The relationship between grit and resident well-being

doi:10.1016/j.amjsurg.2013.09.006

The American Journal of Surgery

Volume 207, Issue 2, February 2014, Pages 251-254

https://doi.org/10.1016/j.amjsurg.2013.09.006 Get rights and content

Abstract

Background

The well-being of residents in general surgery is an important factor in their success within training programs. Consequently, it is important to identify individuals at risk for burnout and low levels of well-being as early as possible. The aim of this study was to test the hypothesis that resident well-being may be related to grit, a psychological factor defined as perseverance and passion for long-term goals.

Methods

One hundred forty-one residents across 9 surgical specialties at 1 academic medical center were surveyed; the response rate was 84%. Perseverance was measured using the Short Grit Scale. Resident well-being was measured with (1) burnout using the Maslach Burnout Inventory and (2) psychological well-being using the Dupuy Psychological General Well-Being Scale.

Results

Grit was predictive of later psychological well-being both as measured by the Maslach Burnout Inventory (B = −.20, P = .05) and as measured by the Psychological General Well-Being Scale (B = .27, P < .01).

Conclusions

Measuring grit may identify those who are at greatest risk for poor psychological well-being in the future. These residents may benefit from counseling to provide support and improve coping skills.

Section snippets

Methods

In the context of a larger longitudinal study, we combined several previously validated scales to assess residents' perseverance, burnout, and psychological well-being. We used the Short Grit Scale⁴ as a measure of perseverance. This includes items such as “Setbacks don't discourage me” and “I often set a goal but later choose to pursue a different one.” The Maslach Burnout Inventory (MBI)5, 6 was used as a measure of burnout. One representative item from this scale is “I feel emotionally

Results

One hundred forty-one residents (52 women; response rate, 84%) participated in the study. See Table 1 for a breakdown of age, gender, and response rate by specialty. We first examined the data to see whether grit was a stable measure over the period of study. In keeping with previous data,² the participants' grit scores were highly positively correlated across time points (r = .71, P < .01; baseline mean, 3.65 ± .53; follow-up mean, 3.64 ± .53). The average level of burnout at baseline was 3.05

Comments

The data presented here show that grit was predictive of psychological health in a sample of 141 surgical residents. This suggests that measuring grit may be one way to identify those who are at risk for burnout or lower overall well-being. Thus, program directors could use grit as a measure to identify residents who could benefit from additional support throughout their training. Although this could also be done by administering the MBI and the PGWB directly, these instruments contain

References (13)

P.C. Bergen et al.
Gender-related attrition in a general surgery training program
J Surg Res
(1998)
W.E. Longo et al.
Attrition of categoric general surgery residents: results of a 20-year audit
Am J Surg
(2009)
W.E. Longo
Attrition: our biggest continuing challenge
Am J Surg
(2007)
J.S. Cohen et al.
Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta
BMC Med Educ
(2005)
A.L. Duckworth et al.
Grit: perseverance and passion for long-term goals
J Pers Soc Psych
(2007)
S. Lyubomirsky et al.
The benefits of frequent positive affect: does happiness lead to success?
Psych Bull
(2005)

There are more references available in the full text version of this article.

