The Association of Master Adaptive Learning With Less Burnout and More Resilience in Obstetrics and Gynecology Residents

Sally A Santen; Samara B Ginzburg; Martin V Pusic; Judee Richardson; Erika Banks; Karen E George; Maya M Hammoud; Meg Wolff; Helen K Morgan

doi:10.1097/ACM.0000000000005733

The Association of Master Adaptive Learning With Less Burnout and More Resilience in Obstetrics and Gynecology Residents

Acad Med. 2024 Apr 5. doi: 10.1097/ACM.0000000000005733. Online ahead of print.

Authors

Sally A Santen¹, Samara B Ginzburg², Martin V Pusic³, Judee Richardson⁴, Erika Banks⁵, Karen E George⁶, Maya M Hammoud⁷, Meg Wolff⁸, Helen K Morgan⁹

Affiliations

¹ S.A. Santen was senior associate dean, Virginia Commonwealth University School of Medicine, Richmond, Virginia, at the time of writing and is now associate dean and professor of emergency medicine and medical education, University of Cincinnati, Cincinnati, Ohio; ORCID: https://orcid.org/0000-0002-8327-8002.
² S.B. Ginzburg is vice dean, dean for education, and associate professor of medicine and science education, Donald and Barbara Zucker School of Medicine, Hempstead, New York.
³ M.V. Pusic is associate professor of pediatrics and emergency medicine, Harvard Medical School, Boston, Massachusetts, and director, American Board of Medical Specialties Research Education Foundation, Chicago, Illinois; ORCID: https://orcid.org/0000-0001-5236-6598.
⁴ J. Richardson is director of medical education research and program evaluation, American Medical Association, and adjunct lecturer, Department of Medical Education, University of Illinois College of Medicine, Chicago, Illinois; ORCID: https://orcid.org/0000-0001-5869-4293.
⁵ E. Banks is professor and chair of obstetrics and gynecology, NYU Langone Hospital-Long Island, Mineola, New York.
⁶ K.E. George is associate dean for students and associate professor of obstetrics and gynecology, The Robert Larner, M.D., College of Medicine, University of Vermont, Burlington, Vermont; ORCID: https://orcid.org/0000-0003-2925-2351.
⁷ M.M. Hammoud is professor of obstetrics and gynecology and learning health sciences, University of Michigan, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0001-7829-7930.
⁸ M. Wolff is associate professor of emergency medicine and pediatrics, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0002-3637-2653.
⁹ H.K. Morgan is clinical professor of obstetrics and gynecology and learning health sciences, University of Michigan, Ann Arbor, Michigan; ORCID: https://orcid.org/0000-0002-6674-5377.

PMID: 38579263
DOI: 10.1097/ACM.0000000000005733

Abstract

Purpose: Medical education should prepare learners for complex and evolving work, and should ideally include the Master Adaptive Learner (MAL) model-meta-learning skills for continuous self-regulated learning. This study aimed to measure obstetrics and gynecology (OB/GYN) residents' MAL attributes, assess associations with burnout and resilience, and explore learning task associations with MAL.

Method: OB/GYN residents were surveyed electronically at an in-training examination in January 2022. The survey included demographic information, the 2-item Maslach Burnout Inventory, the 2-item Connor-Davidson Resilience Scale, 4 MAL items (e.g., "I take every opportunity to learn new things"), and questions about training and learning experiences.

Results: Of 5,761 residents, 3,741 respondents (65%) were included. A total of 1,478 of 3,386 (39%) demonstrated burnout (responded positive for burnout on emotional exhaustion or depersonalization items). The mean (SD) Connor-Davidson Resilience Scale score was 6.4 (1.2) of a total possible score of 8. The mean (SD) MAL score was 16.3 (2.8) of a total possible score of 20. The MAL score was inversely associated with burnout, with lower MAL scores for residents with (mean [SD] MAL score, 16.5 [2.4]) vs without (mean [SD], 16.0 [2.3]) burnout (P < .001). Higher MAL scores were associated with higher resilience (R = 0.29, P < .001). Higher MAL scores were associated with the statement, "I feel that I was well prepared for my first year of residency" (R = 0.19, P < .001) and a plan to complete subspecialty training after residency (mean [SD] of 16.6 [2.4] for "yes" and 16.2 [2.4] for "no," P < .001).

Conclusions: Residents who scored higher on MAL showed more resilience and less burnout. Whether less resilient, burned-out residents did not have the agency to achieve MAL status or whether MAL behaviors filled the resiliency reservoir and protected against burnout is not clear.