Resilience Approach for Medical Residents

Medical residents are in a vulnerable position. While still in training, they are responsible for patient care. They have a dependent relation with their supervisor and low decision latitude. An intervention was developed to increase individual and system resilience, addressing burnout, patient safety, and intention to leave. A participative development protocol was followed in close collaboration with residents and doctors in a middle-sized general hospital. The evaluation combined a quantitative and qualitative approach. Medical residents and their supervisors filled out questionnaires on indicators of resilience and outcomes. Focusgroup meetings and interviews were part of the intervention. The prevalence of burnout among residents was relatively high, involvement in patient safety issues was rather low and very few considered to leave their training. Results are summarised in a ‘resilience profile’ of the system, consisting of five dimensions. A “Health Care Resilience Approach” (HCRA) defines four steps: Resilience Profile, Participation, Performing & Monitoring, and Embedding & Connecting. The Resilience Profile gives insight and the HCRA helps improve resilience in a practical way. Success factors are simultaneously: participatory approach, focus on individuals, system of medical education. Close collaboration might be a bottleneck, since adhoc patient care always has priority.