COVID-19 Limitations on Doodling in Measuring Burnout: History
Please note this is an old version of this entry, which may differ significantly from the current revision.

Burnout is a negative, job-related psychological state exhibited through physical fatigue, emotional exhaustion, and loss of motivation. Pre-COVID-19, doodling was identified as a measure of burnout in researchers attending a weekly, in-person health narratives research group manifesting team mindfulness. Doodling was not retained as a possible measure of burnout during COVID-19 once the weekly health narratives research group moved online and aware attention to present perceptions—one aspect of team mindfulness—was no longer evident.

  • COVID-19
  • burnout
  • doodling
  • team mindfulness
  • anxiety
  • depression

1. Introduction

Burnout is a syndrome arising from prolonged chronic interpersonal stressors associated with work. It is represented by three key dimensions [1]: overwhelming exhaustion, negative work-related feelings of cynicism and disassociation, and a sense of futility from perceived job-affiliated failure. Furthermore, it has been particularly associated with the health professions [2]. Early in the history of burnout research, it was found to be significantly related to job termination but not to absenteeism [3]. For healthcare researchers and their employers, the discontinuation of work undertaken equates to a loss of the production of valuable research [4]. Directly associated with symptoms of depression and anxiety [5][6], if burnout is to be diminished, an easily employed and reliable measure of depression and anxiety is important.

Team mindfulness, with respect to the construction and maintenance of work environments that protect against burnout, has become an increasingly relevant consideration regarding enhanced, work-related, personal fulfilment [7]—where team mindfulness is defined as a common belief among team members that their group’s cohesiveness is based on non-judgmental awareness and attention in realizing team-related experiences [8].
Doodling is defined as aimless scrawl made while a person’s attention is otherwise engaged [9]. Reasons for this behavior have been identified as boredom, the need for a productive activity while otherwise engaged, a form of fidgeting when forced to stay inactive, a means of artistic expression [10], to provide “thinking” benefits [11], as a method of discovery [12], or as something, when compared with coloring and free drawing, that is paramount in activating the medial prefrontal cortex [13]. What doodling behavior is not is a method to improve task-related episodic memory [14].
Doodling has recently been recognized as a potential measure of depression and anxiety based on unexpected outcomes from comparing doodles over a number of years, associated with one discretional health narrative research group supporting diversity of membership where doodling was introduced [15]. The result regarding casual, self-reported levels of depression and anxiety of group participants indicated—under the well-defined conditions of the group—that modifications in doodling over the sessions offered a measure of change in these internal states of the researchers. As such, there is reason to suppose that doodling holds the potential to directly appraise the range of disaffect associated with burnout and increase work engagement in researchers under conditions where team mindfulness is supported and maintained.
If doodling retained its ability to identify the researchers’ depression and/or anxiety status when meetings were online as a result of COVID-19 restrictions, then there is reason to believe it represents a robust measure. Otherwise, the usefulness of doodling for reflecting internal states may be dependent on in-person meetings under the specific conditions of this health narratives research group where team mindfulness was supported.

2. Doodling and COVID-19 Limitations

Whether depression and anxiety could be measured with the aid of doodles produced during a weekly, online meeting during COVID-19 was retrospectively investigated for the University of Toronto Health Narratives Research Group (HeNReG) and compared with published results of the group from pre-COVID-19 years [15].  These results were gathered from feedback forms provided to all participants online at the end of the academic year and an examination of the doodles produced and posted to a private Facebook group.

What is particularly interesting about the feedback results from the period when online meeting was required as a result of COVID-19 limitations is that there were only two members who, when asked, “What are your thoughts on doodling aspect of the HeNReG experience?” provided a reply that focused on the fact that they themselves did not doodle. Why this is noteworthy is that only five members doodled more than five times throughout the course of the twenty-eight-week academic year, and seven members never doodled at all this year when the HeNReG was conducted online—in contrast to pre-COVID-19, in-person years when most participants doodled at each meeting. Yet, rather than mention that they themselves did not doodle as their response, the majority of the participants either said they found doodling somehow useful to them or that they really loved or enjoyed doodling.
There were only two members of the HeNReG who reported being affected by both depression and anxiety over more than a one-year period. Before COVID-19, the doodles of these two HeNReG participants attested to their internal mental state at the time each doodle was created. During these years, when they felt particularly depressed, this showed in the types of doodles both researchers created and how they chose and engaged with their materials. Intense depression brought with it doodles unique to that experience.  However, once the HeNReG meetings moved online, these two members, continuing their participation in the group, did not produce doodles that reflected their internal mental state.  Instead, the doodles produced—greatly reduced in number from years before—were records of what was in front of the researcher at the time. In both cases, while doodling alone, the researchers’ mental states were obscured from what they were doodling in ways that they had not been in previous years.  

