title: Pediatric Resident Burnout and Attitudes Toward Patients.
abstract: OBJECTIVE
  Burnout occurs in up to 75% of resident physicians. Our study objectives were to: (1) determine the prevalence of burnout, and (2) examine the association between burnout and self-reported patient care attitudes and behaviors among pediatric residents.
  
  
  METHODS
  A total of 258 residents (53% response rate) from 11 pediatric residency programs completed a cross-sectional Web-based survey. Burnout was measured with 2 items from the Maslach Burnout Inventory. Patient care attitudes and behaviors were measured with 7 questions from a standardized qualitative survey. χ2and logistic regression tested the association between burnout and self-reported patient care attitudes and behavior.
  
  
  RESULTS
  A total of 39% of respondents (mean age, 29.4 years ± 2.3 SD; 79% female; 83% white; 35% postgraduate year [PGY] -1, 34% PGY-2, and 31% PGY-3), endorsed burnout. Residents with burnout had significantly greater odds (P< .01) of reporting suboptimal patient care attitudes and behaviors, including: discharging patients to make the service more manageable (adjusted odds ratio [aOR] 4.2; 95% confidence interval [CI], 1.6-11.1), not fully discussing treatment options or answering questions (aOR 3.5; 95% CI, 1.7-7.1), making treatment or medication errors (aOR 7.1; 95% CI, 2.0-25.8), ignoring the social or personal impact of an illness (aOR 9.6; 95% CI, 3.2-28.9), and feeling guilty about how a patient was treated (aOR 6.0; 95% CI, 1.6-22.1).
  
  
  CONCLUSIONS
  Burnout is highly prevalent among pediatric residents and is associated with self-reported negative patient care attitudes and behaviors. Residency programs should develop interventions addressing burnout and its potential negative impact on patient care.
authors.affiliation: Divisions of Adolescent/Young Adult Medicine, tamara.baer@childrens.harvard.edu.|Department of Medicine, Harvard Medical School, Boston, Massachusetts.
authors.forename: Tamara Elizabeth
authors.initials: TE
authors.lastname: Baer
authors.affiliation: Department of Medicine, Harvard Medical School, Boston, Massachusetts.|Hematology/Oncology, and.|Department of Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Feraco
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.
authors.forename: Selin
authors.initials: S
authors.lastname: Tuysuzoglu Sagalowsky
authors.affiliation: Clinical Research Center, Boston Children's Hospital, Boston, Massachusetts.
authors.forename: David
authors.initials: D
authors.lastname: Williams
authors.affiliation: Department of Biostatistics and Epidemiology, Corrona, LLC, Southborough, Massachusetts; and.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Litman
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Vinci
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000150:complications* / Q000523:psychology; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006167:Guilt; D006801:Humans; D007396:Internship and Residency; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data; D009511:New England / Q000453:epidemiology; D010351:Patient Discharge; D000072143:Pediatricians / Q000523:psychology*; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires