Do physical activity intensity and sedentary behaviour relate to burnout among medical students? Insight from two Canadian medical schools
DOI:
https://doi.org/10.36834/cmej.79169Abstract
Background: Medical school involves high expectations of medical students, which may increase their risk for burnout. Physical activity (PA) and sedentary behaviour (SB) are modifiable risk factors for burnout. However, medical students are insufficiently taught about PA and SB and may therefore be less likely to meet guideline-recommended levels of these two movement behaviours or promote them in practice. Few studies have examined the relationships between medical students’ PA intensity, SB, and burnout; such examination could help clarify educational needs for improving levels of movement behaviours and their promotion.
Purpose: This study investigated (1) the relationships between light, moderate, vigorous, and total PA, SB, and burnout among medical students, and (2) moderate-to-vigorous PA as a moderator of the relationship between SB and burnout, to guide future curriculum renewal.
Methods: Medical students (N = 129) at two Canadian institutions completed online validated questionnaires assessing light, moderate, vigorous, and total PA, SB, and burnout.
Results: Regression analyses indicated that light PA (β = -.191, p = .039) and SB (β=-.230, p = .013) were negatively associated with burnout. Moderate-to-vigorous PA did not significantly moderate the relationship between SB and burnout.
Conclusions: Engaging in lighter forms of PA and SB within guideline recommendations may help mitigate medical student burnout. Competencies to promote movement behaviours may dually target medical student burnout and curriculum gaps.
Metrics
References
Frank JR, Snell LS, Cate OT, et al. Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638–45. https://doi.org/10.3109/0142159X.2010.501190 DOI: https://doi.org/10.3109/0142159X.2010.501190
Frank JR, Danoff D. The CanMEDS initiative: Implementing an outcomes-based framework of physician competencies. Med Teach. 2007;29(7):642–7. https://doi.org/10.1080/01421590701746983 DOI: https://doi.org/10.1080/01421590701746983
Cusano R, Busche K, Coderre S, Woloschuk W, Chadbolt K, McLaughlin K. Weighing the cost of educational inflation in undergraduate medical education. Adv Health Sci Educ. 2017;22(3):789–96. https://doi.org/10.1007/s10459-016-9708-3 DOI: https://doi.org/10.1007/s10459-016-9708-3
Slavin S, D’Eon FM. Overcrowded curriculum is an impediment to change (Part A). Can Med Educ J. 2021;12(4):1–6. https://doi.org/10.36834/cmej.73532 DOI: https://doi.org/10.36834/cmej.73532
Babenko O, Mosewich A, Abraham J, Lai H. Contributions of psychological needs, self-compassion, leisure-time exercise, and achievement goals to academic engagement and exhaustion of Canadian medical students. J Educ Eval Health Prof. 2018;15:2. https://doi.org/10.3352/jeehp.2018.15.2 DOI: https://doi.org/10.3352/jeehp.2018.15.2
Frajerman A, Morvan Y, Krebs MO, Gorwood P, Chaumette B. Burnout in medical students before residency: a systematic review and meta-analysis. Eur Psychiatry. 2019;55:36–42. https://doi.org/10.1016/j.eurpsy.2018.08.006 DOI: https://doi.org/10.1016/j.eurpsy.2018.08.006
Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory. In: Maslach Burnout Inventory. Palo Alto, CA: Consulting Psychologists Press; 1996. p. 191–218. Available at https://www.researchgate.net/publication/277816643_The_Maslach_Burnout_Inventory_Manual [Accessed Nov 7, 2017].
