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Developmental challenges, stressors and coping strategies in medical residents: a qualitative analysis of support groups
Author(s) -
Satterfield Jason M,
Becerra Caroline
Publication year - 2010
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/j.1365-2923.2010.03736.x
Subject(s) - burnout , stressor , psychological intervention , psychology , coping (psychology) , attendance , anxiety , social support , clinical psychology , qualitative research , feeling , psychiatry , social psychology , social science , sociology , economics , economic growth
Medical Education 2010: 44 : 908–916Objectives Stress and burnout are endemic in postgraduate medical training, but little research is available to guide supportive interventions. The identification of the longitudinal emotional and developmental coping needs of internal medicine residents could assist in the better design and implementation of supportive interventions. Methods In this retrospective, exploratory study, six internal medicine resident support groups ( n = 62; residents in postgraduate years [PGY] 1–3) were followed for a period of 2 years. Qualitative data were extracted from monthly support group process notes to identify common themes, stressors, emotions, coping strategies and developmental challenges faced during training. Quantitative questionnaire data were collected on burnout, group attendance and resident satisfaction. Results Using professional identity development models and classic stress and coping theory as a starting point, a derivation of grounded theory was used to identify common themes and emotions documented in support group process notes. The most common themes included understanding resident roles and responsibilities, developing an identity as a resident and doctor, building professional confidence, cognitive and behavioural responses to stress, and concerns about flaws in local and national health care training and delivery systems. Anxiety and guilt were the most commonly reported emotions, followed by positive emotions and anger. Burnout scores were highest for the second half of PGY1, but improved over subsequent training years. Support group attendance and satisfaction were both high. Residents overwhelmingly pointed to peer relationships as the most critical source of support throughout postgraduate training. Conclusions Developmentally informed programmatic adaptations could better support the emotional growth and personal and professional development of postgraduate medical trainees. Future directions should include a controlled trial of resident support groups, assessments of ‘active ingredients’ (i.e. to establish which supportive interventions are most effective), and evaluations of programmatic adaptations.