Gender Difference of Burnout in Physicians Working in Tertiary Care Hospital: A Cross-Sectional Study.

Burnout and emotional exhaustion are becoming common among health workers in the busy teaching hospitals due to increased workload and the dearth of human resource. This study aimed to determine the causes of burnout among doctors and across gender differences. This was a descriptive cross-sectional study conducted in the Fauji Foundation Hospital, Rawalpindi, Pakistan, from 1st July to 30th September 2022. Two hundred and forty-five randomly recruited doctors who filled out self-administered questionnaires were included in the study. Independent samples t-test was used for comparison of the mean emotional burnout score. Female doctors felt more emotionally drained, more fatigued, and more worn out from work than male doctors (p < 0.05). Overall emotional exhaustion was also higher in female doctors (p < 0.05). This situation was more serious during the COVID-19 pandemic. Gender-sensitive environments, workplace policies, and necessary interventions will save physicians' burnout and brain drain. Emotional burnout is greater in female doctors as compared to their male counterparts. This evidence not only calls for prevention and treatment but also certain service-related reforms to facilitate female physicians to balance out their work and family lives more effectively. Key Words: Physicians, Emotional exhaustion, Burnout, Gender difference, Pakistan.

The Impact of Various Cockpit Display Interfaces on Novice Pilots' Mental Workload and Situational Awareness: A Comparative Study.

Future airspace is expected to become more congested with additional in-service cargo and commercial flights. Pilots will face additional burdens in such an environment, given the increasing number of factors that they must simultaneously consider while completing their work activities. Therefore, care and attention must be paid to the mental workload (MWL) experienced by operating pilots. If left unaddressed, a state of mental overload could affect the pilot's ability to complete his or her work activities in a safe and correct manner. This study examines the impact of two different cockpit display interfaces (CDIs), the Steam Gauge panel and the G1000 Glass panel, on novice pilots' MWL and situational awareness (SA) in a flight simulator-based setting. A combination of objective (EEG and HRV) and subjective (NASA-TLX) assessments is used to assess novice pilots' cognitive states during this study. Our results indicate that the gauge design of the CDI affects novice pilots' SA and MWL, with the G1000 Glass panel being more effective in reducing the MWL and improving SA compared with the Steam Gauge panel. The results of this study have implications for the design of future flight deck interfaces and the training of future pilots.

Adjunct Preceptor Perceptions of Motivation, Understanding, and Support for the Precepting Role.

OBJECTIVE: To determine adjunct pharmacist preceptor perceptions of their precepting role related to three domains: motivation to precept, understanding the precepting role, and support for precepting. METHODS: An online cross-sectional survey of 2429 adjunct preceptors for four schools of pharmacy was conducted. Participants ranked their agreement with 81 statements regarding the three domains, including eleven subdomains. RESULTS: Mean scores for the three domains were slightly below the positive response level, with lower scores found for the subdomains of workload, precepting norms, and extrinsic benefits/rewards. Individual statements indicated increased workload due to precepting, need for more preceptor recognition and appreciation, perceptions that precepting was stressful or draining, and a preference for one concurrent learner. More frequent need for extra coaching for APPE students negatively impacted all domains, including nine subdomains. CONCLUSION: This study provides a formal evaluation of adjunct preceptor perceptions of their precepting role. Compared to previous studies, these results may indicate lower satisfaction with precepting, suggesting opportunities exist to improve the adjunct precepting experience. Actions by schools/colleges of pharmacy are necessary to ensure experiential education capacity including addressing workload concerns, increasing preceptor recognition and appreciation, and supporting preceptors when students need extra coaching.

Gaze entropy metrics for mental workload estimation are heterogenous during hands-off level 2 automation.

