Differential Sources of Distress in Clinical and Research Trainees: A Focus on Work and Role Relationships

Abstract

Objective

To examine the experience of clinical and research trainees within an academic medical center setting to identify and compare factors influencing their wellbeing.

Participants and Methods

A cross-sectional, anonymous survey was conducted from June to July 2022 at a large academic medical center. Responses from clinical and research trainees were analyzed for this study. The survey assessed participant wellbeing using the Well-Being Index (WBI), in addition to perceptions of individual and organizational factors. Data were analyzed to identify correlates of elevated WBI scores and differences in clinical and research experience.

Results

Ordinal logistic regression analysis identified low sense of recognition (odds ratio [OR], 0.59; 95% CI, 0.44-0.79), low role clarity (OR, 0.58; 95% CI, 0.42-0.80), moral distress (OR, 1.61; 95% CI, 1.24-2.10), and social isolation or loneliness (OR, 2.79; 95% CI 1.69-4.61) as significantly associated with high WBI scores, accounting for 48.8% of predicted variance. Additionally, distressed clinical trainees (WBI≥2) reported lower control over their work (P<.001) and significantly higher perceived stress from heavy workload (P<.05) and long hours (P<.01), compared with distressed research trainees. Distressed research trainees reported lower levels of trust in their supervisor (P<0.01), lower perceived organizational support (P<.05), and lower role clarity (P<.05), compared with distressed medical trainees. Low recognition, moral distress, and perceived stress from social isolation and loneliness were experienced similarly between groups.

Conclusion

Our study indicates that trainees experience high levels of distress, although the sources differ. To effectively address these challenges, organizations should implement interventions targeted to address specific stressors of each group.