Examining Resident Burnout Through the Lens of Self-Determination Theory: The Role of General Causality Orientations

Background Burnout continues to plague graduate medical education, and theory-informed approaches are lacking for effectively tackling this problem. Studies on personal factors that explain physician burnout have also neglected the role of self-determination. In self-determination theory, general causality orientations— autonomy , control , and impersonal —represent individual differences in self-determination that can be socialized and primed within environments, each relating to different motivation, behavior, and well-being outcomes. Objective To investigate how each general causality orientation relates to resident burnout, the hypothesis being that the autonomy orientation will negatively correlate, while the control and impersonal orientations will positively correlate. Methods Surveys containing demographic questions and 2 scales—the Causality Orientations at Work Scale and Oldenburg Burnout Inventory—were sent in 2023 to a sample of Canadian residents across 3 institutions. Correlation and multiple regression analyses were performed, controlling for significant demographic factors. Results A total of 243 of 1200 residents (20.5%) completed the survey. The 3 general causality orientations accounted for 31.5% of the variance in resident burnout, with autonomy correlating negatively ( B =-0.24; P <.001; 95% CI, -0.37 to -0.11) and control ( B =0.20; P =.003; 95% CI, 0.07 to 0.33) and impersonal ( B =0.28; P <.001; 95% CI, 0.13 to 0.42) correlating positively. Conclusions Resident burnout is positively associated with the control and impersonal causality orientations, and negatively associated with the autonomy causality orientation.