As the level of vehicle automation increases, drivers are more likely to engage in non-driving related tasks which take their hands, eyes, and/or mind away from the driving task. Consequently, there has been increased interest in creating Driver Monitoring Systems (DMS) that are valid and reliable for detecting elements of driver state. Workload is one element of driver state that has remained elusive within the literature. Whilst there has been promising work in estimating mental workload using gaze-based metrics, the literature has placed too much emphasis on point estimate differences. Whilst these are useful for establishing whether effects exist, they ignore the inherent variability within individuals and between different drivers. The current work builds on this by using a Bayesian distributional modelling approach to quantify the within and between participants variability in Information Theoretical gaze metrics. Drivers (N = 38) undertook two experimental drives in hands-off Level 2 automation with their hands and feet away from operational controls. During both drives, their priority was to monitor the road before a critical takeover. During one drive participants had to complete a secondary cognitive task (2-back) during the hands-off Level 2 automation. Changes in Stationary Gaze Entropy and Gaze Transition Entropy were assessed for conditions with and without the 2-back to investigate whether consistent differences between workload conditions could be found across the sample. Stationary Gaze Entropy proved a reliable indicator of mental workload; 92 % of the population were predicted to show a decrease when completing 2-back during hands-off Level 2 automated driving. Conversely, Gaze Transition Entropy showed substantial heterogeneity; only 66 % of the population were predicted to have similar decreases. Furthermore, age was a strong predictor of the heterogeneity of the average causal effect that high mental workload had on eye movements. These results indicate that, whilst certain elements of Information Theoretic metrics can be used to estimate mental workload by DMS, future research needs to focus on the heterogeneity of these processes. Understanding this heterogeneity has important implications toward the design of future DMS and thus the safety of drivers using automated vehicle functions. It must be ensured that metrics used to detect mental workload are valid (accurately detecting a particular driver state) as well as reliable (consistently detecting this driver state across a population).

Investigating learning burnout and academic performance among management students: a longitudinal study in English courses.

This study aims to move away from the cross-sectional approach related to burnout and conduct a longitudinal study to explore the factors influencing learning burnout among management students. The study primarily adopts a questionnaire survey, with students majoring in business management. Descriptive statistics and structural equation modeling (SEM) are used to analyze the data and validate the hypotheses. The findings are: (1) There is a significant negative relationship between English anxiety and self-efficacy and a significant positive relationship between past English learning performance and self-efficacy. (2) The changes in self-efficacy are negatively related to the changes in burnout, while the changes in workload are positively related to the changes in burnout. Additionally, there is a positive relationship between English anxiety and learning burnout. (3) There is a significant negative relationship between English learning performance and burnout. The direct impact of self-efficacy on English learning performance is not supported, but it has an indirect effect through the mediating role of burnout. The study proposes strategies to improve student outcomes and well-being: (1) making English courses more engaging to boost performance and confidence, reducing learning burnout; (2) encouraging and supporting students to enhance self-efficacy and motivation; (3) assigning tasks seen as useful and interesting to lessen perceived workload and emotional exhaustion; (4) and considering English anxiety in admissions to decrease learning burnout, especially as schools gain more autonomy in their policies.

Job stress and burnout among Finnish municipal employees without depression or anxiety.

BACKGROUND: Job burnout is associated with job stress but also with mental health symptoms, depression and anxiety. AIMS: This study aims to evaluate the effect of job stress on burnout without the effect of depression and anxiety. METHODS: A cross-sectional study was conducted in 2015 among 673 employees (88% female) from four public service sectors in Pori, Finland. Job burnout was assessed with the Bergen Burnout Indicator (BBI-15). Job stress was assessed by combining psychological risk factors (demand control, effort rewards and mental workload). Respondents who reported symptoms of depression and anxiety were excluded from the analyses. RESULTS: Of the eligible study subjects (n = 617), 10% reported symptoms of at least mild burnout but only 1% severe burnout. The burnout symptoms varied from 6% to 21% by sector of public service. Job burnout was cumulatively associated with job stress factors. One job stress factor increased the risk of burnout 2-fold (relative risk [RR] 2.13; confidence interval [CI] 0.97-4.68), two factors 6-fold (RR 6.56; 2.92-14.8Or), and three factors even more (RR 23.5; CI 8.67-63.8). Similar trends were observed in the analysis of job burnout components (exhaustion, cynicism and professional inadequacy). CONCLUSIONS: Our results indicate that job burnout is also strongly associated with job stress in employees who do not have depressive or anxiety symptoms. As job burnout may precede clinical depression or reduce productivity and well-being at work, it is essential to perform surveys to monitor burnout symptoms among the workforce, and design interventions to prevent remarkable job strain.

