BackgroundBurnout and depression are common among medical trainees and intensive care unit providers, negatively impacting both providers and patients. We hypothesized that at the end of the pediatric intensive care unit (PICU) rotation, there would be an increased prevalence of depression and burnout in pediatric residents when compared to the beginning.MethodsPediatric residents were assessed prior to and following their PICU rotation using the Maslach Burnout Inventory, the Center for Epidemiologic Studies Depression Screen and a survey assessing positive and negative aspects of the rotation.ResultsSixty residents were eligible to participate and initial response rate was 40%. The prevalence of positive depression screen increased from 4% to 41% during the PICU rotation. Regarding burnout, the prevalence of residents meeting criteria for emotional exhaustion increased from 41% to 59% and depersonalization increased from 41% to 53%. Fewer residents had low personal accomplishment scores at the end of the rotation, 13% to 0%. Autonomy, procedural opportunities, and interactions with non-trainee PICU providers were commonly cited negative aspects of the rotation. Resident education, patient acuity, and nursing-integrated rounding were consistently rated positively.ConclusionCompared to the beginning, at the end of the PICU rotation there is a significantly higher prevalence of depression, emotional exhaustion, and depersonalization among pediatric residents. Pediatric residents may have a more favorable PICU experience if they feel involved in procedural aspects of patient care, are allowed more autonomy in decision making, and there is a continued focus on resident education and team-based care.
This novel simulation-based curriculum targets a gap in pediatric training and offers an effective way to train pediatricians. We plan to expand this curriculum to new populations of participants and have integrated it into our resident cardiology rotation.
A formal session on informed consent in the pediatrics residency educational program positively affects residents' knowledge and attitudes about informed consent.
A concentrated assessment program using simulation can be a valuable tool to assess residents' skills in communication and acute resuscitation and provide directed formative feedback. However, such a program requires considerable financial and staffing resources.
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