4. BURNOUT IN PEDIATRIC RESIDENTS: INSIGHTS FROM THREE YEARS OF LONGITUDINAL NATIONAL SURVEY DATA

Abstract

Background Burnout is highly prevalent among residents and associated with poor personal health and worse patient outcomes. Little is known about the factors which impact burnout longitudinally. Objectives 1) Define burnout prevalence (via Maslach Burnout Inventory) from 2016-2018 among pediatric residents; 2) Explore demographic factors and experiences related to burnout over time; and 3) Elucidate factors that predict future burnout, stress, and confidence in providing compassionate care (CPCC). Methods The Pediatric Residency Burnout-Resilience Consortium, a national sample of 34 programs in 2016, 43 programs in 2017, and 49 programs in 2018, conducted an annual anonymous survey of residents for 3 years via APPD LEARN. The survey included personal qualities (quality of life, sleepiness, mindfulness, self-compassion, empathy); experiences (current rotation, recent errors/patient deaths and time off, special learning tracks), satisfaction (career, work/life balance, support, learning environment) and measures of burnout, stress, and CPCC. Cross-sectional and longitudinal regression analyses for these measures was performed. Results >60% of eligible residents participated each year; burnout rates (54%-56%) were similar all 3 years and not associated with any specified demographic characteristic. In each year burnout was associated with stress, sleepiness, dissatisfaction with work/life balance, and reporting a recent medical error; burnout was inversely associated with higher levels of empathy, self-compassion, quality of life, and CPCC. Higher self-compassion in 2017 correlated with lower stress in 2018. Mindfulness and satisfaction with learning environment and pediatrics as career in 2017 correlated with higher CPCC in 2018. Conclusion Nationally, burnout prevalence in pediatric residents consistently exceeds 50%. We identified modifiable factors associated with lower burnout including empathy, mindfulness, self-compassion and stress and programmatic interventions which may mitigate burnout such as training in medical errors response, and healthy scheduling paradigms.