Dian Puspita Sari(1), Yoga Pamungkas Susani(2*), Emmy Amalia(3)

(1) Health Professional Education Development Laboratory, Faculty of Medicine, Universitas Mataram
(2) Health Professional Education Development Laboratory, Faculty of Medicine, Universitas Mataram
(3) Psychiatry Department, Faculty of Medicine, Universitas Mataram
(*) Corresponding Author


Background: The COVID-19 pandemic has caused tremendous and abrupt changes in all aspects of social life, including healthcare and education. It has caused stress and psychological impact on physicians and other healthcare workers globally. Exposure to chronic occupational stress can lead to burnout. The multiple responsibilities of academic physicians potentially lead to a higher risk of burnout, particularly during this pandemic. This study aimed to obtain burnout profiles in academic physicians and factors associated with burnout during the COVID-19 pandemic.

Methods: This was a cross-sectional study. The MBI-HSS was used to measure the three dimensions of burnout. Academic physicians' perception of distance learning, involvement in the clinical care of COVID-19 patients, involvement in faculty management, and healthcare facilities management were also included in the survey.

Results: Among 42 participants (response rate 56%), 45.2% provided care to COVID-19 patients, 42.9% were involved in the management of healthcare facilities, and 35.7% in faculty management. Median of Emotional Exhaustion (EE) was 12 (1-35), Depersonalization (DP) 6 (0-19) and Personal Accomplishment (PA) 32.5 (16-47). Based on Z-score for each dimension, 23.8% have high EE, 16.7% high DP, 50% low PA, and 11.9% categorized as burnout. Involvement in healthcare facilities management and providing care for COVID-19 patients were significantly associated with higher EE (p = .030 and p = .029 respectively), while the perception of the workload of distance learning associated significantly with higher EE (p = .046) and DP (p = .014).

Conclusion: Workload related to clinical work, healthcare management, and distance learning, associated with higher burnout in academic physicians during COVID-19 pandemic.


