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Group 7 Research Proposal

Dos 711 – Research Methodology
04/01/22

Working Title
Perceptions of burnout in medical dosimetry in a post-pandemic work environment

Problem Statement
The problem is that medical dosimetrists could be experiencing increased burnout in the
workplace post-pandemic due to staff shortages and increased remote planning which may have
a negative impact on work performance.

Purpose Statement
The purpose of the study is to evaluate perceptions of medical dosimetrists specific to workplace
burnout in a post-pandemic environment.

Research Questions
For this draft, we have included sample survey questions relating to each of our categorized
research questions as requested by Nishele. The survey questions associated with research
question, Q1, are taken directly from Michelle Howard’s study since we planned to use her
method of assessing burnout. She categorized questions into emotional exhaustion,
depersonalization, and presence of personal achievement. Therefore the first 2 survey questions
in Q1 are Howard’s questions relating to emotional exhaustion, the 3rd is a depersonalization
question, and the 4th assesses presence of personal achievement.
(Q1) What effect do staffing shortages have on perceived burnout among medical dosimetrists?

a. Have you experienced staffing shortages since the start of the COVID-19 pandemic?
b. Choose your level of agreement: Due to staffing shortages, at the end of the day, I feel as
if I have nothing left to give.1
c. Choose your level of agreement: Due to staffing shortages, I dread the idea of going back
to work in the morning, after a weekend, etc.1
d. Choose your level of agreement: A shortage of staff has forced me to take on more work
than I can handle for given deadlines.

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e. Choose your level of agreement: Hiring new staff at my clinic would positively impact
my mood and well-being.

(Q2) What effect does remote planning appear to have on perceived burnout among medical
dosimetrists?

a. Choose the answer that applies: My clinic allows me to plan remotely…

a. Once a week, more than once a week, I am completely remote, or not at all
b. The constant demand (interruptions) from other people leaves me feeling frustrated at
work.1
c. Choose your level of agreement: I believe that remote planning allows me to complete
my work more efficiently than at the clinic (if not applicable, select NA)
d. Choose your level of agreement: I believe that remote planning has or could positively
impact my mood and well-being.

Literature Review Summary

Workplace burnout is closely related to other stress and anxiety disorders and can affect a
person’s mental and physical state.1 According to The World Health Organization, burnout is
described as having a negative attitude regarding one’s work and being exhausted.2 Medical
dosimetrists are of concern to succumbing to workplace burnout due to the demands of the job,
such as working on radiation treatment plans for terminally ill patients in a timely fashion.
Howard did a study in 2012 that focused on the incidence rates of burnout and compassion
fatigue (CF) among medical dosimetrists because although there have been burnout studies prior,
none have been hyper focused on this profession. A person can be assessed for burnout based on
exhibiting emotional exhaustion (EE), depersonalization (DP), and level of personal
accomplishment (PA). Therefore, Howard’s study involved questions that were aimed at
discovering whether a dosimetrist was experiencing issues in these areas. The survey included 40
questions and was disbursed to 2,072 members of the American Association of Medical
Dosimetrists (AAMD), but only 417 people met the requirements of the study. The survey was
based on the Maslach Burnout Inventory, but was not assessed for reliability. The study found
that over 25% of subjects exhibited EE, DP, or low PA.1
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The COVID-19 pandemic accelerated technological advancements for workers to be able

to work from home which may have affected the mental health of employees.3 The pandemic did
not just affect the workforce, but incorporated other potential stressors, such as school closures
which can cause caregiving issues to arise at home.2 A study by Hayes et al. assessed the
incidence of burnout among individuals with remote work access during the pandemic and
discovered that there was a higher rate of burnout among those who had remote access to work
prior to the pandemic.3 Since the inception of the Howard study, another burnout study involving
dosimetrists was conducted by Hoffman et al. This study included virtually all members of the
radiation oncology team as well, and out of 572 participants, only 42 were dosimetrists. The goal
of this study was to determine whether there was a link between working from home and
occupational burnout amidst the COVID-19 pandemic. Most of the participants from this study
admitted to being able to work remotely at least part of the time. Even with 100% of dosimetrists
capable of working remote to some capacity, 31% of them responded as experiencing burnout
according to their own interpretation of the term.2
There is a predicted imbalance in the number of dosimetrists per available dosimetry job
in the near future due to a variety of causes which could be affecting the burnout incidence of
these workers. Over the years, the standards for a dosimetrist’s education level have changed.
From 2012 to 2020, there was a 24% increase in dosimetrists with, or attempting to obtain, at
least a bachelor’s degree, and the number of dosimetrists who have attended a Joint Review
Committee for Education of Radiologic Technology (JRCERT) program grew within that same
timeframe. Being that a JRCERT degree is the gateway to sitting for the Medical Dosimetry
Certification Board (MDCB) exam, the pool of potential candidates for dosimetry jobs could
potentially shrink since many of the dosimetrists in years past did not need this credential.
Additionally, retirement rates of medical dosimetrists are expected to continuously increase until
2025-2030. During the COVID-19 pandemic, the average dosimetrist worked 6.4 hours less than
he did prior, indicating a possible correlation between the pandemic and sufficient staff
coverage. In 2020, when supply of dosimetrists met demand, a staff shortage was expected to
increase until 2035, and this may contribute to a current staff shortage in 2022 along with
COVID-19 and many of its restrictions still in place, some of which have impacted dosimetry
training.4
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Medical dosimetry makes for a potentially high stress environment. Dosimetrists are
expected to complete many treatment plans, sometimes simultaneously, in a short timeframe
with little to no mental decompression time, and the technology in the field is rapidly advancing,
which can be difficult to keep up with. These reasons make the members of this profession
exceptional candidates for an occupational burnout study. Hayes et al. and Hoffman et al. give
good examples of how occupational burnout exists among members of other job titles being that
these studies include an indiscriminate survey to remote workers, in that not one job title was
targeted, and a survey for non-dosimetrist in addition to dosimetrist radiation oncology workers
respectively.2,3 The problem is that medical dosimetrists could be experiencing increased burnout
in the workplace post-pandemic due to staff shortages and increased remote planning which may
have a negative impact on work performance. The purpose of the study is to evaluate perceptions
of medical dosimetrists specific to workplace burnout in a post-pandemic environment. In the
pursuit of this discovery, the researchers plan to answer questions such as, (Q1) what effect do
staffing shortages have on perceived burnout among medical dosimetrists and (Q2) what effect
does remote planning appear to have on perceived burnout among medical dosimetrists?
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References

1. Howard, M. The incidence of burnout or compassion fatigue in medical dosimetrists as a

function of various stress and psychologic factors. Med Dosim. 2013; 38(1):88-94.
https://doi.org/10.1016/j.meddos.2012.07.006
2. Hoffman KE, Garner D, Koong AC, Woodward WA. Understanding the intersection of
working from home and burnout to optimize post-covid19 work arrangements in
radiation oncology. Int J Radiat Oncol Biol Phys. 2020; 108(2):370-373. https://doi:
1016/j.ijrobp.2020.06.062
3. Hayes SW, Priestley JL, Moore BA, Ray HE. Perceived stress, work-related burnout, and
working from home before and during covid-19: an examination of workers in the United
States. SAGE Open. 2021; 11(4): https://doi.org/10.1177/21582440211058193
4. American Association of Medical Dosimetrists: Executive summary – medical dosimetry
workforce study: https://pubs.medicaldosimetry.org/pub/6C754B84-E1AA-DDA9-1C85-
2F6282AEA009. Updated June 21, 2021. Accessed April 12, 2022.