Evaluating Creative Cognition as a Risk and Resilience Factor for Burnout in Pediatric Emergency Medicine

Burnout is common among pediatric emergency medicine (PEM) physicians, but the relationship between creative problem-solving (CPS) preferences and burnout is not well understood. This study examined associations between CPS mindsets and burnout in PEM.

This cross-sectional study included PEM (attending physicians and fellows) from 3 emergency departments. Measures: Maslach Burnout Inventory-Human Services Survey for Burnout; FourSight for CPS preferences (clarifying, ideating, developing, implementing). The primary outcome was the association between burnout and CPS preferences, and the secondary outcomes were comparisons of burnout prevalence and CPS preferences in PEM compared with published norms.

Participation was 100%, with 96.7% providing complete data. Participants: female 58%; median age 41 years; 51% White, 23% Asian, and 83% married. High clarifying scores were associated with greater emotional exhaustion (EE; adjusted β = 0.67; 95% CI, 0.15 to 1.19), with a stronger association among women (adjusted β = 0.76; 95% CI, 0.03 to 1.48). Ideating was associated with higher personal accomplishment (PA; β = 0.31; 95% CI, 0.08 to 0.55). In univariate analysis, female sex (β = 5.03; 95% CI, 0.17 to 9.89) and educational debt (β = 5.46; 95% CI, 0.47 to 10.4) were each associated with higher EE. Compared with health care norms, PEM demonstrated higher PA scores (mean = 5.00; 95% CI, 4.84 to 5.15 vs. 4.30). PEM were more likely to show an implementing mindset (55% vs. 21%, P < 0.001) and less likely to show a Developing mindset (10% vs. 23%, P = 0.007).

A clarifying mindset was associated with higher EE, particularly among women, while Ideating was associated with greater PA. CPS self-awareness and targeted training may offer novel strategies to mitigate burnout among PEM.