Stress and burnout among attending and resident physicians in the ED: a comparative study

Emergency department physicians work in complex care settings with frequent exposure to stressful conditions. Burnout in physicians is increasing each year, and one of the most prone groups are emergency medicine providers. This research sought to understand if a difference in stress levels and burnout rate exists between attending and resident physicians working in an academic Level 1 trauma center emergency department on the same shift. Twelve attending and resident physicians from Greenville Memorial Hospital in Greenville, SC, participated in the study. Stress levels were estimated using physiological measures, including heart rate variability and electrodermal activity. Burnout scores and workload index were collected using the Maslach Burnout Inventory-Human Services Survey, and the NASA-TLX survey. Over 100h of physiological data were collected, and 42 events were compared across the two physician groups. Attending physicians showed a higher heart rate variability for the entire shift, RMSSD (44.2 vs. 35.4, p = .033) and during the trauma events, RMSSD (47.0 vs. 35.2, p = .001), LF/HF ratio (1.7 vs. 2.5, p = .001), implying lower stress levels. Furthermore, attending physicians recorded a lower workload index (35.1 vs. 49.2, p=.004). However, no significant differences were observed in the burnout scores.