Exploring the challenges and risks of dead body handling faced by healthcare professionals during the coronavirus pandemic: Cross sectional survey study.

The coronavirus pandemic shocked the already overwhelmed global healthcare system, challenging its preparedness to deal with mass fatalities. Our research examines the safety issues faced by healthcare workers when handling dead (deceased) bodies, highlighting the need for better strategies in the event of mass fatalities. Healthcare providers involved in dead body handling during the COVID-19 pandemic in the U.S. were eligible to participate in our study. Using a web-based survey, we analyzed responses of 206 participants across 43 U.S. states. We used the Systems Engineering Initiative for Patient Safety (SEIPS) framework to deduce themes from participants' open-ended responses. The study showed how routine tasks become extraordinarily challenging during pandemic due to increased workload, emotional stress, and resource constraints. Tasks such as lifting and transferring bodies, underscored physical and emotional toll on workers. The mental strain induced by mass fatalities and the complexities of communicating with families and peers were also prominent, adding to the overall burden on healthcare workers. The participants emphasized the importance of specialized training, policy refinements, and improvements in its implementation. In conclusion, our study contributes to understanding the complexities of dead body handling during a pandemic. It underscores the need for emergency response planning and systemic changes in healthcare policies and practices to ensure the safety and well-being of healthcare workers engaged in these critical tasks.

Analysis of driver behavior at grade-separated intersections to support design.

Understanding driver behaviors in varied traffic scenarios is critical to the design of safe and efficient roadways and traffic control device. This research presents an analysis of driver cognitive workload, situation awareness (SA) and performance for three different scenarios, including a standard intersection and contraflow grade-separated intersections (C-GSI) and quadrant GSI (Q-GSI) with lane assignment sign manipulations. The study used a simulator-based driving experiment with application of the NASA Task Load Index and Situation Awareness Global Assessment Technique to assess the influence of the scenarios on driver behavioral responses. The findings reveal challenges for drivers navigating the C-GSI, characterized by diminished SA and elevated workload. These states were associated with behaviors such as delayed lane changes, missed opportunities for appropriate lane changes, heightened acceleration behavior within deceleration segments, and frequent speeding. In contrast, while drivers in the Q-GSI scenario faced elevated workloads, their SA remained steady, largely due to lane-specific signs facilitating early lane changes. Although the Q-GSI led to increased speed variability and slight increases in deceleration, the use of supplementary speed signage revealed a promising alternative to the S-intersection. Correlation analysis highlighted a significant relationship between mental workload and acceleration responses, indicating that increased acceleration was associated with higher mental workload. In addition, a significant negative correlation between driver perceived performance and absolute lane deviations indicated that drivers with higher self-assessed performance were more accurate in lane-keeping. The study underscores the need for GSIs and signage designs that support driver SA, manage cognitive workload to improve driver performance and increase road safety.

Identifying and validating perceived workload metrics for emergency medical services.

The most common workload surrogates used by Emergency Medical Services (EMS)- overall call volume (CV) and unit hour utilization (UHU)-have not been validated. This study investigates the relationship between EMS operational metrics and perceived workload, measured through the NASA task load index (TLX) survey. We paired crew member survey responses with the operational metrics based on dispatch data. Linear regression was used to evaluate the influence of each metric on perceived workload. Logistic regression was used to identify values of workload indicating a fair day's work. We found that the overall CV (p < 0.001, R2=0.32) and UHU (p < 0.001, R2=0.22) explained less variability in perceived workload than a priority (P)-stratified CV (p < 0.001, R2=0.41). However, we found no clear fair day's workload threshold. We conclude that a priority-stratified CV is a better workload surrogate than a CV and UHU.

A Review of the Use of Gaze and Pupil Metrics to Assess Mental Workload in Gamified and Simulated Sensorimotor Tasks.

