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15. USE OF A MODIFIED NOMINAL GROUP TECHNIQUE TO EVALUATE A PEDIATRIC RESIDENCY WELLNESS CURRICULUM
TAGEDENACADEMIC PEDIATRICS 14. BURNOUT IN PEDIATRIC RESIDENTS: WHEN IS BURNOUT MOST LIKELY TO OCCUR DURING AN INPATIENT SERVICE MONTH AND WHAT ARE ITS ASSOCIATED FACTORS Maria J. Skorey, MD, Valerie H. Rinehart, MD, Hao Hsu, MD, Kortany McCauley, MD, Robin High, MBA, MA, Katie Greenwood, MD, University of Nebraska Medical Center College of Medicine, Omaha, NE BACKGROUND: Burnout is a work-related syndrome characterized by emotional exhaustion (EE), depersonalization (DP), and a sense of lack of personal accomplishment (PA). Data show those in medical training suffer from burnout, but neither the timing of burnout in a narrower timeframe nor its associations is known. OBJECTIVE: A single center prospective study was conducted to establish the prevalence of burnout in pediatric residents during an inpatient month, monitor the pattern of burnout progression throughout the month, and ascertain what factors may be associated with that burnout. METHODS: Surveys assessing burnout, symptoms of depression, quality of life, fatigue, clinical and personal experiences were distributed to pediatric residents every week for a total of five weeks during an inpatient service month. Surveys included the Maslach Burnout Inventory (MBI), considered the gold-standard for measuring burnout, and the McCauley Survey, a survey created by one of our authors to measure burnout. Inpatient service months included a rotation on the wards, pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU). First, second and third year pediatric residents were included in the study. A washout period of at least one month was required before a resident was surveyed a second time. RESULTS: Mean values of EE had statistically significant worsening between the start and end of an inpatient month. Similarly, the prevalence of burnout increased from 71% to 83%. 71% of residents had positive screens for depression. 38% of residents had answered “yes” to the question “have you doubted your career choice in the last week.” The McCauley Survey results for burnout correlated well with the standard MBI surveys. CONCLUSIONS: A large majority of pediatric residents are burned out and burnout increases during an inpatient rotation. Many pediatric residents trigger positive screens for depression and question their career choice during an inpatient rotation. Intervention is warranted in this center and is currently underway. Future multi-center studies are needed to validate this data, as well as follow-up studies to evaluate the possible impact of current interventions at this center. 15. USE OF A MODIFIED NOMINAL GROUP TECHNIQUE TO EVALUATE A PEDIATRIC RESIDENCY WELLNESS CURRICULUM Grace Fisler, MD, Patrice Pryce, MD, Jami Zaretsky, MD, Alexandra Killinsky, DO, Cheryl Taurassi, MD, Hofstra Northwell School of Medicine at Cohen Children’s Medical Center, New Hyde Park, NY BACKGROUND: Wellness is a hot topic in GME, with many pediatric residency programs adopting formalized curricula. Significant literature describes these efforts but little exists on their evaluation. A modified nominal group technique (MNGT) involves semi-quantitative rank-ordered evaluation on learner perceptions of curricular elements. MNGT has not previously been used to evaluate a residency wellness curriculum.
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METHODS: A wellness curriculum was designed and implemented during the 2017-2018 year. Elements included structured didactics meant to grow resiliency and well-being, improvement of retreats to promote team-building, weekly resident recognition, and resident coverage for the annual graduation party. In June, a session was held with about 50% of the residents to evaluate the curriculum. Participants were divided into groups of 610 learners. The session was facilitated by two experienced educators not affiliated with the residency program. After MNGT steps were performed, facilitators asked groups to list one item to improve the curriculum RESULTS: Elements that scored highest included coverage for all residents to attend the end-of-year graduation party (score 94) and the resident retreats focused on team-building (score 76). Of didactics, the session on approaching difficult conversations with families scored highest (score 19). Elements residents identified as most negatively impacting their wellness included inability to attend sessions if on certain rotations (score 67) and lack of protected time (score 50). Residents identified having more free time while at work and increased ability of residents to attend sessions as the greatest areas for improvement. CONCLUSIONS: Evaluation of our wellness program via a MNGT elucidated unexpected findings; many formalized sessions were not viewed as important. Residents valued elements that allow teambuilding and socialization. This leaves the question as to whether the formal sessions are truly not advantageous or are undervalued by residents despite long-term benefit. 