Faculty Bibliography

BACKGROUND AND OBJECTIVES/OBJECTIVE:Burnout occurs in up to 75% of resident physicians. Our study objectives were to: (1) determine the prevalence of burnout, and (2) examine the association between burnout and self-reported patient care attitudes and behaviors among pediatric residents. METHODS:and logistic regression tested the association between burnout and self-reported patient care attitudes and behavior. RESULTS:< .01) of reporting suboptimal patient care attitudes and behaviors, including: discharging patients to make the service more manageable (adjusted odds ratio [aOR] 4.2; 95% confidence interval [CI], 1.6-11.1), not fully discussing treatment options or answering questions (aOR 3.5; 95% CI, 1.7-7.1), making treatment or medication errors (aOR 7.1; 95% CI, 2.0-25.8), ignoring the social or personal impact of an illness (aOR 9.6; 95% CI, 3.2-28.9), and feeling guilty about how a patient was treated (aOR 6.0; 95% CI, 1.6-22.1). CONCLUSIONS:Burnout is highly prevalent among pediatric residents and is associated with self-reported negative patient care attitudes and behaviors. Residency programs should develop interventions addressing burnout and its potential negative impact on patient care.

Procedural skills are integral to the practice of pediatric emergency medicine, but provider experience is limited by case rarity. Simulation-based medical education allows for the practice of rare procedures without compromising patient safety. Simulation-based procedural training improves provider confidence, knowledge, and performance, and may translate to better patient outcomes. However, optimal instructional designs for simulation-based training remain unclear, and educators have a plethora of didactic approaches and simulator characteristics to consider. This article reviews how simulation can be used for pediatric procedural skills training and maintenance, focusing on instructional design features, simulationmodalities, and the use of simulation as an assessment tool in the era of competency-based medical education. Conflicts of Interest: The authors have no conflicts of interest to declare.

PURPOSE/OBJECTIVE:To assess youths' attitudes, knowledge, and behaviors regarding rapid HIV testing (RHT) and measure acceptability and feasibility of RHT in an adolescent clinic setting. METHODS:A 2007-2008 project introduced free RHT at an urban, hospital-based adolescent and young adult clinic in Boston, MA. Patients and HIV testing clients were offered either free nonrapid tests or fingerstick RHT. An anonymous questionnaire assessed youths' testing attitudes, knowledge, and behaviors (N = 127). Ordinal logistic regression model was used to determine associations with youth demographic characteristics and testing experience. RESULTS:Most participants valued rapid results. A minority desired confidentiality from parents and insurance providers. Older youth were more likely to know about testing methods (OR: 1.25; CI: 1.04-1.51) and plan for follow-up (OR: 1.43; CI: 1.14-1.81). Age, gender, and race were unrelated to testing facilitators such as rapidity, confidentiality, and cost, although younger clients were more likely to prefer noninvasive methods. Individuals with previous testing experience were more likely to say that they would contribute to expenses and value rapidity over cost. CONCLUSION/CONCLUSIONS:There was strong support for RHT among youth receiving HIV testing. Offering RHT to youth may facilitate routine testing. Future research should focus on increasing RHT access among diverse populations of youth.