Defining Key Factors in Burnout and Resilience in Pediatric Residents and the Relationship to Performance Maneesh Batra, MD MPH and John Mahan, MD For the Pediatric Resident Burnout – Resilience Study Consortium BACKGROUND OBJECTIVES SURVEY INSTRUMENTS Burnout is associated with poor physical and mental health in health care professionals Among trainees, burnout is associated with increased error rates, poor communication, low adherence to guidelines, poor quality of care, and low patient satisfaction Little is known about the natural history, and modifiable risk factors that impact trainee burnout and resilience Early intervention may provide long-term benefits to young health care professionals Single center studies lack the power to address these questions Describe the epidemiology and relationships between burnout, resilience, empathy, and confidence in providing compassionate care in pediatric and medicine-pediatric (P/M-P) residents Define the natural history of these parameters among P/M-P residents over time during training Identify modifiable factors for promoting wellness and that increase or decrease the risk of developing burnout Develop and test interventions (such as in-person seminars, on-line mind-body skills training, and individualized curricula such as global health electives) which may impact burnout, resilience, empathy, compassion and wellness Demographics/Resident Characteristics PROMIS Global Health Scale Cohen’s Perceived Stress Scale Hatch Spirituality Scale (subset) Cognitive and Affective Mindfulness Scale-Revised Neff’s Self-Compassion Scale Smith’s Brief Resilience Scale Maslach Burnout Inventory-HSS One Item Burnout Assessment Resident Career Satisfaction Survey Davis Empathy Scales - PT and EC Calm, Compassionate Care Scale Epworth Sleepiness Scale Prior Training in Mind-Body Skills Total of 141 items 15 minutes to complete STUDY OVERVIEW Phase 1: Cross-sectional survey in Spring 2016 in trainees of consortium member institutions Assess relationships among: mindfulness, self-compassion, resilience, burnout, confidence in providing calm, compassionate care, demographic factors of individual residents, engagement in special educational activities (including global health, advocacy and mindfulness training) Phase 2: Assess relationships between burnout, resilience and other factors with resident performance as assessed by ACGME milestones Phase 3: Develop and test interventions (e.g.: educational environment and skills training) to prevent and/or mitigate burnout and/or promote wellness Phase 4: Describe the natural history of burnout and resilience over the course of residency through repeated annual sampling for 3 years THE STUDY CONSORTIUM Established with a common mission to mprove pediatric resident resilience, compassion, confidence in providing calm, compassionate care and wellness More than 20 US based pediatric and pediatric-medicine residency programs Equipped to study the epidemiology, natural history and impact of interventions designed to address burnout and resilience among pediatric residents PHASE 1 PROGRAMS Albert Einstein College of Medicine Baylor College of Medicine/Texas Children’s Case Western/Rainbow Babies and Children's Children’s Mercy Crozer-Chester Medical Center Duke U Johns Hopkins U Mayo Clinic College of Medicine Medical College of Wisconsin Cornell U/New York Presbyterian Northwestern U/Lurie Children's Ohio State U/Nationwide Children's Stanford U U of Arizona U of California Davis U of California Los Angeles/Mattel Children’s U of California San Diego/Rady Children’s U of Chicago/Corner Children's U of Cincinnati/Cincinnati Children’s U of Colorado/Denver Children's U of Illinois Chicago U of Kansas U of Louisville U of Minnesota U of New Mexico U of Oklahoma U of Pennsylvania/Children's Philadelphia U of Pittsburgh U of Texas Houston U of Washington/Seattle Children's U of Wisconsin Vanderbilt U Wright State U RECRUITMENT AND ENROLLMENT Conducted in collaboration with APPD LEARN; IRB Exemptions/Approval sought for each site 4 week enrollment window at each institution (between April 1 – May 31, 2016) High recruitment is key for powering this study - programs are encouraged to employ their own recruitment strategies (including inducements) Monetary award incentives for top 3 enrolling programs International partner institution participation being planned STEERING COMMITTEE Maneesh Batra MD, MPH (University of Washington/Seattle Children’s Hospital); John D Mahan MD (Ohio State University/Nationwide Children’s Hospital); Kathi Kemper MD, MPH (Ohio State University); Hilary McClafferty MD (University of Arizona); Chuck Schubert MD (University of Cincinnati/Cincinnati Children’s Hospital); Janet Serwint MD, MPH (Johns Hopkins University); Betty Staples MD (Duke University); Paria M Wilson MD, MEd (University of Cincinnati/Cincinnati Children’s Hospital)