Harries AJ, Lee C, Jones L, et al. Effects of the COVID-19 pandemic on medical students: a multicenter quantitative study. BMC Med Educ. 2021 Dec 6;21(1):14. https://doi.org/10.1186/s12909-020-02462-1 DOI: https://doi.org/10.1186/s12909-020-02462-1
Ross R, Chaput JP, Giangregorio LM, et al. Canadian 24-Hour Movement Guidelines for adults aged 18-64 years and adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab. 2020;45:S57–102. https://doi.org/dx.doi.org/10.1139/apnm-2020-0467 DOI: https://doi.org/10.1139/apnm-2020-0843
Tremblay MS, Aubert S, Barnes JD, et al. Sedentary Behavior Research Network (SBRN) - Terminology consensus project process and outcome. Int J Behav Nutr Phys Act. 2017;14:75. https://doi.org/10.1186/s12966-017-0525-8 DOI: https://doi.org/10.1186/s12966-017-0525-8
van der Ploeg HP, Hillsdon M. Is sedentary behaviour just physical inactivity by another name? Int J Behav Nutr Phys Act. 2017;14(1):1–8. https://doi.org/10.1186/s12966-017-0601-0 DOI: https://doi.org/10.1186/s12966-017-0601-0
Chellaiyan VG, Ali FL, Maruthappapandian J. Association between sedentary behaviour and depression, stress and anxiety among medical school students in Chennai, India. J Clin Diagn Res. 2018;12(11):9–12. https://doi.org/10.7860/JCDR/2018/37129.12216 DOI: https://doi.org/10.7860/JCDR/2018/37129.12216
D’Urzo KA, Flood SM, Baillie C. Evaluating the implementation and impact of a motivational interviewing workshop on medical student knowledge and social cognitions towards counseling patients on lifestyle behaviors. Teach Learn Med. 2020;32(2):218–30. https://doi.org/10.1080/10401334.2019.1681273 DOI: https://doi.org/10.1080/10401334.2019.1681273
World Health Organization. Physical activity. 2021. Available from: https://www.who.int/westernpacific/health-topics/physical-activity [Accessed Jun 1, 2021].
McFadden T, Fortier M, Sweet SN, Tomasone JR, McGinn R, Levac BM. Canadian medical students’ perceived motivation, confidence and frequency recommending physical activity. Prev Med Rep. 2019;15(December 2018):100898. https://doi.org/10.1016/j.pmedr.2019.100898 DOI: https://doi.org/10.1016/j.pmedr.2019.100898
Wattanapisit A, Vijitpongjinda S, Saengow U, Amaek W, Thanamee S, Petchuay P. Results from the Medical School Physical Activity Report Card (MSPARC) for a Thai medical school: a mixed methods study. BMC Med Educ. 2018;18(1):1–9. https://doi.org/10.1186/s12909-018-1408-7 DOI: https://doi.org/10.1186/s12909-018-1408-7
Faught E, Morgan TL, Tomasone JR. Five ways to counter ableist messaging in medical education in the context of promoting healthy movement behaviours. Can Med Educ J. 2022;13(5):82–6. https://doi.org/10.36834/cmej.74119 DOI: https://doi.org/10.36834/cmej.74119
Fowles JR, O’Brien MW, Solmundson K, Oh PI, Shields CA. Exercise is medicine Canada physical activity counselling and exercise prescription training improves counselling, prescription, and referral practices among physicians across Canada. Appl Physiol Nutr Metab. 2018;43(5):535–9. https://doi.org/10.1139/apnm-2017-0763 DOI: https://doi.org/10.1139/apnm-2017-0763
Holtz KA, Kokotilo KJ, Fitzgerald BE, Frank E. Exercise behaviour and attitudes among fourth-year medical students at the University of British Columbia. Can Fam Physician. 2013;59(1). Available at https://www.cfp.ca/content/59/1/e26.long [Accessed Mar 7, 2021].
