Stress, resilience linked to burnout dimensions in Chinese residency faculty survey

A multicentre cross-sectional survey of 478 residency programme faculty at 15 hospitals found that perceived stress was associated with all three dimensions of teaching-related burnout, while resilience had its clearest association with professional efficacy. The analysis indicated that perceived stress was more strongly linked to emotional exhaustion and cynicism than to reduced professional efficacy, revealing a different pattern across the burnout dimensions examined. Nearly all participants were based in Guangdong Province, China: 99.0% of the 478 respondents were recruited there.

The investigators used blockwise regression models for 471 complete cases, incorporated hospital fixed effects and adjusted inference for clustering by hospital, and compared standardised coefficients across outcomes using 10,000 hospital bootstrap replicates. Because the study was observational, its results identify associations rather than establishing that stress, resilience or social support causes burnout. After adjustment, perceived stress was associated with greater emotional exhaustion, with a standardised coefficient of β = 0.457, and greater cynicism, at β = 0.369.

It was also associated with lower professional efficacy, although this relationship was weaker, at β = −0.199. The cross-dimension comparison found no clear difference between the strength of the stress associations with emotional exhaustion and cynicism after the coefficient directions were aligned. Resilience showed a different pattern.

Taken together, the adjusted results suggest that perceived stress and resilience were connected to different dimensions of the burnout measure, with the stress relationship strongest for exhaustion and cynicism and the resilience relationship concentrated around professional efficacy. Unadjusted bivariate analyses also identified correlations involving anxiety symptoms, depressive symptoms and sleep quality. Greater anxiety and depressive symptoms and poorer sleep quality were each correlated with greater emotional exhaustion and cynicism and with lower professional efficacy.

These correlations were not the principal focus of the adjusted models, which concentrated on perceived stress, resilience and general social support when examining their relationships with the three burnout dimensions. General social support had comparatively small adjusted associations with the burnout outcomes. It was associated with lower cynicism, at β = −0.101, and higher professional efficacy, at β = 0.096, although the cynicism estimate was less consistent across analytical methods.

An exploratory interaction between perceived stress and general social support for cynicism was also small, at β = −0.093, and accounted for ΔR² = 0.008. Its Benjamini–Hochberg-adjusted q value was 0.008, but its inferential support varied when individual hospitals were omitted. The researchers used wild cluster and site influence analyses to assess whether the results remained robust given the limited number of hospitals and their unequal sizes.

The findings nevertheless have important scope limits. The sample was geographically concentrated in Guangdong Province, and the cross-sectional design cannot determine whether the measured psychological and psychosocial factors preceded changes in burnout. The exploratory interaction also should not be interpreted as evidence that social support buffers the relationship between perceived stress and cynicism.

Overall, the study reports a differentiated association pattern among residency programme faculty: perceived stress was linked to all three measured burnout dimensions but less strongly to professional efficacy, whereas resilience was associated mainly with professional efficacy. General social support showed only small direct associations. The authors said that longitudinal studies using teaching-specific measures are needed to clarify how these relationships develop over time, while the concentration of participants in one Chinese province limits generalisation beyond the participating hospitals.

Subject of Research: Psychological and psychosocial correlates of teaching-related burnout among residency programme faculty

Article Title: Psychological and psychosocial correlates of teaching-related burnout dimensions among residency programme faculty: a multicentre cross-sectional study

Article References: Sun, T., Yang, X., Chen, Q., Wu, X., Xu, Z., Yu, J., Yao, Y., & Zhang, M. (2026). Psychological and psychosocial correlates of teaching-related burnout dimensions among residency programme faculty: a multicentre cross-sectional study. BMC Psychology. https://doi.org/10.1186/s40359-026-05599-8

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05599-8

Keywords: teaching-related burnout, residency programme faculty, perceived stress, resilience, general social support, emotional exhaustion, cynicism, professional efficacy, cross-sectional survey, multicentre study, Psychological, psychosocial