16. STRESS, BURNOUT, AND HELP-SEEKING BEHAVIOR AMONG PEDIATRIC FELLOWS Anna K. Weiss, MD, MSEd, Sheila Quinn, DO, Children’ s Hospital of Philadelphia, Philadelphia, PA, Amy L. Danley, MBA, EdD, Not Affiliated with Program/Institution listed above, Wilmington, DE, Kandi Wiens, MBA, EdD, Not Affiliated with Program/Institution listed above, Jay Mehta, MD, MSEd, Children’ s Hospital of Philadelphia, Philadelphia, PA Burnout is highly prevalent among graduate medical trainees and is often associated with serious personal and professional consequences. While burnout among medical students and residents has been studied, few studies have examined burnout among fellowship trainees. We measured rates of stress and burnout among fellows in our freestanding children’s hospital and evaluated fellows’ perceptions of stigma around, and willingness to seek treatment for, mental illness. OBJECTIVES: 1)To measure burnout among pediatric fellowship trainees using the Maslach Burnout Inventory (MBI) 2)To assess fellows’ perceptions of stigma around help-seeking for mental illness 3)To examine the relationship between burnout and willingness to seek help for emotional distress METHODS: We distributed a 48-item inventory to all 288 fellows in our pediatric center. Survey items included the MBI in addition to questions measuring professional fulfillment and attitudes toward mental health treatment. Stress, burnout, and professional fulfillment were measured with descriptive statistics. Pearson correlations were used to associate burnout variables with willingness to seek mental health treatment. RESULTS: 152 fellows (52%) responded to the inventory in its entirety. Fellows reported high levels of stress (7 on a 10-point scale). On the MBI, they reported moderate levels of exhaustion, low levels of cynicism, and high levels of personal accomplishment. They did not perceive stigma around seeking mental health treatment, and most noted that they would “probably go”
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METHODS: A wellness curriculum was designed and implemented during the 2017-2018 year. Elements included structured didactics meant to grow resiliency and well-being, improvement of retreats to promote team-building, weekly resident recognition, and resident coverage for the annual graduation party. In June, a session was held with about 50% of the residents to evaluate the curriculum. Participants were divided into groups of 610 learners. The session was facilitated by two experienced educators not affiliated with the residency program. After MNGT steps were performed, facilitators asked groups to list one item to improve the curriculum RESULTS: Elements that scored highest included coverage for all residents to attend the end-of-year graduation party (score 94) and the resident retreats focused on team-building (score 76). Of didactics, the session on approaching difficult conversations with families scored highest (score 19). Elements residents identified as most negatively impacting their wellness included inability to attend sessions if on certain rotations (score 67) and lack of protected time (score 50). Residents identified having more free time while at work and increased ability of residents to attend sessions as the greatest areas for improvement. CONCLUSIONS: Evaluation of our wellness program via a MNGT elucidated unexpected findings; many formalized sessions were not viewed as important. Residents valued elements that allow teambuilding and socialization. This leaves the question as to whether the formal sessions are truly not advantageous or are undervalued by residents despite long-term benefit. 16. STRESS, BURNOUT, AND HELP-SEEKING BEHAVIOR AMONG PEDIATRIC FELLOWS Anna K. Weiss, MD, MSEd, Sheila Quinn, DO, Children’ s Hospital of Philadelphia, Philadelphia, PA, Amy L. Danley, MBA, EdD, Not Affiliated with Program/Institution listed above, Wilmington, DE, Kandi Wiens, MBA, EdD, Not Affiliated with Program/Institution listed above, Jay Mehta, MD, MSEd, Children’ s Hospital of Philadelphia, Philadelphia, PA Burnout is highly prevalent among graduate medical trainees and is often associated with serious personal and professional consequences. While burnout among medical students and residents has been studied, few studies have examined burnout among fellowship trainees. We measured rates of stress and burnout among fellows in our freestanding children’s hospital and evaluated fellows’ perceptions of stigma around, and willingness to seek treatment for, mental illness. OBJECTIVES: 1)To measure burnout among pediatric fellowship trainees using the Maslach Burnout Inventory (MBI) 2)To assess fellows’ perceptions of stigma around help-seeking for mental illness 3)To examine the relationship between burnout and willingness to seek help for emotional distress METHODS: We distributed a 48-item inventory to all 288 fellows in our pediatric center. Survey items included the MBI in addition to questions measuring professional fulfillment and attitudes toward mental health treatment. Stress, burnout, and professional fulfillment were measured with descriptive statistics. Pearson correlations were used to associate burnout variables with willingness to seek mental health treatment. RESULTS: 152 fellows (52%) responded to the inventory in its entirety. Fellows reported high levels of stress (7 on a 10-point scale). On the MBI, they reported moderate levels of exhaustion, low levels of cynicism, and high levels of personal accomplishment. They did not perceive stigma around seeking mental health treatment, and most noted that they would “probably go”