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BMJ 2008;336:488-491 (1 March), doi:10.1136/bmj.39469.763218.BE (published 7 February 2008)
Amy M Fahrenkopf, instructor of paediatrics1, Theodore C Sectish, associate professor of paediatrics2, Laura K Barger, research fellow3, Paul J Sharek, assistant professor of paediatrics2, Daniel Lewin, assistant professor of psychiatry and paediatrics4, Vincent W Chiang, assistant professor of paediatrics1, Sarah Edwards, project coordinator3, Bernhard L Wiedermann, associate professor of paediatrics4, Christopher P Landrigan, assistant professor of paediatrics and medicine1,3
1 Harvard Medical School, Department of Medicine, Childrens Hospital Boston, Boston, MA 02115, USA, 2 Stanford Medical School, Lucile Packard Childrens Hospital, Palo Alto, CA, USA, 3 Division of Sleep Medicine, Brigham and Womens Hospital, Boston, MA, USA, 4 George Washington University Medical School, Childrens National Medical Center, Washington, DC, USA
Correspondence to: A M Fahrenkopf amy.fahrenkopf{at}tch.harvard.edu
Design Prospective cohort study.
Setting Three urban freestanding childrens hospitals in the United States.
Participants 123 residents in three paediatric residency programmes.
Main outcome measures Prevalence of depression using the Harvard national depression screening day scale, burnout using the Maslach burnout inventory, and rate of medication errors per resident month.
Results 24 (20%) of the participating residents met the criteria for depression and 92 (74%) met the criteria for burnout. Active surveillance yielded 45 errors made by participants. Depressed residents made 6.2 times as many medication errors per resident month as residents who were not depressed: 1.55 (95% confidence interval 0.57 to 4.22) compared with 0.25 (0.14 to 0.46, P<0.001). Burnt out residents and non-burnt out residents made similar rates of errors per resident month: 0.45 (0.20 to 0.98) compared with 0.53 (0.21 to 1.33, P=0.2).
Conclusions Depression and burnout are major problems among residents in paediatrics. Depressed residents made significantly more medical errors than their non-depressed peers; however, burnout did not seem to correlate with an increased rate of medical errors.
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