Critical reflection is a tool that can amplify learning in residents and fellows. Added research is needed to understand how reflection can influence growth in professional capacities and patient-level outcomes in ways that can be measured.

BackgroundPhysician well-being impacts both doctors and patients. In light of high rates of physician burnout, enhancing resilience is a priority. To inform effective interventions, educators need to understand how resilience develops during residency.MethodsA qualitative study using grounded theory examined the lived experience of resilience in residents. A cohort of obstetrics and gynecology residents were selected as a purposive, intensity sample.. Eighteen residents in all years of training participated in semi-structured interviews. A three-phase process of open coding, analytic coding and thematic analysis generated a conceptual model for resilience among residents.ResultsResilience among residents emerged as rooted in the resident’s calling to the work of medicine. Drive to overcome obstacles arose from personal identity and aspiration to professional ideals. Adversity caused residents to examine and cultivate coping mechanisms. Personal connections to peers and mentors as well as to patients and the work helped buffer the stress and conflicts that present. Resilience in this context is a developmental phenomenon that grows through engagement with uncertainty and adversity.ConclusionResilience in residents is rooted in personal and professional identity, and requires engagement with adversity to develop. Connections within the medical community, finding personal fulfillment in the work, and developing self-care practices enhance resilience.

PURPOSE: To understand how resilience manifests during the critical developmental time of residency. BACKGROUND: Physician well-being has been connected with outcomes for the health of physicians and also their patients' safety and satisfaction. Better understanding of resilience could guide interventions aiming to relieve burnout. METHODS: A qualitative study was performed using grounded theory to analyze the lived experience of resilience in residents. Obstetrics and gynecology residents were selected as an intensity sample, presumed to have an intense but not extreme experience of resilience. Eighteen residents in all years of training participated in semi-structured interviews based on concepts identified by the literature. A three-phase process of open coding, analytic coding and thematic analysis generated a conceptual model for resilience among residents RESULTS: Resilience among residents emerged as rooted in the resident's calling to the work of medicine, informed by aspirations to perform work valued by their community and cultivate connections with patients. Drive to overcome obstacles arose from strong affiliation with professional identity and values. Residency itself presented adversity, which caused residents to examine and cultivate coping mechanisms. Strong supports from peers and mentors in medicine as well as connections outside of medicine represented powerful buffers through conflicts presented throughout training. DISCUSSION: Resilience among residents is a dynamic and developmental phenomenon, informed by their background and personal goals, and influenced by the surrounding culture. Educational programs that foster deeper connections to the human dimension of the work, and allow residents to attend to their personal needs and development, may enhance resilience.