Burnout in Pediatric Critical Care Medicine Fellows*

Abstract

Objectives: Assess the overall level of burnout in pediatric critical care medicine fellows and examine factors that may contribute to or protect against its development. Design: Cross-sectional observational study. Setting: Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs across the United States. Subjects: Pediatric critical care medicine fellows and program directors. Interventions: Web-based survey that assessed burnout via the Maslach Burnout Inventory, as well as other measures that elicited demographics, sleepiness, social support, perceptions about prior training, relationships with colleagues, and environmental burnout. Measurements and Main Results: One-hundred eighty-seven fellows and 47 program directors participated. Fellows from 30% of programs were excluded due to lack of program director participation. Average values on each burnout domain for fellows were higher than published values for other medical professionals. Personal accomplishment was greater (lower burnout) among fellows more satisfied with their career choice (β 9.319; p ≤ 0.0001), spiritual fellows (β 1.651; p = 0.0286), those with a stress outlet (β 3.981; p = 0.0226), those comfortable discussing educational topics with faculty (β 3.078; p = 0.0197), and those comfortable seeking support from their co-fellows (β 3.762; p = 0.0006). Depersonalization was higher for second year fellows (β 2.034; p = 0.0482), those with less educational debt (β –2.920; p = 0.0115), those neutral/dissatisfied with their career choice (β –6.995; p = 0.0031), those with nursing conflict (β –3.527; p = 0.0067), those who perceived burnout among co-fellows (β 1.803; p = 0.0352), and those from ICUs with an increased number of patient beds (β 5.729; p ≤ 0.0001). Emotional exhaustion was higher among women (β 2.933; p = 0.0237), those neutral/dissatisfied with their career choice (β –7.986; p = 0.0353), and those who perceived burnout among co-fellows (β 5.698; p ≤ 0.0001). Greater sleepiness correlated with higher burnout by means of lower personal accomplishment (r = –1.64; p = 0.0255) and higher emotional exhaustion (r = 0.246; p = 0.0007). Except for tangible support, all other forms of social support showed a small to moderate correlation with lower burnout. Conclusions: Pediatric critical care medicine fellows in the United States are experiencing high levels of burnout, which appears to be influenced by demographics, fellow perceptions of their work environment, and satisfaction with career choice. The exclusion of fellows at 30% of the programs may have over or underestimated the actual level of burnout in these trainees.

Association between resilience and burnout of front‐line nurses at the peak of the COVID‐19 pandemic: Positive and negative affect as mediators in Wuhan

“…Burnout was assessed using the Maslach Burnout Inventory‐General Survey (MBI‐GS), a validated version for measuring burnout in HCWs (Suttle et al, 2020; Wu et al, 2020). This instrument encompasses emotional exhaustion (tiredness, somatic symptoms, and decreased emotional resources), depersonalization (developing negative, cynical attitudes, and impersonal feelings), and reduced personal accomplishment (feelings of incompetence, inefficiency, and inadequacy) (Kumar, 2007).…”

Thematic analysis comparing stressors for pediatric residents and subspecialty fellows at a large children’s hospital

“…At the start of their training, pediatric cardiology fellows at a single institution self-reported fears and stressors [ 22 ]. Pediatric emergency medicine and critical care fellows across the country self-reported stressors, and identified factors associated with burnout using Likert scales [ 5 , 23 ]. The findings in these studies were similar to ours: fellows identified stressors including mental illness and burnout, finances, underrepresented group discrimination, especially based on gender, work-life balance, unusual work schedule, high work load and expectations, negative work environment, and lack of confidence and feelings of inadequacy.…”

“…No studies have identified self-reported stressors for pediatric residents; they have only been identified by program directors [ 19 ] or by collecting objective data such as work hours and demographics and comparing them to burnout data [ 4 , 20 , 21 ]. Only a few studies have queried pediatric subspecialty fellows about their stressors [ 5 , 22 , 23 ], but all of these studies focused on specific subspecialties rather than pediatric fellows more generally.…”

Virtual Learning Improves Attendance for Critical Care Education During the COVID-19 Pandemic

“…We have previously seen that schedule flexibility reduces clinician burnout. 9 While clinical responsibilities rarely afford this freedom, the asynchronous opportunity provided by VL may be an invaluable resource to give providers flexibility for conference and didactic review at their own pace. The present study did not account for additional asynchronous attendance from those who later watched recordings.…”