Presentation
Exploring Burnout in Prehospital Care: The Role of Emotional Intelligence and Conflict Management Styles.
DescriptionIntroduction
Prehospital care professionals are exposed to numerous occupational stressors, including irregular working hours, environmental constraints, and frequent exposure to interpersonal conflicts. Such conflicts may occur within the team, with other professionals, patients, their relatives, or with potentially hostile bystanders (Parvaresh-Massoud et al., 2021). At the same time, these providers must manage life-threatening emergencies under strict time pressure. Together, these factors can lead to high levels of emotional stress which, if sustained, may result in burnout syndrome.
Originally studied in human service professions, burnout is typically defined by three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment (Maslach & Jackson, 1981). These dimensions are also observed among healthcare professionals, although there is variability in prevalence rates (Rotenstein et al., 2018). While burnout is recognized as a multifactorial phenomenon influenced by organizational, interpersonal, and contextual factors, recent studies have also highlighted individual-level protective factors, such as emotional intelligence (EI) (Vlachou et al., 2016).
EI is a multidimensional construct linking emotion and cognition to enhance interpersonal functioning (Mayer & Salovey, 1997). Despite differences across models, most agree on two core components, emotional awareness and emotional management, each expressed on intrapersonal and interpersonal levels. In healthcare, EI has been associated with improved teamwork, communication, stress management, leadership (Arora et al., 2010), and performance during emergency care (Bourgeon et al., 2016). However, little research has explored the specific role of EI in mitigating burnout among prehospital physicians, despite the unique stressors they face.
A recent study among firefighters suggested a link between conflict management styles, EI, and burnout (Michinov, 2022). Given the frequency and emotional intensity of conflicts in prehospital care, we hypothesized a similar relationship in the preshopital physician population. To test this, we conducted a cross-sectional study using an online survey. Our aim was to inform targeted interventions for burnout prevention in this high-risk group.
Methods
Participants
Forty physicians (17 women, 23 men) from the Paris Fire Brigade (PFB) participated in the study, representing 59% of this physician population. Only physicians working on intensive care ambulances were included. Participants ranged in age from 28 to 60 years (mean = 41.6 ± 9.3), with experience in the PFB ranging from 1 to 25 years (mean = 9.8 ± 8.3), and total prehospital care experience ranging from 1 to 38 years (mean = 13.8 ± 10.1).
Measures
Participants completed an online survey comprising three validated self-report instruments:
• The Work Group Emotional Intelligence Profile – Short version (WEIP-S) (Jordan & Lawrence, 2009 ; Michinov & Michinov, 2022) to assess EI. The 16-item questionnaire evaluates four dimensions: awareness and management of one's own emotions, and awareness and management of others’ emotions.
• The Thomas-Kilmann Conflict Mode Instrument (TKI) (Kilmann & Thomas, 1977), consisting of 30 paired statements used to identify predominant conflict management styles. The five styles—collaborating, competing, compromising, accommodating, and avoiding—are defined by varying levels of assertiveness and cooperativeness.
• The Maslach Burnout Inventory (MBI, Maslach & Jackson, 1981), a 22-item tool that measures the three burnout dimensions.
Statistical Analysis : Pearson correlations were calculated to examine relationships among EI dimensions, conflict management styles, and burnout dimensions.
Results
Significant correlations were found between burnout and several EI and conflict management variables.
Emotional exhaustion was negatively correlated with awareness of one’s own emotions (r = –.47, p < .05). Personal accomplishment was positively correlated with management of one’s own emotions (r = .36, p < .05), awareness of others’ emotions (r = .51, p < .001), and management of others’ emotions (r = .53, p < .001).
Emotional exhaustion was negatively correlated with collaborating (r = –.49, p < .001) and positively with accommodating (r = .35, p < .05). Depersonalization was negatively correlated with collaborating (r = –.55, p < .001) and compromising (r = –.34, p < .05), and positively with competing (r = .37, p < .05). Personal accomplishment was positively correlated with collaborating (r = .32, p < .05).
In addition, EI was significantly associated with conflict styles: Awareness of one’s own emotions was negatively correlated with competing (r = –.38, p < .05). Management of one’s own emotions was positively correlated with compromising (r = .39, p < .05).
