1. 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)