Responsiveness of the Oldenburg Burnout Inventory for Medical Students and Predictors of Sustained Burnout during Clinical Clerkships: A Five‐Wave Longitudinal Cohort Study

要旨

RATIONALE: Robust outcome measurement is central to evaluating clinical training environments and providing timely support to medical students. Burnout during clinical clerkships is common; however, evidence of the capability of instruments to monitor sustained risks and detect meaningful changes remains limited. AIMS AND OBJECTIVES: To evaluate the responsiveness of the 11-item Oldenburg Burnout Inventory-Medical Student version (OLBI-MS-11) and examine the baseline predictors of individuals' sustained burnout during their clerkships. METHODS: We examined within-person change correlations between the OLBI-MS-11 and domain-matched anchors (Maslach Burnout Inventory-General Survey [MBI-GS] subscales) in a five-wave longitudinal cohort study of Japanese medical students (N = 162). We assessed the instrument's discrimination of MBI-defined burnout caseness and analysed associations between burnout trajectories and clinically relevant constructs, including psychological flexibility, depressive symptoms, perceived stigma, mistreatment, and absence of clerkship. RESULTS: The OLBI-MS-11 demonstrated moderate, domain-concordant correlations in within-person changes with the MBI-GS subscales across adjacent time points and maintained a stable discrimination of burnout caseness (AUC ≈ 0.82-0.84). Changes in burnout were associated with concurrent changes in psychological flexibility and depressive symptoms. Higher baseline psychological flexibility was associated with a reduced risk of sustained burnout, whereas mistreatment predicted persistent burnout. CONCLUSIONS: The OLBI-MS-11 showed responsiveness and discriminative validity in clinical clerkships. Its use may facilitate the longitudinal monitoring of medical students' well-being and inform the identification of sustained burnout risk. Continuous-change metrics may provide a more nuanced evaluation of individual trajectories than dichotomous classifications alone.

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