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Do Mindfulness and Self-Compassion Predict Burnout in Pediatric Residents?
Kathi J Kemper1, Hilary McClafferty, Paria M Wilson
1K.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 codirector, Fellowship in Integrative Medicine, University of Arizona Center for Integrative Medicine, University of Arizona College of Medicine, Tucson, Arizona. P.M. Wilson is assistant professor, Division of Emergency Medicine, Children's Hospital of Pittsburgh and 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 University of Washington, 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 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.
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; a 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.
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