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Do Mindfulness and Self-Compassion Predict Burnout in Pediatric Residents?

Kemper, Kathi J., MD, MPH; McClafferty, Hilary, MD; Wilson, Paria M., MD, MEd; Serwint, Janet R., MD; Batra, Maneesh, MD, MPH; Mahan, John D., MD; Schubert, Charles J., MD; Staples, Betty B., MD; Schwartz, Alan, PhD on behalf of the Pediatric Resident Burnout-Resilience Study Consortium

doi: 10.1097/ACM.0000000000002546
Research Report: PDF Only

Purpose: Burnout symptoms are common among health professionals. Gaps remain in understanding both the stability of burnout and compassion over time and relationships among burnout, self-compassion, stress, and mindfulness in pediatric residents.

Method: The authors conducted a prospective cohort study of residents at 31 U.S. residency programs affiliated with the Pediatric Resident Burnout – Resilience Study Consortium. Residents completed online cross-sectional surveys in spring 2016 and 2017. The authors assessed demographic characteristics and standardized measures of mindfulness, self-compassion, stress, burnout, and confidence in providing compassionate care.

Results: Of 1,108 eligible residents, 872 (79%) completed both surveys. Of these, 72% were women. The prevalence of burnout was 58% and the level of mindfulness was 2.8 in both years; levels of stress (16.4 and 16.2), and self-compassion (37.2 and 37.6) were also nearly identical in both years. After controlling for baseline burnout levels in linear mixed model regression analyses, mindfulness in 2016 was protective for levels of stress and confidence in providing compassionate care in 2017. Self-compassion in 2016 was protective for burnout, stress, and confidence in providing compassionate care in 2017; one standard deviation increase in self-compassion score was associated with a decrease in the probability of burnout from 58% to 48%.

Conclusions: Burnout and stress were prevalent and stable over at least 12 months among pediatric residents; mindfulness and self-compassion were longitudinally associated with lower stress and greater confidence in providing compassionate care. Future studies are needed to evaluate the effectiveness of training that promotes mindfulness and self-compassion in pediatric residents.

K.J. Kemper is founding director, Center for Integrative Health and Wellness and professor of pediatrics, The Ohio State University, Columbus, Ohio.

H. McClafferty is director, Pediatric Integrative Medicine in Residency Program and co-director, the Fellowship in Integrative Medicine, The University of Arizona Center for Integrative Medicine, The University of Arizona College of Medicine, Tucson, Arizona.

P.M. Wilson is assistant professor, Division of Emergency Medicine, Children’s Hospital of Pittsburgh and the University of Pittsburgh, Pittsburgh, Pennsylvania.

J.R. Serwint is professor emeritus of pediatrics, Johns Hopkins University, Baltimore, Maryland.

M. Batra is associate program director, Pediatric Residency Program and associate professor of pediatrics, Seattle Children’s Hospital and the University of Washington in Seattle, Washington.

J.D. Mahan is director, Pediatric Residency Program and professor of pediatrics, Nationwide Children’s Hospital and The Ohio State University, Columbus, Ohio.

C.J. Schubert is professor of pediatrics, Cincinnati Children’s Hospital Medical Center and The University of Cincinnati, Cincinnati, Ohio.

B.B. Staples is director, Pediatric Residency Program and associate professor of pediatrics, Duke University Medical Center, Durham, North Carolina.

A. Schwartz is Michael Reese Endowed Professor of Medical Education and director of research, University of Illinois College of Medicine, Chicago, Illinois, and data analyst, Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A620.

Acknowledgements: The authors wish to thank all the residents who completed the surveys. The authors also thank the staff at the Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network office, particularly, Ms. Beth King whose diligence and tireless efforts were instrumental in the establishment of the consortium.

The forty-six participating residency programs listed in Supplemental Digital Appendix 1 (available at http://links.lww.com/ACADMED/A620) are all members of the Pediatric Resident Burnout-Resilience Study Consortium and participated in one or both years of the study. Each institution had one or more site principal investigator(s) who served as collaborators for this study and this report. They are listed in the Supplemental Digital Appendix by name and with their institution.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: The institutional review board of Nationwide Children’s Hospital andof participating institutions, as required locally, approved the study reported herein.

Correspondence should be addressed to Kathi J. Kemper, 021 Meiling Hall, College of Medicine, 370 W. 9th Avenue, The Ohio State University, Columbus, OH 43210; telephone: (614) 685-9052; e-mail: Kathi.kemper@osumc.edu; Twitter: @MDKathi.

© 2018 by the Association of American Medical Colleges