Gaze and pupil metrics are used to represent higher cognitive processes in a variety of contexts. One growing area of research is the real-time assessment of workload and corresponding effort in gamified or simulated cognitive and motor tasks, which will be reviewed in this paper. While some measurements are consistent across studies, others vary and are likely dependent on the nature of the effort required by the task and the resulting changes in arousal. Pupil diameter is shown to consistently increase with task effort and arousal; however, the valence of arousal must be considered. In many cases, measures of pupil diameter were sensitive to both excessive and insufficient challenge. Overall, it is evident that gaze and pupil metrics are valuable to assess the cognitive state during gamified and simulated tasks, and further research is indicated regarding their use in clinical populations in rehabilitation to inform optimally engaging interventions.

Determining Cognitive Workload Using Physiological Measurements: Pupillometry and Heart-Rate Variability.

The adoption of Industry 4.0 technologies in manufacturing systems has accelerated in recent years, with a shift towards understanding operators' well-being and resilience within the context of creating a human-centric manufacturing environment. In addition to measuring physical workload, monitoring operators' cognitive workload is becoming a key element in maintaining a healthy and high-performing working environment in future digitalized manufacturing systems. The current approaches to the measurement of cognitive workload may be inadequate when human operators are faced with a series of new digitalized technologies, where their impact on operators' mental workload and performance needs to be better understood. Therefore, a new method for measuring and determining the cognitive workload is required. Here, we propose a new method for determining cognitive-workload indices in a human-centric environment. The approach provides a method to define and verify the relationships between the factors of task complexity, cognitive workload, operators' level of expertise, and indirectly, the operator performance level in a highly digitalized manufacturing environment. Our strategy is tested in a series of experiments where operators perform assembly tasks on a Wankel Engine block. The physiological signals from heart-rate variability and pupillometry bio-markers of 17 operators were captured and analysed using eye-tracking and electrocardiogram sensors. The experimental results demonstrate statistically significant differences in both cardiac and pupillometry-based cognitive load indices across the four task complexity levels (rest, low, medium, and high). Notably, these developed indices also provide better indications of cognitive load responding to changes in complexity compared to other measures. Additionally, while experts appear to exhibit lower cognitive loads across all complexity levels, further analysis is required to confirm statistically significant differences. In conclusion, the results from both measurement sensors are found to be compatible and in support of the proposed new approach. Our strategy should be useful for designing and optimizing workplace environments based on the cognitive load experienced by operators.

Comparing Synchronous and Asynchronous Task Delivery in Mixed Reality Environments.

Asynchronous digital communication is a widely applied and well-known form of information exchange. Most pieces of technology make use of some variation of asynchronous communication systems, be it messaging or email applications. This allows recipients to process digital messages immediately (synchronous) or whenever they have time (asynchronous), meaning that purely digital interruptions can be mitigated easily. Mixed Reality systems have the potential to not only handle digital interruptions but also interruptions in physical space, e.g., caused by co-workers in workspaces or learning environments. However, the benefits of such systems previously remained untested in the context of Mixed Reality. We conducted a user study ($\mathrm{N}=26$) to investigate the impact that the timing of task delivery has on the participants' performance, workflow, and emotional state. Participants had to perform several cognitively demanding tasks in a Mixed Reality workspace. Inside the virtual workspace, we simulated in-person task delivery either during tasks (i.e., interrupting the participant) or between tasks (i.e., delaying the interruption). Our results show that delaying interruptions has a significant impact on subjective metrics like the perceived performance and workload.

Non-invasive stress estimation in simulative endoscopy setting: literature review.

One of the most common stressors is so-called "occupational stress." It is defined as the sum of physical, mental and physiological responses to work in situations where the workload or stress associated with it intensifies for an extended period of time. It is a gradual process in which individual cognitive assessments of occupational stressors generate adverse health events and may lead to burnout. Since it has become a major problem in the medical field, studying, measuring and limiting it have been set as goals for the future.

Job demands and DHEA-S levels: a study on healthcare workers.

BACKGROUND: The intricate interplay between work-related stress and its physiological impact has drawn extensive research attention. Dehydroepiandrosterone sulphate (DHEA-S) emerges as a potential biomarker reflecting stress-related endocrine changes. AIMS: This cross-sectional study aimed to examine the association between job demands and DHEA-S levels among healthcare workers. The study also explored potential correlations between DHEA-S levels and psychophysical symptoms commonly linked to work-related stress. METHODS: A sample of 488 healthcare workers from a local health authority participated. Job demands were measured using the Demands scale of the Health and Safety Management Standards Indicator Tool. DHEA-S levels and symptom prevalence were assessed through serum analysis and questionnaires, respectively. RESULTS: Workers exposed to high job demands exhibited significantly lower DHEA-S levels compared to those with low job demands. Psychophysical symptoms, including sleep disorders, depression, and headache, were more prevalent in the high-demands group. DHEA-S levels showed significant negative correlations with the prevalence of all considered symptoms. CONCLUSIONS: The study shows the inverse relationship between job demands and DHEA-S levels among healthcare workers, indicating that high job demands correlate with reduced DHEA-S secretion and increased symptom prevalence. The findings suggest DHEA-S as a potential biomarker for assessing the physiological consequences of work-related stress. Proactive interventions in managing job demands are crucial for promoting employee well-being and productivity in demanding work environments. By recognizing DHEA-S as a stress biomarker, organizations can effectively address stress-related health risks and implement targeted interventions for enhancing employees' overall health and work performance.

The role of visual conditions and aircraft type on different aspects of pilot workload.

OBJECTIVE: The objective of our work was to assess the impact of flight conditions by aircraft type on the workload estimated using NASA-Task Load Index (NASA-TLX). BACKGROUND: Learning about subjective workload is important for assessing the impact of a pilot's work environment on their performance in the cockpit. This is an important element of flight safety and includes the prevention of aviation accidents. METHODS: The study included 146 military pilots that fly the following aircrafts: flying fast-jet (21), fixed-wing (24), and rotary-wing (101). The NASA-TLX questionnaire was used to assess workload and pilots were asked to determine the level of workload resulting from flying under the following conditions: daytime flight (VFR), night-vision flight performed under Night Visual Flight Rules (NVFR), and night-vision flight using night-vision goggles (NVGs). RESULTS: The highest level of workload was consistently attributed to flights performed under NVG conditions. NVFR conditions were rated as the most burdensome, while VFR conditions were rated as the least burdensome. Fast-jet pilots rated their mental performance and effort workload as significantly higher than pilots of other aircrafts. CONCLUSION: Pilots' perceived workload is influenced by both flight conditions and the type of aircraft they fly. Workload knowledge is important for flight safety and should be taken into account during training and flight-task planning. APPLICATION: The results of our study can be useful both in flight training and in work on the effectiveness of the human-machine interface. Awareness of one's own limitations due to the work environment can help improve flight safety.

Ghosts and Ghosting in Digital Communications.

Ghosting, professionally and personally, occurs when there is an abrupt end to communication between 2 individuals without any explanation or when an individual does not follow through on commitments to others associated with their communication. The increase in the available communication channels and speed at which messages can now be transmitted between individuals is resulting in a greater incidence of ghosting or perceived ghosting in our colleges/schools of pharmacy. The impact of ghosting is the disruption of effective communication and communication strategies that are essential to the development of positive and thriving cultures and subcultures in our institutions. The causes of ghosting (real or perceived) in our pharmacy academy could be attributed to increased workload and speed of communication, increased workload and productivity expectations, and increased workload and information volume. The consequences of ghosting in our colleges/schools can result in decreased psychological safety in our cultures, adversely impacting individual well-being, resiliency, grit, and satisfaction and adversely impacting student academic performance and success. There are simple steps that individuals and institutions can implement to minimize ghosting or the perception of ghosting that may occur with online communication channels used by our faculty, staff, students, and outside individuals.

Cognitive Job Demands and Sports Participation among Young Workers: What Moderates the Relationship?

Cognitive job demands are theoretically and empirically associated with sports participation in various ways. Workers may be overwhelmed by stress and fatigue from their workload and therefore refrain from sports activities, but they can also feel the need to use sports as a way to recover and detach from work. The strategy to which workers adhere can depend on workers' resources that moderate the cognitive job demands and sports participation relationship, such as educational attainment, being a parent, or having worktime and work location control. To test our expectations, we used recent information on sports participation by young working adults from the Netherlands (N = 2032). Using multinomial logistic regression modelling, we found that workers in mentally demanding jobs were more likely to participate in sports more than three times a week. In particular, workers without children reported a higher likelihood of participating in sports more than three times a week when they experienced high cognitive job demands. Among the higher-educated, workers with high cognitive job demands were less likely to participate in sports one to three times a week. We reflect on the academic and policy-related implications of our findings.

