Pediatric Resident Burnout and Attitudes Toward Patients

Author:

Baer Tamara Elizabeth12,Feraco Angela M.234,Tuysuzoglu Sagalowsky Selin5,Williams David6,Litman Heather J.7,Vinci Robert J.8

Affiliation:

1. Divisions of Adolescent/Young Adult Medicine,

2. Department of Medicine, Harvard Medical School, Boston, Massachusetts;

3. Hematology/Oncology, and

4. Department of Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts

5. Division of Emergency Medicine, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York;

6. Clinical Research Center, Boston Children’s Hospital, Boston, Massachusetts;

7. Department of Biostatistics and Epidemiology, Corrona, LLC, Southborough, Massachusetts; and

8. Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts

Abstract

BACKGROUND AND OBJECTIVES: Burnout occurs in up to 75% of resident physicians. Our study objectives were to: (1) determine the prevalence of burnout, and (2) examine the association between burnout and self-reported patient care attitudes and behaviors among pediatric residents. METHODS: A total of 258 residents (53% response rate) from 11 pediatric residency programs completed a cross-sectional Web-based survey. Burnout was measured with 2 items from the Maslach Burnout Inventory. Patient care attitudes and behaviors were measured with 7 questions from a standardized qualitative survey. χ2 and logistic regression tested the association between burnout and self-reported patient care attitudes and behavior. RESULTS: A total of 39% of respondents (mean age, 29.4 years ± 2.3 SD; 79% female; 83% white; 35% postgraduate year [PGY] -1, 34% PGY-2, and 31% PGY-3), endorsed burnout. Residents with burnout had significantly greater odds (P < .01) of reporting suboptimal patient care attitudes and behaviors, including: discharging patients to make the service more manageable (adjusted odds ratio [aOR] 4.2; 95% confidence interval [CI], 1.6–11.1), not fully discussing treatment options or answering questions (aOR 3.5; 95% CI, 1.7–7.1), making treatment or medication errors (aOR 7.1; 95% CI, 2.0–25.8), ignoring the social or personal impact of an illness (aOR 9.6; 95% CI, 3.2–28.9), and feeling guilty about how a patient was treated (aOR 6.0; 95% CI, 1.6–22.1). CONCLUSIONS: Burnout is highly prevalent among pediatric residents and is associated with self-reported negative patient care attitudes and behaviors. Residency programs should develop interventions addressing burnout and its potential negative impact on patient care.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

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