burnout, academic physician, COVID-19 pandemic

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  1. Nassar AK, Reid S, Kahnamoui K, Tuma F, Waheed A, McConnell M. Burnout among Academic Clinicians as It Correlates with Workload and Demographic Variables. Behav Sci (Basel) [Internet]. 2020 May 27;10(6):94. Available from: https://www.mdpi.com/2076-328X/10/6/94
  2. The Lancet. Icd-11. Lancet. 2019;393(10188):2275.
  3. Maslach C, Leiter MP. New insights into burnout and health care: Strategies for improving civility and alleviating burnout. Med Teach [Internet]. 2017;39(2):160–3. Available from: http://dx.doi.org/10.1080/0142159X.2016.1248918
  4. The Lancet. Physician burnout: a global crisis. Lancet [Internet]. 2019;394(10193):93. Available from: http://dx.doi.org/10.1016/S0140-6736(19)31573-9
  5. Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, et al. Prevalence of burnout among physicians a systematic review. JAMA - J Am Med Assoc. 2018;320(11):1131–50.
  6. Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, et al. Changes in Burnout and Satisfaction with Work-Life Balance in Physicians and the General US Working Population between 2011 and 2014. Mayo Clin Proc [Internet]. 2015;90(12):1600–13. Available from: http://dx.doi.org/10.1016/j.mayocp.2015.08.023
  7. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med [Internet]. 2012 Oct 8;172(18):1377–85. Available from: http://dx.doi.org/10.1001/archinternmed.2012.3199
  8. Shanafelt TD, Sinsky C, Dyrbye LN, Trockel M, West CP. Burnout Among Physicians Compared With Individuals With a Professional or Doctoral Degree in a Field Outside of Medicine. Mayo Clin Proc. 2019;94(3):549–51.
  9. Imo UO. Burnout and psychiatric morbidity among doctors in the UK: A systematic literature review of prevalence and associated factors. BJPsych Bull. 2017;41(4):197–204.
  10. Ziad K, Laurent B, Marianne H, Virginie V, Christophe L, Guillaume F. Burnout in French physicians: A systematic review and meta-analysis. J Affect Disord. 2019;246:132–47.
  11. Lo D, Wu F, Chan M, Chu R, Li D. A systematic review of burnout among doctors in China: A cultural perspective. Asia Pac Fam Med [Internet]. 2018;17(1):1–13. Available from: https://doi.org/10.1186/s12930-018-0040-3
  12. Sutoyo D, Kurniadi R, Fuadi I, Timur NT. Sindrom burnout pada peserta program pendidikan dokter spesialis anestesiologi dan terapi intensif Fakultas Kedokteran Universitas Padjadjaran. J Anestesi Perioper. 2018;6(3):153–61.
  13. Amoafo E, Hanbali N, Patel A, Singh P. What are the significant factors associated with burnout in doctors? Occup Med (Lond). 2015;65(2):117–21.
  14. Rao SK, Kimball AB, Lehrhoff SR, Hidrue MK, Colton DG, Ferris TG, et al. The impact of administrative burden on academic physicians: Results of a hospital-wide physician survey. Acad Med. 2017;92(2):237–43.
  15. Carmen MG, Herman J, Rao S, Hidrue MK, Ting D, Lehrhoff SR, et al. Trends and Factors Associated With Physician Burnout at a Multispecialty Academic Faculty Practice Organization. 2019;2(3):1–10.
  16. West CP, Dyrbye LN, Shanafelt TD. Physician burnout : contributors , consequences and solutions. 2018;
  17. Patel RS, Bachu R, Adikey A, Malik M, Shah M. Factors related to physician burnout and its consequences: A review. Behav Sci (Basel). 2018;8(11).
  18. Panagioti M, Geraghty K, Johnson J, Zhou A, Panagopoulou E, Chew-Graham C, et al. Association between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis. JAMA Intern Med. 2018;178(10):1317–30.
  19. Dewa CS, Loong D, Bonato S, Thanh NX, Jacobs P. How does burnout affect physician productivity? A systematic literature review. BMC Health Serv Res. 2014;14(1).
  20. Willard-Grace R, Knox M, Huang B, Hammer H, Kivlahan C, Grumbach K. Burnout and health care workforce turnover. Ann Fam Med. 2019;17(1):36–41.
  21. Glasheen JJ, Misky G., Reid MB, Harrison RA, Sharpe B, Auerbach A. Career Satisfaction and Burnout in Academic Hospital Medicine. Arch Intern Med [Internet]. 2011 Apr 25;171(8):782. Available from: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/archinternmed.2011.153