Strong A, Stoutenberg M, Hobson-Powell A, Hargreaves M, Beeler H, Stamatakis E. An evaluation of physical activity training in Australian medical school curricula. J Sci Med Sport. 2017;20(6):534–8. https://doi.org/10.1016/j.jsams.2016.10.011 DOI: https://doi.org/10.1016/j.jsams.2016.10.011
Morgan TL, Nowlan Suart T, Fortier MS, Tomasone JR. Moving toward co-production: five ways to get a grip on collaborative implementation of Movement Behaviour curricula in undergraduate medical education. Can Med Educ J. 2022 Jun 20;13(5):87–100. https://doi.org/10.36834/cmej.74083 DOI: https://doi.org/10.36834/cmej.74083
Kushner RF, Kessler S, McGaghie WC. Using behavior change plans to improve medical student self-care. Acad Med. 2011;86(7):901–6. https://doi.org/10.1038/jid.2014.371 DOI: https://doi.org/10.1097/ACM.0b013e31821da193
Dyrbye LN, Satele D, Shanafelt TD. Healthy exercise habits are associated with lower risk of burnout and higher quality of life among U.S. medical students. Acad Med. 2017 Jul;92(7):1006–11. https://doi.org/10.1097/ACM.0000000000001540 DOI: https://doi.org/10.1097/ACM.0000000000001540
Payton AR. Mental health, mental illness, and psychological distress: Same continuum or distinct phenomena? J Health Soc Behav. 2009;50(June):213–27. https://doi.org/10.1177/002214650905000207 DOI: https://doi.org/10.1177/002214650905000207
Tsai HH, Yeh CY, Su CT, Chen CJ, Peng SM, Chen RY. The effects of exercise program on burnout and metabolic syndrome components in banking and insurance workers. Ind Health. 2013;51:336–46. https://doi.org/10.2486/indhealth.2012-0188 DOI: https://doi.org/10.2486/indhealth.2012-0188
McFadden T, Fortier M, Sweet SN, Tomasone JR. Physical activity participation and mental health profiles in Canadian medical students: latent profile analysis using continuous latent profile indicators. Psychol Health Med. 2021;26(6):671–83. https://doi.org/10.1080/13548506.2020.1757131 DOI: https://doi.org/10.1080/13548506.2020.1757131
Koutsimani P, Montgomery A, Georganta K. The relationship between burnout, depression, and anxiety: A systematic review and meta-analysis. Front Psychol. 2019;10(MAR):1–19. https://doi.org/10.3389/fpsyg.2019.00284 DOI: https://doi.org/10.3389/fpsyg.2019.00284
Biswas A, Oh PI, Faulkner GE, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults a systematic review and meta-analysis. Ann Intern Med. 2015;162(2):123–32. https://doi.org/10.7326/M14-1651 DOI: https://doi.org/10.7326/M14-1651
Artino AR, Durning SJ, Sklar DP. Guidelines for reporting survey-based research submitted to Academic Medicine. Acad Med. 2018 Mar;93(3):337–40. https://doi.org/10.7326/M14-1651 DOI: https://doi.org/10.1097/ACM.0000000000002094
Amireault S, Godin G. The Godin-Shephard Leisure-Time Physical Activity Questionnaire: validity evidence supporting its use for classifying healthy adults into active and insufficiently active categories. Percept Mot Ski Phys Dev Meas. 2015;120(2):604–22. https://doi.org/10.2466/03.27.PMS.120v19x7 DOI: https://doi.org/10.2466/03.27.PMS.120v19x7
Wolf MR, Rosenstock JB. Inadequate sleep and exercise associated with burnout and depression among medical students. Acad Psychiatry. 2017;41(2):174–9. https://doi.org/10.1007/s40596-016-0526-y DOI: https://doi.org/10.1007/s40596-016-0526-y
Sloan RA, Sawada SS, Girdano D, Liu YT, Biddle SJH, Blair SN. Associations of sedentary behavior and physical activity with psychological distress: a cross-sectional study from Singapore. BMC Public Health. 2013;13(1):1. https://doi.org/10.1186/1471-2458-13-885 DOI: https://doi.org/10.1186/1471-2458-13-885
Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc. 2019;94(9):P1681-1694. https://doi.org/10.1016/j.mayocp.2015.08.023 DOI: https://doi.org/10.1016/j.mayocp.2015.08.023
West CP, Dyrbye LN, Satele DV, Sloan JA, Shanafelt TD. Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. J Gen Intern Med. 2012;27(11):1445–52. https://doi.org/10.1007/s11606-012-2015-7 DOI: https://doi.org/10.1007/s11606-012-2015-7
IBM Inc. IBM SPSS Statistics for Windows 23.0. Armonk, New York, USA: IBM Corp; 2015.
Pallant J. SPSS survival manual: a step by step guide to data analysis using SPSS. Australia: Allen & Unwin; 2011. https://doi.org/10.4324/9781003117452 DOI: https://doi.org/10.4324/9781003117452
Cohen JE. Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.; 1988. https://doi.org/10.4324/9780203771587 DOI: https://doi.org/10.4324/9780203771587
Erdfelder E, Faul F, Buchner A. GPower: A general power analysis program. Behav Res Methods Instrum Comput. 1996;28(1):1–11. https://doi.org/10.1016/s0167-9473(99)90014-2 DOI: https://doi.org/10.3758/BF03203630
Cecil J, Mchale C, Hart J, Laidlaw A. Behaviour and burnout in medical students. Med Educ Online. 2014;19(25209):1–9. https://doi.org/10.3402/meo.v19.25209 DOI: https://doi.org/10.3402/meo.v19.25209
Musil CM, Warner CB, Yobas PK, Jones SL. A comparison of imputation techniques for handling missing data. West J Nurs Res. 2002;24(7):815–29. https://doi.org/10.1177/019394502237390 DOI: https://doi.org/10.1177/019394502762477004
The Association of Faculties of Medicine of Canada. Canadian medical education statistics. Vol. 39. 2017 p. 1–156.