3. Measuring Burnout

Although doodling was not found to be a potential measure of burnout under the restrictions imposed by COVID-19 for this particular group, measures of burnout have been developed and studied by psychometric researchers with respect to COVID-19 in various settings. Examples of these include: the COVID-19 Burnout Scale (COVID-19-BS) —investigating the mediating effect of resilience on the relationship between COVID-19 stress and burnout [16]; the Copenhagen Burnout Inventory—measuring burnout, as well as depression, anxiety, distress, and stress [17]; and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS)—assessing burnout directly while highlighting emotional exhaustion [18]. Nevertheless, none of these measures employed and examined during COVID-19 were tested on researchers per se, nor are they simple to administer, as doodling might be if it were found useful as a measure. There is little research on burnout in researchers in general. One study [19] published during COVID-19, but conducted before the pandemic, tested the usefulness of Achievement Goal Theory and found that burnout in researchers is related to normative performance avoidance goals, causing unfavorable goal setting processes. The intention of this study, however, was not to provide a measure of burnout in researchers. Instead, its purpose was to evaluate the usefulness of Achievement Goal Theory for describing research motivations, investigating which goals researchers pursue, and examine their associations with job burnout/engagement and professional learning. As such, the findings on burnout in researchers were evaluated from the perspective of achievement goals with respect to the rubric of this particular theory, and may not provide an entirely appropriate nor useful measure of burnout regarding researchers participating in research groups with the particular features of the Health Narratives Research Group.

4. Conclusions

In a health narratives research group organized to appeal to those indicating burnout from work-related depression and anxiety, a possible way to measure the participants’ change in depression and/or anxiety is intriguing [20], especially when comparing pre-COVID-19 years with the first full academic year of the pandemic. What has been identified is that researchers encouraged to doodle under these pandemic conditions, when asked for their feedback, are positive about the activity of doodling. Nevertheless, few of them doodled themselves. Therefore, it can be concluded that seeing the doodles of others posted to a private Facebook group was sufficient to make them believe they felt more relaxed in group participation online. However, when the doodles of those who had indicated that their depression and anxiety related to work were examined, unlike the years pre-COVID-19, the doodles were unable to measure the changes in depression and anxiety expressed by these researchers. Although the participants themselves may have seen no difference in comparison with previous years, doodling was seen to provide ineffective results for measuring depression and anxiety related to burnout in those researchers who doodle.

With respect to team mindfulness, the outcome of doodling in the setting of the HeNReG can be compared to the two dimensions of team mindfulness: receptive, open, and non-judgmental experiential processing; and aware attention to present perceptions [8]. During the years when the HeNReG was able to meet in person, both of these dimensions were evident in the function of the group. However, during COVID-19—when meetings were no longer conducted in person—the aware attention to present perceptions was lost to the group; although the receptive, open, and nonjudgmental experiential processing of the group’s interactions remained within the online meetings through the private Facebook group. This gives reason for why the participants believed that the doodling relaxed them and improved their interaction within the group while, at the same time, the doodles produced by those indicating depression and anxiety were unable to act as a measure of depression and anxiety related to burnout when the group met online only. The key component of aware attention to present perceptions that was lost in online meetings is likely the active listening [21] by the participants to each other’s in-person descriptions of their doodles. If what is required is active listening to the in-person sharing of doodles, then it should not be expected that doodling can act as a measure of depression and anxiety in researchers when they are unable to interact in person.
Regarding burnout, the online results of 2020/21 for the HeNReG show that, although doodling is unable to measure changes to depression and anxiety, doodling retains its valuable ability to relax participants. 

This entry is adapted from the peer-reviewed paper 10.3390/ejihpe11040118


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