Discussion
In line with previous findings (Michinov, 2022; Vlachou et al., 2016), our results confirmed the hypothesis that EI plays a protective role against burnout. Physicians with higher awareness of their own emotions reported lower emotional exhaustion, while those with higher scores on the other three EI dimensions reported greater personal accomplishment. These findings suggest that EI includes key competencies for reducing burnout risk in prehospital care.
Interestingly, no correlation was found between EI and depersonalization. This may reflect the high-pressure emergency context, where the clinical focus may outweigh interpersonal connection with patients.
Regarding conflict styles, collaborating emerged as the only style positively associated with all three burnout dimensions—linked to lower emotional exhaustion, lower depersonalization, and higher personal accomplishment. This mirrors findings in firefighter populations (Michinov, 2022). Compromising was also associated with lower depersonalization. Both styles involve a balance of assertiveness and cooperativeness, suggesting that constructive conflict resolution may mitigate burnout.
In contrast, accommodating (high cooperativeness, low assertiveness) was linked to higher emotional exhaustion, suggesting that assertiveness is crucial for emotional resilience. Conversely, competing (high assertiveness, low cooperativeness) was associated with increased depersonalization. Thus, both unbalanced conflict styles appear related to burnout, albeit through different mechanisms.
Conclusion
Our findings indicate that developing emotional intelligence and training prehospital physicians in collaborative conflict management styles may be effective strategies for preventing burnout in this high-stress field.
References
Arora, S., Ashrafian, H., Davis, R., Athanasiou, T., Darzi, A., & Sevdalis, N. (2010). Emotional intelligence in medicine: a systematic review through the context of the ACGME competencies. Medical Education, 44, 749-764. https://doi.org/10.1111/j.1365-2923.2010.03709.x
Bourgeon, L., Bensalah, M., Vacher, A., Ardouin, J., -C., & Debien, B. (2016). Role of emotional competence in residents' simulated emergency care performance: a mixed-methods study. BMJ Quality & Safety, 25, 364-371. https://doi.org/10.1136/bmjqs-2015-004032
Jordan, P.J., & Lawrence, S.A. (2009). Emotional intelligence in teams: Development and initial validation of the short version of the Workgroup Emotional Intelligence Profile (WEIP-S). Journal of Management & Organization, 15(4), 452-469. https://doi.org/10.5172/jmo.15.4.452
Kilmann, R. H., & Thomas, K. W. (1977). Developing a forced-choice measure of conflict-handling behavior: The « Mode » Instrument. Educational and Psychological Measurement, 37(2), 309-325. https://doi.org/10.1177/001316447703700204
Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of occupational behaviour, 2, 99-113.
Mayer, J. D., & Salovey, P. (1997). What is emotional intelligence ? In P. Salovey & D. Sluyter (Eds.), Emotional development and emotional intelligence: Educational implications (pp. 3-31). New-York: Basic Books.
Michinov, E. (2022). The moderating role of emotional intelligence on the relationship between conflict management styles and burnout among firefighters. Safety and Health at Work, 13(4), 448-455. https://doi.org/10.1016/j.shaw.2022.07.001
Michinov, E., & Michinov, N. (2022). When emotional intelligence predicts team performance: Further validation of the short version of the Workgroup Emotional Intelligence Profile. Current Psychology, 41(3), 1323-1336. https://doi.org/10.1007/s12144-020-00659-7
Parvaresh-Masoud, M., Cheraghi, M. A., Imanipour, M. (2021). Workplace interpersonal conflict in prehospital emergency : Concept analysis. Journal of Education and Health Promotion, 10, 347. https://doi.org/10.4103/jehp.jehp_213_21
Rotenstein, L. S., Torre, M., Ramos, M. A., Rosales, R. C., Guille, C., Sen, S., & Mata, D. A. (2018). Prevalence of burnout among physicians: A systematic review. JAMA, 320 (11), 1131-1150. https://doi.org/10.1001/jama.2018.12777
Vlachou, E. M., Damigos, D., Lyrakos, G., Chanopoulos, K., Kosmidis, G., & Karavis, M. (2016). The relationship between burnout syndrome and emotional intelligence in healthcare professionals. Health Science Journal, 10(5), 1-9. https://doi.org/10.4172/1791-809X.1000100502
Prehospital care professionals are exposed to numerous occupational stressors, including irregular working hours, environmental constraints, and frequent exposure to interpersonal conflicts. Such conflicts may occur within the team, with other professionals, patients, their relatives, or with potentially hostile bystanders (Parvaresh-Massoud et al., 2021). At the same time, these providers must manage life-threatening emergencies under strict time pressure. Together, these factors can lead to high levels of emotional stress which, if sustained, may result in burnout syndrome.