EEG Dataset Collection for Mental Workload Predictions in Flight-Deck Environment.

High mental workload reduces human performance and the ability to correctly carry out complex tasks. In particular, aircraft pilots enduring high mental workloads are at high risk of failure, even with catastrophic outcomes. Despite progress, there is still a lack of knowledge about the interrelationship between mental workload and brain functionality, and there is still limited data on flight-deck scenarios. Although recent emerging deep-learning (DL) methods using physiological data have presented new ways to find new physiological markers to detect and assess cognitive states, they demand large amounts of properly annotated datasets to achieve good performance. We present a new dataset of electroencephalogram (EEG) recordings specifically collected for the recognition of different levels of mental workload. The data were recorded from three experiments, where participants were induced to different levels of workload through tasks of increasing cognition demand. The first involved playing the N-back test, which combines memory recall with arithmetical skills. The second was playing Heat-the-Chair, a serious game specifically designed to emphasize and monitor subjects under controlled concurrent tasks. The third was flying in an Airbus320 simulator and solving several critical situations. The design of the dataset has been validated on three different levels: (1) correlation of the theoretical difficulty of each scenario to the self-perceived difficulty and performance of subjects; (2) significant difference in EEG temporal patterns across the theoretical difficulties and (3) usefulness for the training and evaluation of AI models.

More than Just Workload-Personnel's Perspective on Workload at the Royal Netherlands Marechaussee: A Qualitative Study.

OBJECTIVES: We investigated the perspective on workload within the Royal Netherlands Marechaussee, part of the Dutch armed forces. METHODS: This qualitative study follows an emergent design based on grounded theory principles and used semistructured interviews and focus groups with 91 Royal Netherlands Marechaussee employees. The interviews ( n = 31) and focus groups ( n = 14) were transcribed verbatim and analyzed by two researchers (C.B. and J.v.d.Z.) according to comparative data analysis. RESULTS: Participants believed the perception of workload to be more important than the actual workload. Furthermore, participants mentioned that indirect factors, such as organizational factors and recruitment, could modulate their workload perception. CONCLUSIONS: The perception of workload is key within the context of the Royal Netherlands Marechaussee. Modifiable factors related to the perceived workload could facilitate employee well-being without reducing the actual workload.

Burnout and Perceived Workload Among Behavioral Health Providers During the COVID-19 Pandemic: Importance of Supervisory, Leadership, and Organizational Support.

PURPOSE: To assess the relationship between behavioral health provider (BHP) perceptions of support during COVID-19 and burnout and self-reported workload. DESIGN: We conducted a cross-sectional analysis of provider-level data collected from the 2020 and 2021 All Employee Survey (AES). SETTING: The Veterans Health Administration. SUBJECTS: 36,541 (10,332 [28.28%] with missing data) respondents in 2020 and 2021 combined. MEASURES: Main outcomes were self-reported burnout and self-reported workload. Main predictors were 6 COVID-19-related provider-perceived support domains. Covariates were 11 AES demographic predictors. ANALYSIS: We conducted mixed-effects logistic regression modeling for each domain and outcome pairing. We summarized our results using average marginal effects (AMEs) and odds ratios (ORs). RESULTS: All 6 domains of feeling prepared, heard, protected, cared for, honored, and having flexible policies were significantly negatively associated with burnout (AMEs -.20 to -.10, ORs .38-.63, P < .001) and positively associated with reasonable workload (AMEs .11-.20, ORs 1.63-2.59, P < .001). Feeling prepared had the largest associations with burnout (OR .38) and reasonable workload (OR 2.59). CONCLUSION: Creating a work environment with flexible policies and where staff feel prepared, heard, protected, cared for, and honored could support BHPs in feeling less burned out and that their workload is reasonable.