Kikuchi H, Inoue S, Lee IM, et al. Impact of moderate-intensity and vigorous-intensity physical activity on mortality. Med Sci Sports Exerc. 2018;50(4):715–21. https://doi.org/10.1249/MSS.0000000000001463 DOI: https://doi.org/10.1249/MSS.0000000000001463
Taylor J, McLean L, Richards B, Glozier N. Personalised yoga for burnout and traumatic stress in junior doctors. Postgrad Med J. 2020;96(1136):349–57. https://doi.org/10.1136/postgradmedj-2019-137413 DOI: https://doi.org/10.1136/postgradmedj-2019-137413
Shreffler J, Huecker M, Martin L, et al. Strategies to combat burnout during intense studying: utilization of medical Student feedback to alleviate burnout in preparation for a high stakes examination. Health Prof Educ. 2020;6:334–42. https://doi.org/10.1016/j.hpe.2020.04.009 DOI: https://doi.org/10.1016/j.hpe.2020.04.009
Harris S, Stratford P, Bray SR. Is it really worth the effort ? Examining the effects of mentalfatigue on physical activity effort discounting. J Sport Exerc Psychol. 2022;44(6):409–19. https://doi.org/https://doi.org/10.1123/jsep.2021-0330 DOI: https://doi.org/10.1123/jsep.2021-0330
Prasad L, Varrey A, Sisti G. Medical students’ stress levels and sense of well being after six weeks of yoga and meditation. Evid Based Complement Alternat Med. 2016;2016:1–7. https://doi.org/10.1155/2016/9251849 DOI: https://doi.org/10.1155/2016/9251849
Saunders TJ, McIsaac T, Douillette K, et al. Sedentary behaviour and health in adults: an overview of systematic reviews. Appl Physiol Nutr Metab. 2020;45(10 (Suppl. 2)):S197–217. https://doi.org/10.1139/apnm-2020-0272 DOI: https://doi.org/10.1139/apnm-2020-0272
Hébert ET, Caughy MO, Shuval K. Primary care providers’ perceptions of physical activity counselling in a clinical setting: A systematic review. Br J Sports Med. 2012;46(9):625–31. https://doi.org/10.1136/bjsports-2011-090734 DOI: https://doi.org/10.1136/bjsports-2011-090734
Tremblay MS, Ross R. How should we move for health? The case for the 24-hour movement paradigm. Can Med Assoc J. 2020;192(49):E1728–9. https://doi.org/10.1503/cmaj.202345 DOI: https://doi.org/10.1503/cmaj.202345
Loney T, Standage M, Thompson D, Sebire SJ, Cumming S. Self-report vs. objectively assessed physical activity: Which Is right for public health? J Phys Act Health. 2011;8(1):62–70. https://doi.org/10.1123/jpah.8.1.62 DOI: https://doi.org/10.1123/jpah.8.1.62
Downloads
Published
Versions
- 2024-11-12 (2)
- 2024-07-31 (1)
How to Cite
Issue
Section
License
Copyright (c) 2023 Tamara Morgan, Taylor McFadden, Michelle Fortier, Shane Sweet, Jennifer Tomasone
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Submission of an original manuscript to the Canadian Medical Education Journal will be taken to mean that it represents original work not previously published, that it is not being considered elsewhere for publication. If accepted for publication, it will be published online and it will not be published elsewhere in the same form, for commercial purposes, in any language, without the consent of the publisher.
Authors who publish in the Canadian Medical Education Journal agree to release their articles under the Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 Canada Licence. This licence allows anyone to copy and distribute the article for non-commercial purposes provided that appropriate attribution is given. For details of the rights an author grants users of their work, please see the licence summary and the full licence.
