Burnout in Pediatric Residents: Three Years of National Survey Data

Abstract

BACKGROUND: We aimed to describe the national epidemiology of burnout in pediatric residents. METHODS: We conducted surveys of residents at 34 programs in 2016, 43 programs in 2017, and 49 programs in 2018. Survey items included the Maslach Burnout Inventory, demographics, program characteristics, personal qualities, experiences, and satisfaction with support, worklife balance, and learning environment. Analyses included cross-sectional comparisons and cross-sectional and longitudinal regression. RESULTS: More than 60% of eligible residents participated; burnout rates were .50% in all years and not consistently associated with any demographic or residency characteristics. Cross-sectional associations were significant between burnout and stress, sleepiness, quality of life, mindfulness, self-compassion, empathy, confidence in providing compassionate care (CCC), being on a high-acuity rotation, recent major medical error, recent time off, satisfaction with support and career choice, and attitudes about residency. In cross-sectional logistic regression analyses, 4 factors were associated with an increased risk of burnout: stress, sleepiness, dissatisfaction with work-life balance, and recent medical error; 4 factors were associated with lower risk: empathy, self-compassion, quality of life, and CCC. Longitudinally, after controlling for 2017 burnout and 2018 risk factors (eg, recent error, sleepiness, rotation, and time off), 2017 quality of life was associated with 2018 burnout; 2017 self-compassion was associated with lower 2018 stress; and 2017 mindfulness, empathy, and satisfaction with learning environment and career choice were associated with 2018 CCC. CONCLUSIONS: A majority of residents met burnout criteria. Several identified factors (eg, stress, sleepiness, medical errors, empathy, CCC, and self-compassion) suggest targets for interventions to reduce burnout in future studies. WHAT'S KNOWN ON THIS SUBJECT: Small studies in pediatric residents and larger studies on medical students and practicing physicians suggest that burnout is common, increasing, and associated with demographic and other risk factors, but most are cross-sectional. WHAT THIS STUDY ADDS: We examined burnout' s epidemiology in a national sample of pediatric residents over 3 years, assessing a broad range of risk and protective factors. We identified modifiable risk factors for both individuals and programs, laying the groundwork for intervention studies.

Natural history of burnout, stress, and fatigue in a pediatric resident cohort over three years

“…The data indicate that burnout is too common among pediatric residents to be the result of personal attributes. While there may be individual factors that impair or protect well-being [31], it is evident that systemic problems in residency training must be identified and addressed.…”

“…Generalization of results to all pediatric residency programs should be made with caution, but recent data from a multi-center cross-sectional study of pediatric residents surveyed annually during the 3 years of our study showed that burnout was prevalent amongst pediatric trainees nationwide [ 30 , 31 ]. Our program participated in that study.…”

“…Generalization of results to all pediatric residency programs should be made with caution, but recent 57.7% 47.1% 65.0% 52.2% 52.6% a Proportion of competed surveys at each timepoint that were worse than at baseline (T1) b See text for abbreviations and descriptions. References [9][10][11][14][15][16][17][18][19][20][21][22] c See references [17][18][19][20]23] for reported reference ranges data from a multi-center cross-sectional study of pediatric residents surveyed annually during the 3 years of our study showed that burnout was prevalent amongst pediatric trainees nationwide [30,31]. Our program participated in that study.…”

MINdI: Mindfulness Instruction for New Interns

“… 10 Recent literature suggests that rates of burnout in the pediatric trainee population are greater than 50% in each year of training and, not surprisingly, that burnout is associated with stress and sleepiness specifically, both of which may be affected by mindfulness practice. 11 For this reason, the American Association of Pediatrics aligned with the Accreditation Council for Graduate Medical Education in a 2014 statement that emphasized the need for systems-level change to address trainee burnout. 12 Mindfulness was the only evidence-based approach included in the statement that has been shown to reduce trainee burnout.…”

The Champagne Tap: Time to Pop the Cork?

“…This anticipated and sought-after reward fosters a supportive community during training, potentially protecting against resident burnout. [2][3][4]…”