Thriving in scrubs: a qualitative study of resident resilience

Abstract

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.

Physician resilience: a grounded theory study of obstetrics and gynaecology residents

“…The final thematic coding phase generated an explanatory framework for the relationships between the categories. Initial analysis of the first interview data is described elsewhere . Insights from that analysis informed the conceptual model of resilience that was confirmed and expanded in this analysis (Figs.…”

“…OBGYN residents managing these demands and performing well in the clinical environment are likely to have developed resilience. Initial analysis of these interviews suggested that resilience was strongly linked to professional identity, growing through engagement with adversity and fuelled by the resident's values as well as connections to others . This study represents continued engagement with this group over time to allow for circumstantial and seasonal variations, and also observe positive adaptations to earlier adversity .…”

“…Interview questions were based on domains identified in studies of other populations as relevant to resilience (Appendix ) . Follow‐up interview questions were informed by the analysis of the initial interviews (Appendix ) . Interviews lasted 45‐60 minutes and were recorded and professionally transcribed.…”

Resilience in medical doctors: a systematic review

“…For doctors, the influence of social support in both a professional and a personal capacity were identified across the review as important factors in determining resilience. [24,[34][35][36][37][38][39][40][41] Quantitatively, Waddimba et al's [24] study of New York physicians that scored doctors for resilience and assessed unit characteristics reported that clinicians who worked on a smaller clinical unit (<5 practitioners) scored significantly lower for resilience than those who worked on larger units. Waddimba concluded from this that the social support of colleagues was an important determinant of a doctor's resilience.…”

Evaluation of a leadership development program to enhance university staff and student resilience

“…Interestingly, the potential for relationships with work colleagues to have a significant impact on staff resilience was evident in Ovans' (2015) study of over 800 employees in the UK where 75% of respondents reported that managing difficult people and office politics were the biggest drains on their resilience. While the link between resilience and both social support such as relationships with colleagues (Luthar, 2015) and self-care (Winkel, Honart, Robinson, Jones, & Squires, 2018) has been reported, further research on university staff resilience is needed.…”