Originally studied in human service professions, burnout is typically defined by three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment (Maslach & Jackson, 1981). These dimensions are also observed among healthcare professionals, although there is variability in prevalence rates (Rotenstein et al., 2018). While burnout is recognized as a multifactorial phenomenon influenced by organizational, interpersonal, and contextual factors, recent studies have also highlighted individual-level protective factors, such as emotional intelligence (EI) (Vlachou et al., 2016).
EI is a multidimensional construct linking emotion and cognition to enhance interpersonal functioning (Mayer & Salovey, 1997). Despite differences across models, most agree on two core components, emotional awareness and emotional management, each expressed on intrapersonal and interpersonal levels. In healthcare, EI has been associated with improved teamwork, communication, stress management, leadership (Arora et al., 2010), and performance during emergency care (Bourgeon et al., 2016). However, little research has explored the specific role of EI in mitigating burnout among prehospital physicians, despite the unique stressors they face.
A recent study among firefighters suggested a link between conflict management styles, EI, and burnout (Michinov, 2022). Given the frequency and emotional intensity of conflicts in prehospital care, we hypothesized a similar relationship in the preshopital physician population. To test this, we conducted a cross-sectional study using an online survey. Our aim was to inform targeted interventions for burnout prevention in this high-risk group.
Methods
Participants
Forty physicians (17 women, 23 men) from the Paris Fire Brigade (PFB) participated in the study, representing 59% of this physician population. Only physicians working on intensive care ambulances were included. Participants ranged in age from 28 to 60 years (mean = 41.6 ± 9.3), with experience in the PFB ranging from 1 to 25 years (mean = 9.8 ± 8.3), and total prehospital care experience ranging from 1 to 38 years (mean = 13.8 ± 10.1).
Measures
Participants completed an online survey comprising three validated self-report instruments:
• The Work Group Emotional Intelligence Profile – Short version (WEIP-S) (Jordan & Lawrence, 2009 ; Michinov & Michinov, 2022) to assess EI. The 16-item questionnaire evaluates four dimensions: awareness and management of one's own emotions, and awareness and management of others’ emotions.
• The Thomas-Kilmann Conflict Mode Instrument (TKI) (Kilmann & Thomas, 1977), consisting of 30 paired statements used to identify predominant conflict management styles. The five styles—collaborating, competing, compromising, accommodating, and avoiding—are defined by varying levels of assertiveness and cooperativeness.
• The Maslach Burnout Inventory (MBI, Maslach & Jackson, 1981), a 22-item tool that measures the three burnout dimensions.
Statistical Analysis : Pearson correlations were calculated to examine relationships among EI dimensions, conflict management styles, and burnout dimensions.
Results
Significant correlations were found between burnout and several EI and conflict management variables.
Emotional exhaustion was negatively correlated with awareness of one’s own emotions (r = –.47, p < .05). Personal accomplishment was positively correlated with management of one’s own emotions (r = .36, p < .05), awareness of others’ emotions (r = .51, p < .001), and management of others’ emotions (r = .53, p < .001).
Emotional exhaustion was negatively correlated with collaborating (r = –.49, p < .001) and positively with accommodating (r = .35, p < .05). Depersonalization was negatively correlated with collaborating (r = –.55, p < .001) and compromising (r = –.34, p < .05), and positively with competing (r = .37, p < .05). Personal accomplishment was positively correlated with collaborating (r = .32, p < .05).
In addition, EI was significantly associated with conflict styles: Awareness of one’s own emotions was negatively correlated with competing (r = –.38, p < .05). Management of one’s own emotions was positively correlated with compromising (r = .39, p < .05).
Discussion
In line with previous findings (Michinov, 2022; Vlachou et al., 2016), our results confirmed the hypothesis that EI plays a protective role against burnout. Physicians with higher awareness of their own emotions reported lower emotional exhaustion, while those with higher scores on the other three EI dimensions reported greater personal accomplishment. These findings suggest that EI includes key competencies for reducing burnout risk in prehospital care.