  22. Shanafelt TD, West CP, Sloan JA, Novotny PJ, Poland GA, Menaker R, et al. Career Fit and Burnout Among Academic Faculty. Arch Intern Med [Internet]. 2009 May 25;169(10):990. Available from: http://archinte.jamanetwork.com/article.aspx?doi=10.1001/archinternmed.2009.70
  23. World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard [Internet]. 2021 [cited 2020 Oct 27]. p. 1–6. Available from: https://covid19.who.int/
  24. Shreffler J, Petrey J, Huecker M. The Impact of COVID-19 on Healthcare Worker Wellness : A Scoping Review. West J Emerg Med. 2020;21(5):1059–66.
  25. Piryani RM, Piryani S, Shakya DR. Impact of COVID-19 Pandemic on Medical Education : Challenges and Opportunities for Medical educators in South Asia Impact of COVID-19 Pandemic on Medical Education : Challenges and Opportunities for Medical educators in South Asia. J BP Koirala Inst Heal Sci. 2020;(July).
  26. Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory manual [Internet]. 4th ed. Mind Garden; 2016. 52 p. Available from: https://libris.kb.se/bib/8230616
  27. Amanullah S, Ramesh Shankar R. The Impact of COVID-19 on Physician Burnout Globally: A Review. Healthc (Basel, Switzerland) [Internet]. 2020;8(4):1–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/33105757
  28. Pedersen AF, Ingeman ML, Vedsted P. Empathy, burn-out and the use of gut feeling: A cross-sectional survey of Danish general practitioners. BMJ Open. 2018;8(2):1–8.
  29. Wu Y, Wang J, Luo C, Hu S, Lin X, Anderson AE, et al. A Comparison of Burnout Frequency Among Oncology Physicians and Nurses Working on the Frontline and Usual Wards During the COVID-19 Epidemic in Wuhan, China. J Pain Symptom Manage [Internet]. 2020 Jul;60(1):e60–5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0885392420302050
  30. . West CP, Dyrbye LN, Sinsky C, Trockel M, Tutty M, Nedelec L. Resilience and Burnout Among Physicians and the General US Working Population. JAMA Netw Open. 2020;3(7):1–11.
  31. Khalafallah AM, Lam S, Gami A, Dornbos DL, Sivakumar W, Johnson JN, et al. Burnout and career satisfaction among attending neurosurgeons during the COVID-19 pandemic. Clin Neurol Neurosurg [Internet]. 2020 Nov;198(January):106193. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0303846720305369
  32. Sethi BA, Sethi A, Ali S, Aamir HS. Impact of Coronavirus disease (COVID-19) pandemic on health professionals. Pakistan J Med Sci [Internet]. 2020 May 6;36(COVID19-S4). Available from: https://www.pjms.org.pk/index.php/pjms/article/view/2779
  33. Algunmeeyn A, El-dahiyat F, Altakhineh MM, Azab M. Understanding the factors influencing healthcare providers ’ burnout during the outbreak of COVID-19 in Jordanian hospitals. J Pharm Policy Pract. 2020;13(53):1–8.
  34. Zerbini G, Ebigbo A, Reicherts P, Kunz M, Messman H. Psychosocial burden of healthcare professionals in times of COVID-19 – a survey conducted at the University Hospital Augsburg. GMS Ger Med Sci [Internet]. 2020;18:1–9. Available from: https://www.egms.de/en/journals/gms/2020-18/000281.shtml
  35. Giusti EM, Pedroli E, Aniello GED, Badiale CS, Pietrabissa G, Manna C, et al. The Psychological Impact of the COVID-19 Outbreak on Health Professionals : A Cross-Sectional Study. 2020;11(July):1–9.
  36. Shanafelt T, Ripp J, Sinai M, Trockel M. Understanding and Addressing Sources of Anxiety Among Health Care Professionals During the COVID-19 Pandemic. 2020;2019:2019–20.
  37. Dimitriu MCT, Pantea-Stoian A, Smaranda AC, Nica AA, Carap AC, Constantin VD, et al. Burnout syndrome in Romanian medical residents in time of the COVID-19 pandemic. Med Hypotheses [Internet]. 2020;144(June):109972. Available from: https://doi.org/10.1016/j.mehy.2020.109972
  38. Shen Y, Cui Y, Li N, Tian C, Chen M. Emergency Responses to Covid-19 Outbreak : Experiences and Lessons from a General Hospital in Nanjing , China. Cardiovasc Intervent Radiol [Internet]. 2020;43(6):810–9. Available from: https://doi.org/10.1007/s00270-020-02474-w
  39. Grassi A, Pizza N, Tedesco D, Zaffagnini S. The COVID-19 outbreak in Italy : perspectives from an orthopaedic hospital. 2020;
