# The association between adverse practice experiences and residency trainee occupational burnout

## TL;DR

This study finds that adverse experiences during residency training in China are strongly linked to higher levels of occupational burnout among trainees.

## Contribution

The study identifies specific adverse practice experiences most strongly associated with burnout in Chinese residency trainees.

## Key findings

- 70.48% of residency trainees in China experience occupational burnout.
- Verbal abuse, personal service demands, and gender discrimination are the most common adverse practice experiences.
- Physical and emotional abuse exposure is most strongly linked to increased burnout scores.

## Abstract

Occupational burnout among the residency trainees in the Standardized Resident Training Program is widely prevalent in China. This study investigated the current status of Adverse Practice Experiences (APEs) among residency trainees, examines their associations with occupational burnout, and ultimately proposes targeted strategies to alleviate occupational burnout and enhance training quality.

The cross-sectional study used multi-stage stratified random sampling method was used to conduct an online survey of 1,328 residency trainees from 18 residency training bases in Guangxi, China. Analysis of variance was used to explore differences in occupational burnout by exposure of APEs, and multiple linear regression was conducted to examine the association of APEs and its exposure on trainees' occupational burnout.

The prevalence of occupational burnout among residency trainees was 70.48%. A total of 68.37% of residency trainees (908 participants) reported having encountered at least one APEs. The most common APEs were verbal abuse, which accounted for 51.51%, followed by being required to perform personal services and gender discrimination, with proportions of 49.25 and 47.14%, respectively. Residency trainees who had encountered at least one adverse practice experiences showed significantly higher occupational burnout scores (β = 0.179, 95% CI [0.119, 0.238], P < 0.001). Results from the multiple linear regression analysis revealed that physical abuse (from “low exposure group” to “high exposure group”, β = 0.172–0.339, P < 0.001) and emotional abuse exposure (from “low exposure group” to “high exposure group”, β = 0.215–0.332, P < 0.001) were the most strongly associated with occupational burnout scores.

This study finds a significant association between APEs and occupational burnout among residency trainee, but these findings do not establish causation. Residency training management departments, training bases, and trainees should collaborate to mitigate occupational burnout and foster a safer, more supportive training environment.