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Defining Key Factors in Burnout and Resilience in Pediatric Residents and the Relationship to Performance: A Study of the Pediatric Resident Burnout –

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Presentation on theme: "Defining Key Factors in Burnout and Resilience in Pediatric Residents and the Relationship to Performance: A Study of the Pediatric Resident Burnout –"— Presentation transcript:

1 Defining Key Factors in Burnout and Resilience in Pediatric Residents and the Relationship to Performance: A Study of the Pediatric Resident Burnout – Resilience Study Consortium A Study of the Pediatric Resident Burnout – Resilience Study Consortium Maneesh Batra, MD and John D Mahan MD for the PRB-RSC Steering Committee

2 PRB-RSC Steering Committee Maneesh Batra, MD, MPH John D Mahan, MD
Kathi Kemper, MD, MPH Betty Staples, MD Janet Serwint, MD, MPH Chuck Schubert, MD, MPH Paria Wilson, MD Hilary McClafferty, MD

3 APPD LEARN APPD LEARN (Longitudinal Educational Assessment Research Network) Provides infrastructure for multicenter, collaborative pediatric educational research Requires approval by APPD LEARN Protocol Review Committee - obtained Study Assistance Provide IRB kits and help Provide Data Capture system and enrolling s and links Provide feedback on enrollment activity Assist in presentations Assist in data analysis and sample manuscript language

4 Goal To improve pediatric resident resilience, compassion, confidence in providing calm, compassionate care and wellness. Through creation of a Pediatric Resident Burnout - Resilience Study Consortium (PRB-RSC), involving pediatric residents in more than 20 residency programs in the US, we will be equipped to study the epidemiology, natural history and impact of interventions designed to address burnout and resilience in pediatric residents.

5 Objectives The PRBRSC is dedicated to achieving 4 objectives:
Describe the epidemiology and relationships between burnout, resilience, empathy, and confidence in providing compassionate care in pediatric and medicine-pediatric (P/M-P) residents. Define the natural history of these parameters over time in P/M-P residents during training. Identify modifiable factors that increase or decrease the risk of developing burnout and promoting positive wellness factors. Develop and test different interventions (such as in-person seminars, on-line mind-body skills training, and individualized curricula such as global health electives) to affect burnout, resilience, empathy, compassion and wellness.

6 Hypotheses Residents with more mindfulness and self-compassion will have higher resilience and lower burnout. Residents with higher mindfulness and self-compassion will have higher ability to provide compassionate care. Burnout penetrance in residents will be more affected by internal factors (mindfulness, self-compassion and resilience) than external factors (work and life factors; special educational activities). There will be significant interest in mind-body skills training and other wellness education among residents related to perceived stress and self-compassion but independent of degree of burnout. Residents with more personalized educational pursuits (global health activities, advocacy, rural/primary care track, etc) will evidence more resilience and less burnout over time than those without these personalized pursuits. Residents with higher mindfulness, self-compassion, resilience and lower burnout will achieve higher performance levels as determined by pediatric milestones assessments, controlling for independent demographic factors.

7

8 Study Overview Phase 1) conduct cross-sectional survey in Spring 2016 [April 1-May 31, 2016] in trainees from a national sample of > 15 pediatric and medicine-pediatric residencies assessing relationships between mindfulness, self-compassion, resilience, burnout, confidence in providing calm, compassionate care, demographic factors of individual residents, engagement in special educational activities (including global health, advocacy and mindfulness training). Phase 2) assess the relationships of burnout and resilience to resident performance as assessed by ACGME milestones. Phase 3) provide platform to study educational and skills training [interventions] on preventing and/or mitigating negative aspects of burnout in our residents. Phase 4) define natural history of burnout and resilience by repeating survey in selected residents in same programs in Spring 2017.

9 Study Overview: Phase 1a
Phase 1a) conduct cross-sectional survey of Program Directors to define wellness efforts currently underway in programs Led by Paria Wilson and Kathi Kemper Accomplished in February 2016 Provide initial work to develop most effective method to define this important program level intervention

10 Study Overview: Phase 1 Phase 1) conduct cross-sectional survey in Spring 2016 [April 1-May 31, 2016] in trainees from a national sample of > 15 pediatric and medicine-pediatric residencies assessing relationships between mindfulness, self-compassion, resilience, burnout, confidence in providing calm, compassionate care, demographic factors of individual residents, engagement in special educational activities (including global health, advocacy and mindfulness training).

11 Study Instruments Demographics (10)/Resident characteristics (15)
Promis Global Health scale (7) Perceived Stress Scale (Cohen’s) (10) Hatch Spirituality Questions (3) Cognitive and Affective Mindfulness Scale – Revised CAMS-R (10) Neff’s Self-Compassion Scale (12) Brief Resilience Scale (Smith’s) (6) Maslach Burnout Inventory – HSS Format (22) One Item Burnout Assessment (1) Resident Career Satisfaction Survey (9) Davis Empathy Scales - PT and EC (14) Calm, Compassionate Care Scale (10) Epworth Sleepiness Scale (8) Prior Training in Mind-Body Skills (4) [* 141 items] – on average residents have taken 15 minutes to complete

12 Phase 1 Study Completed – June 12, 2016
Factors Associated with Burnout and Resilience in Pediatric and Medicine-Pediatric Residents 34 of 40 PRB-RSC programs successful 1692 residents complete the survey Analysis – APPD LEARN Writing Groups, Abstracts – 6 manuscripts outlined Database will be open to other inquires/projects

13 Incentives 3 leading enrolling programs (based on percent of residents completing survey) will qualify for a group incentive Leading enroller - $1500 2nd enroller - $1000 3rd enroller - $500 Sites may incorporate additional local rewards to participates (as approved and funded locally) Reports to sites – de-identified program reports from APPD LEARN

14 Phase 2 Study Completed – Sep 12, 2016
Define the Relationships Between Burnout and Resilience and Performance as Assessed by ACGME Milestones in Pediatric and Medicine-Pediatric Residents 31 of the 34 programs from Phase 1 entered the resident Milestone data

15 Scholarship Writing teams will be developed for each phase of study (and any future phases) based on site investigator interest Each site will be able to have one local PI volunteer and participate in at least one of the initial 3 writing teams (based on interest) Consortium platform will be available to investigators interested in evaluating specific wellness interventions International opportunities (Global Health)

16 Manuscripts – Round 1 Topic 1st Author Abstract Deadline*
Topic 1st Author Abstract Deadline* Writing Group Interest 1. Study Design/Burnout variability and predictors of Burnout Batra APPD/PAS 2. Burnout – Interplay of Resident & Program factors Mahan 3. 1 Question Burnout; key items from surveys [item analysis] Schwartz PAS 4. Burnout – Program interventions Wilson 5. Burnout – PIMR curriculum McClafferty 6. Burnout – Milestones Performance Staples 7. Program Wellness Activities 8. Others?

17 Next Steps Analyze/Report from Data Treasure Trove Website
Plan for Phase 3 (interventions) and 4 (longitudinal issues) studies Recruit new sites Consortium Evolution

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