Empirical Assessment of Well-Being: The Stanford Model of Occupational Well-Being

The Stanford Model of Occupational Well-Being (Stanford Model) hypothesizes that occupational well-being is driven by 3 reciprocally related domains: workplace efficiency, culture of wellness, and individual factors. The current analysis assesses the key elements of this model with cross-sectional empirical data.

In fall 2020 and spring 2022, well-being surveys were distributed to all Stanford School of Medicine clinical faculty working at 50% or more of full-time equivalent. A total of 1,909 clinical faculty were invited to complete the 2020 survey and 2,251 to complete the 2022 survey. The survey assessed burnout and professional fulfillment, along with 9 hypothesized determinants, as occupational well-being outcome indicators. Exploratory factor analysis was used to determine whether these determinants grouped well into the 3 domains described by the model. Domain scores were created based on factor analysis groupings of the scores for the determinants in each domain.

Of 1,909 clinical faculty invited to complete the 2020 survey, 1,479 (78%) participated. Of the 2,251 clinical faculty invited in 2022, 1,552 (69%) participated. The associations of the 3 domain scores with burnout and professional fulfillment were moderate for workplace efficiency ( r = 0.42-0.49; P < .001) and large for culture of wellness ( r = 0.51-0.63; P < .001) and individual factors ( r = 0.52-0.72; P < .001). Domain scores accounted for 45% and 50% of the variance in professional fulfillment and 56% and 58% of variance in burnout in 2020 and 2022 data, respectively.

These results provide empirical evidence to support a widely adopted conceptual model of occupational well-being, including categorization of the hypothesized determinants of well-being into 3 domains, correlations among the domains, and association of the domain scores with burnout and professional fulfillment. Further research is needed to test causal relationships hypothesized by the model.