252 - Teamwork Makes the Dream Work: Relationship between US Pediatric Resident Burnout and the Learning Environment

Poster Number: 252
Publication Number: 252.333

Elizabeth Rodriguez-Lien, University of Texas Medical Branch School of Medicine, Galveston, TX, United States; Eric Zwemer, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States; Alan Schwartz, University of Illinois College of Medicine, Chicago, IL, United States; Jessica Babal, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Janet R. Serwint, Professor Emerita of Pediatrics, Glen Arm, MD, United States; Kira R. Sieplinga, Pediatric Residency - Helen DeVos Children's Hospital/Spectrum Health, Grand Rapids, MI, United States; Kathleen M. Donnelly, Inova Children's Hospital, Falls Church, VA, United States; Maneesh Batra, University of Washington School of Medicine, Seatt;e, WA, United States; Jennifer Reese, University of Colorado School of Medicine, Aurora, CO, United States; Sarah Webber, University of Wisconsin, Madison, WI, United States; Michele Nichols, University of Alabama at Birmingham, Birmingham, AL, United States; Paria M. Wilson, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; John D. Mahan, John D Mahan, Professor of Pediatrics, Nationwide Children's/The Ohio State University, Nationwide Children's Hospital/The Ohio State University, Columbus, OH, OH, United States

Background: Burnout among healthcare providers, specifically residents, has been recognized to be related to the working environment.

Objective: This study examines the relationship between pediatric resident burnout and learning environment (LE) satisfaction.

Design/Methods: The Pediatric Resident Burnout Resilience Study Consortium (PRB-RSC) surveyed 3,157 residents from 46 pediatric residency programs in Spring 2019 via the Association of Pediatric Program Directors’ Longitudinal Educational Assessment Research Network (APPD LEARN). Data was extracted from this retrospective, cross-sectional study.  We compared (t-test) unadjusted differences in resident LE satisfaction to resident burnout, determined by the 2-item Maslach Burnout Inventory screen. Burnout was defined as feeling burned out or callous towards people once weekly or more. We then fitted a mixed-effects logistic regression model with burnout as the outcome and LE satisfaction as the focal predictor. Finally, we examined potential predictors of LE satisfaction, including stress, resilience, quality of life (QOL), and perception of LE collaboration using a set of linear mixed models with similar covariates.

Results: Of the 2,043 residents who responded, 40% (n = 817) screened positive for burnout. Mean satisfaction with the LE was 4.0 out of 5 (SD 0.98). Non-burned-out residents reported significantly greater LE satisfaction (4.4 vs. 3.6, p< 0.001), higher levels of collaboration (4.4 vs. 4.1 p< 0.001), lower perceived stress (29 vs 31, p< 0.001) and higher QOL (7.2 vs 5.5, p< 0.001) than their burned-out colleagues. The finding persisted after controlling for demographic variables of age, marital status, parental status, sex, size of program and race. Controlling for LE collaboration, program and resident characteristics, and resident clustering in programs, more satisfied residents were less likely to be burned out (OR 0.41, 95% CI 0.36-0.47, p< 0.001). Residents reporting higher collaboration levels had higher LE satisfaction, controlling for characteristics and clustering (B=0.62, 95% CI 0.57-0.67, p< 0.001). Lower stress (B=-0.07, 95% CI -0.09-- -0.06, p< 0.001) and higher QOL scores (B=0.29, CI 0.27-0.31, p< 0.001) were each associated with higher LE satisfaction in similar models, but resilience was not. Conclusion(s): The study demonstrates an inverse relationship between pediatric resident burnout and LE satisfaction. Resident perception of LE collaborativeness predicts LE satisfaction. To reduce resident burnout, program directors should pursue efforts that promote more effective collaboration in the LE.
Graph 1. Predicted Probabilities of Burnout based on Learning Environment Satisfaction
Graph 2. Predicted Learning Environment Satisfaction based on Perceived Learning Environment Collaboration