Faculty Burnout in Pharmacy Education

Predictors

The literature reveals a variety of predictors of stress and burnout for health professions faculty members. These include heavy workload, fatigue, poor work-life balance, female gender, having young children, multiple conflicting work responsibilities, negative work culture, policies, and inequities, as well as lower faculty rank and limited autonomy, collegiality, community, resources, training, rewards, and/or prestige.^7,8,12 El-Ibiary and colleagues measured the level of burnout and its predictors among 758 US pharmacy practice faculty members.⁷ Emotional exhaustion was identified in 41% of participants and was higher in women, assistant professors, and those without an outlet, such as a hobby. Having young children or no mentor led to increased depersonalization. The authors concluded that large numbers of US pharmacy practice faculty members are suffering from burnout.⁷ Strong predictors that have been noted among physician faculty members included heavy patient care responsibilities, lack of personal time, and poor work-life balance.¹² Common predictors in clinical nursing faculty members included younger age, emotional exhaustion, and depersonalization.⁹

Consequences

There are significant consequences to burnout, including higher rates of depression, self-medication with illicit drugs, alcohol abuse, suicidality, diminished patient satisfaction scores, and high employee turnover rates.^8,13 Burnout has substantial personal impact and negatively affects academic institutions and our academy as a whole, particularly in the areas of faculty recruitment and retention. While there is a lack of data within pharmacy education, a survey on careers in academic medicine noted that 17% of medical residents described burnout as a reason not to pursue an academic position.¹⁴ Another study found that over 40% of medical faculty members intend to leave academia because of burnout.¹⁵ High burnout rates are also a predictive factor for nursing faculty members to leave academic positions.⁸

Burnout is a clear deterrent to AACP’s strategic plan, which includes the priorities of enriching the applicant pipeline and creating a new portrait of pharmacy and pharmacy careers.¹⁶ We also know that burnout negatively affects the quality of patient care delivered by pharmacists, as evidenced by increased errors and decreased patient satisfaction of care.¹³ There is little known about the impact of faculty burnout on students, but it likely affects the quality of education delivered. This is an important area for exploration.¹⁷

Solutions

The AACP is committed to health care provider, educator, and student well-being and resilience. AACP is a collaborating partner with the National Academy of Medicine, which also recognizes the importance of this issue.¹ Unfortunately, evidence suggests that individual institutions of higher learning have not embraced the call for faculty wellness to the same extent as they have for student wellness.¹³ Because predictors are the foundation for preventative and rehabilitation strategies, collaborative efforts across health care professions and universities in analyzing predictors would facilitate solutions and policies aimed at reducing faculty burnout.^14,18

We are calling for those in supervisory positions to include predictive risk factors based on faculty groups/roles as a component of every pharmacy faculty member’s annual performance review. Risks should be discussed and an evaluation of the faculty members’ well-being should be conducted. Together, supervisors and employees should develop and implement a personalized plan to meet individual needs.^14,18 Solutions might include alternative practice models such as job sharing or restructuring of duties.¹⁹ Sacks and colleagues highlighted two job-sharing models within academic family medicine where faculty teams distribute conflicting faculty responsibilities.¹⁹ Providing increased support staff to assist with research, teaching, and patient care, as well as creating technological solutions may reduce workload stress. Time and responsibilities should be proportionally appropriate for positions that require accountability to multiple supervisors, such as faculty/clinical roles or faculty/administrative roles. Foster et all describe how resilience programs have improved mental health nurses coping self-efficacy and capacity to regulate thoughts and emotions in their work environments and organizations. ²⁰ This approach is supported by a systematic review and meta-analysis by Panagioti and colleagues that describes how organization-directed interventions manage burnout somewhat better than individual faculty-directed interventions.¹³ Some additional areas under institutional control include provision of free or low-cost health and wellness programs, reduction of teaching and/or patient care loads, consolidation of software platforms, and limitations on the use of technology after hour (e.g., checking and responding to email). Academic institutions should examine the mechanisms by which private corporations ensure employee wellness, optimal productivity, and excellent customer service, as they have long recognized that their existence depends on it. Unfortunately, there is little evidence in the literature indicating that academic health care fully recognizes the significance and impact of faculty wellbeing.