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The present study investigated an interpersonal model of development of depressive symptoms in employees, where occupational stress affects burnout, which in turn affects risk for depression, and whether this mediation is moderated by grit.
A total of 11,421 participants, aged 19 to 65 years, who were employees of 18 private companies and local government organizations in Korea were included. They completed questionnaires, including the Korean version of occupational stress scale, Oldenburg Burnout Inventory, Center for Epidemiologic Studies Depression scale and Grit scale. Mediation and moderation analyses were carried out in the Statistical Package for the Social Sciences PROCESS macro.
The association between occupational stress and depressive symptoms was mediated by exhaustion (b = −0.256, 95 % CI [0.244, 0.268]) and disengagement (b = −0.052, 95 % CI [0.039, 0.065]). Moreover, the effect of exhaustion on depressive symptoms was moderated by each grit, with the effect being stronger for employees with low grit (b = 0.939, p < 0.001 for passion and b = 0.629, p < 0.001 for perseverance) than for those with high grit (b = 0.944, p < 0.001 for passion and b = 0.686, p < 0.001 for perseverance).
The cross-sectional design of the study does not allow causal inferences.
These findings contribute to the understanding of how occupational stress predicts depressive symptoms in the workplace and provide practical implications for preventing burnout and nurturing grit to protect employees' mental health in the workplace.
Relational and mental health outcomes of trauma and disaster in couples:The intermediary role of grit
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This study was designed to assess associations between resource loss related to the 2019 hurricane season, and traumatic event exposure history on individual and relational wellbeing. Further, the potential intermediary role of grit was explored. The study was completed with a sample of 240 heterosexual couples who reported living in or near coastal regions in the southeast US, who were at risk of experiencing disaster-related losses during the 2019 hurricane season. A modified actor-partner interdependence model (APIM) was fitted using path analysis to test associations between disaster-related loss (incurred in 2019) and prior traumatic event exposure, and the outcome variables of posttraumatic stress symptoms (PTSS) and attachment behaviors within and across partners, with male and female grit tested as intermediaries. Results showed higher levels of disaster-related loss in 2019 and exposure to prior traumatic events associated significantly with higher levels of PTSS within partners. Higher levels of traumatic event exposure also associated with lower grit within partners. In turn, higher levels of grit associated with higher levels of attachment behaviors and lower levels of PTSS within and across partners. Indirect effects suggested that lower grit may play an intermediary role in the path between higher trauma event exposure history and lower levels of attachment behaviors within partners. Results suggest the primacy of loss in understanding traumatic stress, and further imply the importance of grit as a potential buffer in individual and relational wellbeing.
Self-Reported Physical Function and Grit Are Not Correlated in Patients Who Undergo Open Reduction Internal Fixation for Distal Radius Fractures
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“Grit” is defined as the perseverance and passion for long-term goals. Thus, grittier patients may have a better function after common hand procedures; however, this is not well-documented in the literature. Our purpose was to assess the correlation between grit and self-reported physical function among patients undergoing open reduction internal fixation (ORIF) for distal radius fractures (DRFs).
Between 2017 and 2020, patients undergoing ORIF for DRFs were identified. They were asked to complete the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire before surgery and at 6 weeks, 3 months, and 1 year after surgery. The first 100 patients with at least 1-year follow-up also completed the 8-question GRIT Scale, a validated measure of passion and perseverance for long-term goals measured on a scale of 0 (least grit) to 5 (most grit). The correlation between the QuickDASH and GRIT Scale scores was calculated using Spearman rho (ρ).
The average GRIT Scale score was 4.0 (SD, 0.7), with a median of 4.1 (range, 1.6–5.0). The median QuickDASH scores at the preoperative, 6-week postoperative, 6-month postoperative, and 1-year postoperative time points were 80 (range, 7–100), 43 (range, 2–100), 20 (range, 0–100), and 5 (range, 0–89), respectively. No significant correlation was found between the GRIT Scale and QuickDASH scores at any time.
We found no correlation between self-reported physical function and GRIT levels in patients undergoing ORIF for DRFs, suggesting no correlation between grit and patient-reported outcomes in this context. Future studies are needed to investigate the influence of individual differences in character traits other than grit on patient outcomes, which may help better align resources where needed and further the ability to deliver individualized, quality health care.
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Our research objectives were to (1) assess the correlation between PD perceptions and their residents’ reported experiences and (2) identify PD and program characteristics associated with alignment between PD perceptions and their residents’ reports.
A survey was administered to US general surgery residents following the 2019 American Board of Surgery In-Training Examination (ABSITE) to study wellness (burnout, thoughts of attrition, and suicidality) and mistreatment (gender discrimination, sexual harassment, racial/ethnic/religious discrimination, bullying). General surgery program directors (PDs) were surveyed about the degree to which they perceived mistreatment and wellness within their programs. Concordance between PDs’ perceptions and their residents’ reports was assessed using Spearman correlations. Multivariable logistic regression models examined factors associated with alignment between PDs and residents.
Of 6,126 residents training at SECOND Trial-enrolled programs, 5,240 (85.5%) responded to the ABSITE survey. All 212 PDs of programs enrolled in the SECOND Trial (100%) responded to the PD survey. Nationally, the proportion of PDs perceiving wellness issues was similar to the proportion of residents reporting them (e.g., 54.9% of PDs perceive that burnout is a problem vs. 40.1% of residents experience at least one burnout symptom weekly); however, the proportion of PDs perceiving mistreatment vastly underestimated the proportion of residents reporting it (e.g., 9.3% of all PDs perceive vs. 65.9% of all residents report bullying). Correlations between PDs’ perceptions of problems within their program and their residents’ reports were weak for racial/ethnic/religious discrimination (r = 0.176, p = 0.019), sexual harassment (r = 0.180, p = 0.019), burnout (r = 0.198, p = 0.007), and thoughts of attrition (r = 0.193, p = 0.007), and non-existent for gender discrimination, bullying, or suicidality. Multivariable regression models did not identify any program or PD characteristics that were consistently associated with improved resident-program director alignment.
Resident and PD perceptions were generally disparate regarding mistreatment, burnout, thoughts of attrition, and suicidality. Reconciling this discrepancy is critical to enacting meaningful change to improve the learning environment and resident well-being.
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: The authors declare no conflicts of interest.

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Association for Surgical EducationThe relationship between grit and resident well-being

Abstract

Background

Methods

Results

Conclusions

Section snippets

Methods

Results

Comments

J Surg Res

Am J Surg

Am J Surg

Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta

BMC Med Educ

Grit: perseverance and passion for long-term goals

J Pers Soc Psych

The benefits of frequent positive affect: does happiness lead to success?

Psych Bull

Association for Surgical Education
The relationship between grit and resident well-being