1. How Variable are Burnout and Stress in Pediatric Residents
How Variable are Burnout and Stress in Pediatric Residents? An Exploratory Single Center Study from the Pediatric Resident Burnout – Resilience Study Consortium Suzanne Reed MD, Maneesh Batra MD, Kathi J Kemper MD, Betty B. Staples MD, Janet R. Serwint MD, Hilary McClafferty MD, Charles J. Schubert MD, Paria M. Wilson MD, Alan Schwartz PhD, John D. Mahan MD
Background
Table 1. Variability of Wellness Factors
The complete survey included a series of validated assays related to physician wellness: Promis Global Health Scale, Perceived Stress Scale, Cognitive and Affective Mindfulness Scale (CAMS), Neff’s Self-Compassion Scale, Brief Resilience Scale, Maslach Burnout Inventory (MBI), Calm and Compassionate Care Scale, Interpersonal Reactivity Index, and Epworth Sleepiness Scale
Paired data was subjected to Analysis of Variance Table of type III with Satterthwaite to test our hypotheses, with significance set at p<0.05.
Physician burnout is common and associated with stress, personal health problems, and limitations in ability to provide empathetic and effective patient care.
Residency training is a high-risk period for burnout and decreased wellness (well-being).
Many risk factors have been associated with burnout in residents, but the temporal variability of wellness factors and their association with residency characteristics are unknown.
The Pediatric Resident Burnout and Resilience Study Consortium (PRB-RSC), a multi-institutional collaborative organized to study burnout and resilience in pediatric residents, provided an opportunity to examine these factors in a single center pilot study.
Our objectives were to test our hypotheses that:
Burnout, perceived stress, and empathy have significant variation over a short time during residency training, while self-compassion and resilience do not change over the same time.
First-year residents experience more variability in burnout, stress, and empathy compared to senior residents.
EE=emotional exhaustion; DP=depersonalization; PA=personal accomplishment; PT= perspective-taking; F=fantasy; EC=empathetic concern; PD=personal distress
Discussion
Results
In this group of pediatric residents, there were significant changes over a short period of time in depersonalization and empathy, as predicted.
There were also changes in self-compassion and resilience, contrary to our hypothesis. This supports the ‘changeability’ of these parameters, suggesting that these skills may respond to focused intervention.
Larger multi-center studies are needed to better understand interplay of time and training environment factors affecting these important functions over time.
Careful longitudinal studies will be helpful in developing effective, targeted wellness interventions for residents.
106 (of 147) pediatric residents from NCH completed both sets of surveys
In paired analysis, there were significant changes in residents’ depersonalization (burnout domain), self-compassion, resilience, and empathic concern over this relatively short period time. (Table 1)
There were no significant variations in perceived stress and emotional exhaustion (a burnout domain), though these both were relatively elevated at time 1. (Table 1)
There were no differences in variability of burnout, perceived stress, or interpersonal reactivity in first-year compared to senior residents.
Methods
Using PRB-RSC data, we examined de-identified results from individual pediatric residents from a single institution at 2 points separated by 2-3 months in early 2016.
Acknowledgements
Authors would like to acknowledge APPD LEARN and the PRB-RSC
for their time and critical assistance in this project.