(117) Improving Resident Resilient Coping Through Standardized End-of-Rotation Debriefs in the PICU

Introduction: Pediatric residents have increased incidence of burnout at the end of PICU rotations due to limited and variable exposure to end-of-life care. After a patient death, residents may experience guilt or lose confidence in their future as a doctor. Residents identified debriefs, small group discussions and psychological support as protective factors against burnout. The primary aim of this study is to assess the impact of attending led end of PICU rotation debriefs on pediatric resident resilient coping and burnout.

Methods: A survey based, cohort study was conducted at a single-center academic PICU. All pediatric residents in the PICU were eligible to participate. Participants completed a survey at the start of the academic year and post-intervention. The survey included demographic questions, the Maslach Burnout Inventory (MBI) consisting of 3 domains (emotional exhaustion(EE), depersonalization(DP), personal accomplishment(PA)), and the Brief Resilient Coping Scale (BRCS), which captures adaptive tendencies to cope with stress.

Results: Forty-six percent of eligible residents completed the pre survey, 31% completed the post survey. Mann-Whitney U tests were used to compare pre/post scores for EE, DP, and PA. No significant difference was found in any domain (EE: p-0.40, DP: p-0.90, PA: p-0.16). Scores identified high levels of participant burnout. On the BRCS, half of participants demonstrated low resilient coping before and after the session. A larger proportion of participants scored as medium resilient copers before the debrief (44.4%) than after (33.3%), but more participants had high resilient coping after debriefs than before (16.7%, 5.6%). The Fisher’s exact test found no significant differences in the distribution of scores (p-0.656).

Conclusions: Despite a lack of statistical significance in BRCS and MBI results, all participants who completed the post-survey found the debrief session valuable. This study identified high levels of burnout and a trend toward improvement in resilient coping skills after implementation of a faculty led PICU rotation debrief. Limitations include being a single center study with low survey response rates. The study highlights a need for consistent debriefs during high stress rotations and future work should explore impact on resident resilient coping.