Interestingly, no correlation was found between EI and depersonalization. This may reflect the high-pressure emergency context, where the clinical focus may outweigh interpersonal connection with patients.
Regarding conflict styles, collaborating emerged as the only style positively associated with all three burnout dimensions—linked to lower emotional exhaustion, lower depersonalization, and higher personal accomplishment. This mirrors findings in firefighter populations (Michinov, 2022). Compromising was also associated with lower depersonalization. Both styles involve a balance of assertiveness and cooperativeness, suggesting that constructive conflict resolution may mitigate burnout.
In contrast, accommodating (high cooperativeness, low assertiveness) was linked to higher emotional exhaustion, suggesting that assertiveness is crucial for emotional resilience. Conversely, competing (high assertiveness, low cooperativeness) was associated with increased depersonalization. Thus, both unbalanced conflict styles appear related to burnout, albeit through different mechanisms.
Conclusion
Our findings indicate that developing emotional intelligence and training prehospital physicians in collaborative conflict management styles may be effective strategies for preventing burnout in this high-stress field.
References
Arora, S., Ashrafian, H., Davis, R., Athanasiou, T., Darzi, A., & Sevdalis, N. (2010). Emotional intelligence in medicine: a systematic review through the context of the ACGME competencies. Medical Education, 44, 749-764. https://doi.org/10.1111/j.1365-2923.2010.03709.x
Bourgeon, L., Bensalah, M., Vacher, A., Ardouin, J., -C., & Debien, B. (2016). Role of emotional competence in residents' simulated emergency care performance: a mixed-methods study. BMJ Quality & Safety, 25, 364-371. https://doi.org/10.1136/bmjqs-2015-004032
Jordan, P.J., & Lawrence, S.A. (2009). Emotional intelligence in teams: Development and initial validation of the short version of the Workgroup Emotional Intelligence Profile (WEIP-S). Journal of Management & Organization, 15(4), 452-469. https://doi.org/10.5172/jmo.15.4.452
Kilmann, R. H., & Thomas, K. W. (1977). Developing a forced-choice measure of conflict-handling behavior: The « Mode » Instrument. Educational and Psychological Measurement, 37(2), 309-325. https://doi.org/10.1177/001316447703700204
Maslach, C., & Jackson, S. E. (1981). The measurement of experienced burnout. Journal of occupational behaviour, 2, 99-113.
Mayer, J. D., & Salovey, P. (1997). What is emotional intelligence ? In P. Salovey & D. Sluyter (Eds.), Emotional development and emotional intelligence: Educational implications (pp. 3-31). New-York: Basic Books.
Michinov, E. (2022). The moderating role of emotional intelligence on the relationship between conflict management styles and burnout among firefighters. Safety and Health at Work, 13(4), 448-455. https://doi.org/10.1016/j.shaw.2022.07.001
Michinov, E., & Michinov, N. (2022). When emotional intelligence predicts team performance: Further validation of the short version of the Workgroup Emotional Intelligence Profile. Current Psychology, 41(3), 1323-1336. https://doi.org/10.1007/s12144-020-00659-7
Parvaresh-Masoud, M., Cheraghi, M. A., Imanipour, M. (2021). Workplace interpersonal conflict in prehospital emergency : Concept analysis. Journal of Education and Health Promotion, 10, 347. https://doi.org/10.4103/jehp.jehp_213_21
Rotenstein, L. S., Torre, M., Ramos, M. A., Rosales, R. C., Guille, C., Sen, S., & Mata, D. A. (2018). Prevalence of burnout among physicians: A systematic review. JAMA, 320 (11), 1131-1150. https://doi.org/10.1001/jama.2018.12777
Vlachou, E. M., Damigos, D., Lyrakos, G., Chanopoulos, K., Kosmidis, G., & Karavis, M. (2016). The relationship between burnout syndrome and emotional intelligence in healthcare professionals. Health Science Journal, 10(5), 1-9. https://doi.org/10.4172/1791-809X.1000100502
Event Type
Oral Presentations
TimeWednesday, March 258:52am - 9:15am EDT
LocationMorgan
Simulation and Education