A mixed methods study on the association between burnout symptoms and expectations regarding clerkships in Dutch medical students.

Background: Over half of the Dutch students experience burnout symptoms. In order to design effective interventions, it is important to know more about cognitions and behaviors that relate to burnout. An example of such cognitions might be inaccurate expectations of medical students regarding their study, as studies in other populations already indicated that unmet expectations can relate to burnout symptoms. Therefore, the aim of this study is to evaluate the relationship between an expectation-reality mismatch of medical students and burnout symptoms. Methods: We performed an exploratory mixed methods study consisting of two sequential data collection methods. Firstly, individual semi-structured interviews were performed with six students to explore expectations. Secondly, we designed an anonymous questionnaire to explore presence of expectation mismatches and the relationship with burnout symptoms. Burnout was assessed using the short Burnout Assessment Tool (sBAT). Results: 155 medical students filled in the questionnaire. Important mismatch topics were: level of supervision, feedback quality, amount of time spent on different tasks, amount of initiative needed and culture on clerkship location. We found that 21.9% of the students scored high to very high on the sBAT. Moreover, a mismatch between expectations and reality was positively correlated with burnout. Conclusions: Students that experienced a bigger mismatch between expectations and reality also experienced more burnout symptoms. Consequently, it is important that future research further establishes this relationship, as expectation management might be an interesting avenue to reduce negative experiences and emotions during the clerkships.