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Eval Health Prof. 2017 Jan 1:163278717729732. doi: 10.1177/0163278717729732. [Epub ahead of print]

Effects of Job Burnout and Emotional Labor on Objective Structured Clinical Examination Performance Among Interns and Residents in Taiwan.

Wang CY1,2, Chen JD3, Wang CH4, Wang JY5, Tai CJ5,6, Hsieh TY7,8, Chen DY7,9,10,11.

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1 Department of Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
2 Department of Nursing, Hungkuang University, Taichung, Taiwan.
3 Department of Sports, National Changhua University of Education, Changhua, Taiwan.
4 Graduate Institute of Education, National Changhua University of Education, Changhua, Taiwan.
5 Department of Health Services Administration, China Medical University, Taichung, Taiwan.
6 Department of Otolaryngology, China Medical University Hospital, Taichung, Taiwan.
7 Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan.
8 Department of Computer Science and Information Engineering, Da-Yeh University, Changhua, Taiwan.
9 School of Medicine, National Yang-Ming University, Taipei, Taiwan.
10 Institute of Biomedical Science, National Chung Hsing University, Taichung, Taiwan.
11 Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan.


Medical education faces challenges concerning job burnout and emotional labor among junior physicians, which poses a potential threat to the quality of medical care. Although studies have investigated job burnout and emotional labor among physicians, empirical research on the association between job burnout, emotional labor, and clinical performance is lacking. This study investigated the effects of job burnout and emotional labor on clinical performance by using the objective structured clinical examination (OSCE) scores of interns and residents. Specifically, this cross-sectional study utilized the Maslach Burnout Inventory and the Emotional Labor Questionnaire as measurement instruments. A total of 225 interns and residents in central Taiwan answered structured questionnaires before beginning their OSCE. The major statistical analysis method employed was logistic regression. After adjustment for covariates, first-year residents were less likely than other residents to obtain high OSCE scores. The odds of high OSCE performance among interns and residents with high interaction component scores in emotional labor were significantly higher than those with low interaction scores. A high score in the interaction dimension of emotional labor was associated with strong clinical performance. The findings suggest that interventions which motivate positive attitudes and increase interpersonal interaction skills among physicians should receive higher priority.


clinical performance; emotional labor; job burnout; junior physicians; objective structured clinical examination

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