Impact of resident well-being and empathy on assessments of faculty physicians

Background: Teaching effectiveness is an important criterion for promoting clinician-educators. However, the relationship between residents' psychological characteristics and their assessments of faculty physicians is unknown. Objective: To determine whether residents' well-being and empathy influenced their assessments of faculty physicians. Design, Setting, and Participants: We studied 1,191 assessments of 356 faculty physicians by 209 internal medicine residents at a large academic medical center from 2007 to 2008. A repeated measures design with multivariate generalized estimating equations was used to evaluate associations between resident well-being and empathy, and residents' assessments of faculty. Measurements: Resident surveys included standardized measures of quality of life, burnout, depression, and empathy. Residents assessed faculty members' teaching performance with a validated 16-item instrument. Results: 149 residents (71%) provided well-being, empathy, and assessment data. In multivariate models, faculty assessments from the previous year were the strongest predictor of current resident-of-faculty assessment scores. Residents' Jefferson Scale of Physician Empathy (JSPE) scores were also associated with faculty assessments (beta=0.0063, 95% CI=0.0018-0.0108; p=.0061). On this 140-point, 20-item scale, a 10-point increase in empathy correlated with a 0.063-point increase in residents' assessments of faculty on a 5-point scale. There were no significant associations between residents' assessments of faculty and quality of life, burnout, or depression. Conclusions: This study demonstrates that residents' well-being does not influence their assessments of faculty physicians, thus supporting the trustworthiness of these assessments as a criterion for promoting clinician-educators. However, the association between residents' empathy and resident-of-faculty assessments suggests that faculty assessments may be modestly influenced by residents' intrinsic characteristics.