Applying Job Demands-Resources (JD-R) Theory to the Understanding of Residency Program Director Well-Being

Abstract

Literature on well-being of physicians and residency program directors (PD) has shown a prevalence of burnout of 50 percent in physicians and 20 to 30 percent in PDs. However, few studies have explored engagement, or meaningful aspects of a physician’s work and no study in the PD community. Therefore, this study explored the experiences of PDs and associate program directors (APDs) as they encountered burnout, engagement, and every combination thereof. A qualitative methodology was utilized to include longitudinal and cross-sectional data-collection phases with all participants recruited via email. Phase 1 participants (n = 3) included two PDs and one (APD) from a midwestern university. Phase 1 included three semi-structured interviews and direct observations. Phase 2 participants (n = 5 PDs) completed a single semi-structured interview. All interviews and field notes were analyzed using inductive thematic analysis, with subsequent deductive application of the Job Demands-Resources (JD-R) theory. Findings were multiple subthemes situated within four major themes: It Takes a Village, Integration of the “Hats” They Wear, Motivation and the Meaning of Their Career, and Coping. Exploring the subthemes via JD-R theory allowed contextualization of how job demands, job resources, personal resources, and job-crafting interact, thus adding a broader conceptualization of how PD and APD experienced their roles. This study describes the experiences of PDs and APDs embedded in their social context of responsibilities. The results indicate an understanding of how the individual experiences their job demands influenced by job and personal resources, and how proactively engaging with their environment enables for a deeper appreciation of engagement and burnout.