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August 25, 2020IISE Transactions on Healthcare Systems Engineering

Stress and burnout among attending and resident physicians in the ED: a comparative study

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Key result

Attending physicians demonstrated higher heart rate variability (RMSSD 44.2 vs. 35.4, p=0.033) and a lower workload index compared to resident physicians, implying lower stress levels.

Why the study?

Burnout among physicians is increasing annually, especially in emergency medicine, but whether stress and burnout rates differ between attending and resident emergency physicians on the same shift remains unclear.

Do stress levels and burnout rates differ between attending and resident physicians in the emergency department?

Population

Twelve attending and resident physicians at an academic Level 1 trauma center emergency department

Comparison

Attending vs resident physicians working on the same shift

Design

Comparative observational study

Authors

VPVishnunarayan Girishan PrabhuUniversity of Central FloridaKTKevin TaaffeClemson UniversityRPRonald G. PirralloPrisma Health

Discussion

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Member takes

Overview

Attending ED physicians may have lower acute stress than residents; hypothesis-generating for burnout interventions and needs prospective confirmation.

Study Design

Type

Observational (n=12)

Multicenter

No

Structured PICO

Do stress levels and burnout rates differ between attending and resident physicians in the emergency department?

P
Population
12 attending and resident physicians working in an academic Level 1 trauma center emergency department on the same shift.
E
Exposure
Attending physician status
C
Comparator
Resident physician status
O
Outcome
Stress levels (measured via heart rate variability and electrodermal activity), burnout scores (Maslach Burnout Inventory), and workload index (NASA-TLX)surrogate

Main Result

Absolute Event Rate: 44.2% vs 35.4%

p-value: p=0.033

Attending ED physicians experience lower physiological stress and perceived workload during shifts compared to residents, though burnout levels are similar.

Cite This Study

Prabhu et al. (2020) conducted an observational in Stress and burnout (n=12). Attending physician status vs. Resident physicians was evaluated on Heart rate variability (RMSSD) for the entire shift (p=0.033). Attending physicians demonstrated higher heart rate variability (RMSSD 44.2 vs. 35.4, p=0.033) and a lower workload index compared to resident physicians, implying lower stress levels.

synapsesocial.com/papers/6a9affd3ec841b31226f3746https://doi.org/10.1080/24725579.2020.1814456
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Examining Rates of Burnout Among Emergency Medicine and Pediatric Emergency Medicine Physicians2026
  2. 2Exploring Burnout, Work Addiction, and Stress-Related Growth among Prehospital Emergency Personnel2024 · 14 citations
  3. 3Analysis of factors affecting fatigue in emergency medicine residents: A nationwide, cross-sectional, descriptive study.2025 · 2 citations
  4. 4Burnout Dimensions and Associated Factors Among Orthopedic and Traumatology Physicians: A Cross-Sectional Study from Türkiye2026
  5. 5Measuring resilience, performance anxiety and burnout in emergency medicine residents2025