  40. Arkorful V, Abaidoo N. The role of e-learning, advantages and disadvantages of its adoption in higher education. Int J Instr Technol Distance Learn. 2015;12(1):29–42.
  41. Alsulimani T, Kaabi H. The Effect of E-Learning on Teachers’ Motivation: A Case Study in Jeddah University. Int J Manag Inf Technol. 2018;14:3316–27.
  42. Corry M, Stella J. Teacher self-efficacy in online education: A review of the literature. Res Learn Technol. 2018;26(1063519):1–12.
  43. Hodges C, Moore S, Lockee B, Trust T, Bond A. The Difference Between Emergency Remote Teaching and Online Learning [Internet]. Educause Review. 2020. Available from: https://er.educause.edu/articles/2020/3/the-difference-between-emergency-remote-teaching-and-online-learning
  44. Cutri RM, Mena J, Whiting EF. Faculty readiness for online crisis teaching: transitioning to online teaching during the COVID-19 pandemic. Eur J Teach Educ [Internet]. 2020;43(4):523–41. Available from: https://doi.org/10.1080/02619768.2020.1815702
  45. Adedoyin OB, Soykan E. Covid-19 pandemic and online learning: the challenges and opportunities. Interact Learn Environ [Internet]. 2020;0(0):1–13. Available from: https://doi.org/10.1080/10494820.2020.1813180
  46. Xu D, Jaggars SS. The impact of online learning on students’ course outcomes: Evidence from a large community and technical college system. Econ Educ Rev. 2013;37:46–57.
  47. Hadadnia S, Hadadnia N, Shahidi N. Effects of Teaching through Online Teacher versus Real Teacher on Student Learning in the Classroom. Contemp Educ Technol. 2020;3(1):50–9.
  48. Nguyen T. The Effectiveness of Online Learning: Beyond No Significant Difference and Future Horizons. MERLOT J Online Learn Teach. 2015;11(2):309–19.
  49. Shlenskaya N, Karnaukhova A, Son L, Lapteva E. Teachers’ burnout in online university courses in the time of pandemic. ACM Int Conf Proceeding Ser. 2020;7(916):95–9.
  50. Dedeilia A, Sotiropoulos MG, Hanrahan JG, Janga D, Dedeilias P, Sideris M. Medical and surgical education challenges and innovations in the COVID-19 era: A systematic review. In Vivo (Brooklyn). 2020;34:1603–11.
  51. Nadler R. Understanding “Zoom fatigue”: Theorizing spatial dynamics as third skins in computer-mediated communication. Comput Compos [Internet]. 2020;58:102613. Available from: https://doi.org/10.1016/j.compcom.2020.102613
  52. Slovak P. Effect of Videoconferencing Environments on Perception of Communication. J Psychosoc Res Cybersp. 2007;1(1):8.
  53. Antons JN, Schleicher R, Arndt S, Moller S, Curio G. Too tired for calling? A physiological measure of fatigue caused by bandwidth limitations. 2012 4th Int Work Qual Multimed Exp QoMEX 2012. 2012;(July):63–7.
  54. Sari FTA, Himayani R, Kedokteran F, Lampung U, Kedokteran MF, Lampung U. Faktor Risiko Terjadinya Computer Vision Syndrome Risk Factors Occurrence of Computer Vision Syndrome. Majority [Internet]. 2018;Vol.7 No.2(Maret):278–82. Available from: https://bapin-ismki.e-journal.id/jimki/article/view/50
  55. Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet. 2020;7(April):19–21.
  56. Blake H, Bermingham F, Johnson G, Tabner A. Mitigating the psychological impact of covid-19 on healthcare workers: A digital learning package. Int J Environ Res Public Health. 2020;17(9).
  57. Albott CS, Wozniak JR, McGlinch BP, Wall MH, Gold BS, Vinogradov S. Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Health Care Workers during the COVID-19 Pandemic. Anesth Analg. 2020;XXX(Xxx):43–54.
  58. Card AJ. Physician burnout: Resilience training is only part of the solution. Ann Fam Med. 2018;16(3):267–70.
  59. West M, Coia D. Caring for doctors. Caring for patients [Internet]. General Medical Council. General Medical Council; 2019. Available from: https://www.gmc-uk.org/about/how-we-work/corporate-strategy-plans-and-impact/supporting-a-profession-under-pressure/uk-wide-review-of-doctors-and-medical-students-wellbeing%0Ahttps://www.gmc-uk.org/-/media/documents/caring-for-doctors-caring-for-patients_

DOI: https://doi.org/10.22146/jpki.64636

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