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Prior work demonstrating that burnout is associated with decreased performance in medical trainees has relied on self-report and/or single-site studies. We explored the relationship between burnout status and Milestones-based scores in pediatric residents nationally. In April to June 2016, we confidentially surveyed residents using the Maslach Burnout Inventory. Separately, programs submitted resident Milestones scores in June 2016. We examined the relationship between burnout and performance as assessed by Milestones scores for each domain of competence. We performed multivariate analysis to determine which components of burnout (depersonalization [DP], emotional exhaustion, and lack of personal accomplishment [PA]) were most impactful. About 1494 of 2368 (63%) residents at 32 programs completed the Maslach Burnout Inventory and had Milestones scores submitted. Residents who scored positive for burnout scored lower in all Milestones domains. Subgroup analysis demonstrated that this association was only significant (P <.05) in the post-graduate year 1 (PGY1) categorical pediatric cohort. In the PGY1 residents (n = 442), those positive for burnout had lower Milestones scores in patient care (PC) (2.78 vs 2.98), systems-based practice (2.69 vs 2.87), practice-based learning and improvement (2.77 vs 2.93), professionalism (3.09 vs 3.24), and interpersonal and communication skills (2.95 vs 3.12), but not medical knowledge. Multivariate analysis demonstrated that, in PGY1 residents, lower PC score was associated with lower PA and higher DP. Burnout is associated with decreased Milestones performance for pediatric PGY1 residents. DP and low PA were associated with lower PC scores in PGY1 residents. Future research should address whether strategies to mitigate burnout improve PGY1 performance. [ABSTRACT FROM AUTHOR]

Describe the demographics of pediatric and internal medicine/pediatric residents participating in global health (GH) experiences and examine relationships between GH involvement and self-perceived burnout, resilience, mindfulness, empathy, and spirituality. The Pediatric Resident Burnout and Resilience Study Consortium developed a national longitudinal study through collaboration with the Association of Pediatric Program Directors' Longitudinal Educational Assessment Research Network. Electronic surveys were administered to pediatric trainees annually (2016–2018). GH and well-being data were extracted. Descriptive statistics were calculated. Of 9653 eligible pediatric and medicine/pediatric residents from 55 institutions, 6150 responded to the survey in 1 or more years, with average completion rate of 63.7% over a 3-year period. Controlling for repeat survey-takers, 12.7% (536/4213) of residents reported involvement in a GH-specific pathway, curricula, or track. GH participants were significantly more likely to be unmarried (P <.001), childless (P =.003), and medicine/pediatric trainees (P <.001). Controlling for repeated measures and demographic factors, GH participants demonstrated higher levels of empathic concern (P <.001) and higher spirituality scores in 2 of 3 domains (P <.01/<.05). GH involvement was not associated with lower reports of burnout or improved resilience/mindfulness. Although GH involvement is associated with increased levels of empathy and spirituality, it was not protective against burnout in this study. This highlights the need to study and promote the well-being of all residents, and perhaps especially those experiencing the challenges of working in low-resource settings. Future efforts should determine the impact of predeparture training, programmatic support, and post-trip debriefing on resident well-being. [ABSTRACT FROM AUTHOR]

Measuring burnout symptoms is important, but the Maslach Burnout Inventory (MBI) has 22 items. This project compared 3 single-item measures with the MBI and other factors related to burnout. Data were analyzed from the 2016 and 2017 Pediatric Resident Burnout-Resilience Study Consortium surveys, which included standard measures of perceived stress, mindfulness, resilience, and self-compassion; the MBI; and the 1- and 2-item screening questions. In 2016 and 2017, data were collected from 1785/2723 (65%) and 2148/3273 (66%) eligible pediatric residents, respectively. Burnout rates on the MBI were 56% in 2016 and 54% in 2017. The Physician Work Life Study item generated estimates of burnout prevalence of 43% to 49% and, compared with the MBI for 2016 and 2017, had sensitivities of 69% to 72%, specificities of 79% to 82%, positive likelihood ratios of 3.4 to 3.8, and negative likelihood ratios of 0.35 to 0.38. The combination of an emotional exhaustion item and a depersonalization item generated burnout estimates of 53% in both years and, compared with the full MBI, had sensitivities of 85% to 87%, specificities of 84% to 85%, positive likelihood ratios of 5.7 to 6.4, and negative likelihood ratios of 0.18 for both years. Both items were significantly correlated with their parent subscales. The single items were significantly correlated with stress, mindfulness, resilience, and self-compassion. The 1- and 2-item screens generated prevalence estimates similar to the MBI and were correlated with variables associated with burnout. The 1- and 2-item screens may be useful for pediatric residency training programs tracking burnout symptoms and response to interventions. [ABSTRACT FROM AUTHOR]

The globalization of pediatric graduate medical education is ongoing; thus, this study was conducted to begin to explore the nature of resident interest in global health (GH) training and to further identify potentially modifiable factors influencing participation in away rotations. The authors surveyed all residents at Cincinnati Children’s Hospital Medical Center to identify factors influencing participation in education efforts and away rotations. With a participation rate of 79.4% (n = 143), 5 key factors emerged as most significant in the decision-making process amid all participants. Among residents who had previous experience, 82.1% were interested in participating in an away elective compared with 58.3% of those without experience (P = .002). Residents with previous experience abroad were also more likely to plan to integrate GH into their careers (61.7% vs 26.7%, P < .0001). This article describes specific obstacles to resident participation in GH education and documents the association between previous experience and significant interest in long-term involvement. [ABSTRACT FROM PUBLISHER]

Residency is a high-risk period for physician burnout. We aimed to determine the short-term stability of factors associated with burnout, application of these data to previous conceptual models, and the relationship of these factors over 3 months. Physician wellness questionnaire results were analyzed at 2 time points 3 months apart. Associations among variables within and across time points were analyzed. Logistic regression was used to predict burnout and compassionate care. A total of 74% of residents completed surveys. Over 3 months, burnout (P = .005) and empathy (P = .04) worsened. The most significant cross-sectional relationship was between stress and emotional exhaustion (time 1 r = 0.61, time 2 r = 0.68). Resilience was predictive of increased compassionate care and decreased burnout (P < .05). Mindfulness was predictive of decreased burnout (P < .05). Mitigating stress and fostering mindfulness and resilience longitudinally may be key areas of focus for improved wellness in pediatric residents. Larger studies are needed to better develop targeted wellness interventions. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]