Mary Pat Frintner

At What Age Can Children Report Dependably on Their Asthma Health Status

OBJECTIVE. This study examined psychometric properties and feasibility issues surrounding child-reported asthma health status data. METHODS. In separate interviews, parents and children completed 3 visits. Child questionnaires were interviewer administered. The primary instrument was the Childrens Health Survey for Asthma–Child Version, used to compute 3 scales (physical health, activities, and emotional health). The following were assessed: reliability (internal consistency and test-retest reliability), validity (general health status, symptom burden, and lung function), and feasibility (completion time, missing data, and inconsistent responses). RESULTS. A total of 414 parent-child pairs completed the study (mean child age: 11.5 years). Reliability estimates for the activities and emotional health scales were >.70 in all but 1 age category; 5 of 9 age groups had acceptable internal consistency ratings (≥.70) for the physical health scale. Cronbachs α tended to increase with child age. In general, test-retest correlations between forms and intraclass correlation coefficients were strong for all ages but tended to increase with child age. Correlations between forms ranged from .57 (7-year-old subjects, physical health) to .96 (14-year-old subjects, activities). Intraclass correlation coefficients ranged from .76 (13-year-old subjects, emotional health) to .94 (15–16-year-old subjects, physical health). Children with less symptom burden reported higher mean Childrens Health Survey for Asthma–Child Version scores (indicating better health status) for each scale, at significant levels for nearly all age groups. Childrens Health Survey for Asthma–Child Version completion times decreased from 12.9 minutes at age 7 to 6.9 minutes at age 13. CONCLUSIONS. This research indicates that children with asthma as young as 7 may be dependable and valuable reporters of their health. Data quality tends to improve with age.

Pediatric Training and Career Intentions, 2003–2009

OBJECTIVES: To examine trends in pediatric residents’ training and job search experiences from 2003 through 2009. METHODS: Annual national random samples of 500 graduating pediatric residents from 2003 through 2005 and 1000 from 2006 through 2009 were surveyed. Responses were compared across years to identify trends. We examined resident demographics, training, satisfaction, career intentions, and job search experiences. Overall response rate was 61%. RESULTS: Between 2003 and 2009, there was an increase in the proportion of female graduating pediatric residents (69%–75%), residents from international medical schools (15%–23%), and levels of educational debt among the subgroup of residents with debt (

Pediatric Resident Debt and Career Intentions

139 945 in 2003 to

Work–Life Balance, Burnout, and Satisfaction of Early Career Pediatricians

166 972 in 2009). Residents consistently reported (>90% of residents) that they would choose pediatrics again if they had the choice. By 2009, the majority was very satisfied with the quality of their training in most areas, with ratings improving across years in caring for children with special health care needs, evidence-based medicine, and using information technology in practice. Although primary care remained the most common clinical practice goal, there was a modest decline in interest in primary care practice across survey years, whereas interest in subspecialty practice increased. Residents accepting both general pediatric practice and hospitalist positions reported less difficulty in their job search over time. CONCLUSIONS: Despite continually changing demographics of pediatric training programs, residents overall remain very satisfied with their decision to become pediatricians. Pediatricians continue to face difficult financial challenges associated with rising debt, but they also report increasing job search success.

Do mentors matter in graduating pediatrics residents' career choices?

OBJECTIVE: To examine current levels of educational debt among pediatric residents and the relationship between educational debt and career intentions. METHODS: Annual national random samples of 1000 graduating pediatric residents from 2006 through 2010 were surveyed. Responses were combined. We used t tests and 1-way analysis of variance to compare debt, linear regression to examine factors associated with educational debt, and logistic regression to assess the influence of debt on clinical practice goal. Response rate was 61%. RESULTS: Three in 4 residents reported having educational debt. The mean debt (in 2010 dollars) among all residents, which included spouse’s debt if married, increased 34% from

Pediatric resident perceptions of family-friendly benefits.

104 000 in 2006 to

Relationships Between Program Size, Training Experience, and Career Intentions: Pediatrics Resident Reports From 2010 to 2014

139 000 in 2010. Among the subgroup who reported having any debt, the mean debt increased 24% from

A Longitudinal Study of Pediatricians Early in Their Careers: PLACES

146 000 in 2006 to

Pediatricians Working Part-Time Has Plateaued

181 000 in 2010. Residents had varied clinical practice goals; 43% had goals that required fellowship training (subspecialty and combined primary-subspecialty) and 57% had goals not typically requiring fellowship training (primary care and hospitalist). In multivariate analyses, debt level (low, medium, high) remained an independent predictor of practice goal. Residents with medium debt (adjusted odds ratio: 1.46, 95% confidence interval: 1.16–1.84) and high debt (adjusted odds ratio: 1.51; 95% confidence interval: 1.20–1.90) had higher odds than residents with low debt of having a practice goal that does not typically require fellowship training. Other factors also had an independent association with career choice. CONCLUSIONS: Multiple factors shape decisions about careers. Higher educational debt is one factor that may push residents toward primary care or hospitalist practice, rather than pursuing fellowship training.

Early Career Experiences of Pediatricians Pursuing or Not Pursuing Fellowship Training.

BACKGROUND AND OBJECTIVE: Data describing factors associated with work–life balance, burnout, and career and life satisfaction for early career pediatricians are limited. We sought to identify personal and work factors related to these outcomes. METHODS: We analyzed 2013 survey data of pediatricians who graduated residency between 2002 and 2004. Dependent variables included: (1) balance between personal and professional commitments, (2) current burnout in work, (3) career satisfaction, and (4) life satisfaction. Multivariable logistic regression examined associations of personal and work characteristics with each of the 4 dependent variables. RESULTS: A total of 93% of participants completed the survey (n = 840). A majority reported career (83%) and life (71%) satisfaction. Fewer reported current appropriate work–life balance (43%) or burnout (30%). In multivariable modeling, excellent/very good health, having support from physician colleagues, and adequate resources for patient care were all found to be associated with a lower prevalence of burnout and a higher likelihood of work–life balance and career and life satisfaction. Having children, race, and clinical specialty were not found to be significantly associated with any of the 4 outcome measures. Female gender was associated with a lower likelihood of balance and career satisfaction but did not have an association with burnout or life satisfaction. CONCLUSIONS: Burnout and struggles with work–life balance are common; dissatisfaction with life and career are a concern for some early career pediatricians. Efforts to minimize these outcomes should focus on encouragement of modifiable factors, including health supervision, peer support, and ensuring sufficient patient care resources.