician burnout outcomes.Ĭurrent US health policy discussions surrounding the physician burnout crisis have largely been informed by prevalence studies employing the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI). We produced a crosswalk mapping raw MBI subscale scores to scaled scores and response profiles calibrated in a US physician sample. Each subscale assessed the majority of sample score ranges with ≥ 0.70 reliability. ![]() At the commonly used EE and DP cut-points of 27 and 10, respectively, a physician was unlikely to endorse feeling burned out or any DP symptoms once weekly or more. The average US physician was likely to endorse feeling he/she is emotionally drained, used up, frustrated, and working too hard and all PA indicators once weekly or more but was unlikely to endorse feeling any DP symptoms once weekly or more. Response profiles were mapped to raw subscale scores and used to predict symptom endorsements at mean scores and commonly used cut-points. Using item response theory (IRT) analyses of secondary, cross-sectional survey data, we created response profiles describing the probability of burnout symptoms associated with US physicians’ MBI emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) subscale scores. We described the burnout symptoms and precision associated with MBI scores in US physicians. Current US health policy discussions regarding physician burnout have largely been informed by studies employing the Maslach Burnout Inventory (MBI) yet, there is little in the literature focused on interpreting MBI scores.
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