Introduction: Burnout, a syndrome of emotional exhaustion, depersonalization and low personal achievement, affects approximately 50% of pediatric residents, with higher rates on PICU rotations. Resilience, adapting to challenging life experiences, has been shown to be inversely related to burnout. This relationship has not been studied in pediatric residents. For pediatric residents on their PICU rotation, we sought to: 1) examine the relationship between burnout and resilience and 2) characterize factors influencing burnout and resilience.
Methods: At the end of their PICU rotation, pediatric residents were invited to complete the Maslach Burnout Inventory (MBI) and Connor Davidson Resilience Scale (CD-RISC). Descriptive statistics were calculated and logistic regression assessed associations between MBI and CD-RISC scores. Residents were invited for semi-structured interviews within months of their rotation. Interviews, conducted by a research assistant unaffiliated with the residency, used critical incident technique focused on burnout and resilience experiences. Three authors are conducting thematic analysis using a constructivist approach with open, inductive coding.
Results: 20 residents completed surveys. 70% screened positive for burnout in at least 1 MBI domain. 60% had resilience scores in the lowest quartile, suggesting a low incidence of resilience. CD-RISC scores were not significantly associated with MBI score in total or in any domain. 12 residents have completed interviews. Preliminary analysis shows residents easily recognize and define burnout, often in ways that differ from published definitions. Resilience is more abstract, frequently described as a counterbalance to burnout. Burnout is commonly associated with long hours, night shifts, and isolation. Resilience themes include supportive teams and a sense of purpose.
Conclusions: Burnout is prevalent and resilience is low in pediatric residents on their PICU rotation. While resilience scores were not statistically associated with burnout, small sample size may limit findings. Qualitative data suggest that residents are more attuned to burnout than resilience. Interventions aimed at recognizing resilience may benefit PICU rotations. Additionally, schedule factors may contribute to burnout and represent a modifiable target for improvement.
