Marsha W. Snyder, MD

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The value of resiliency training for residents

May 8, 2013 By Marsha Snyder

Once I gave a one-hour lecture to the resident physicians at a local University Health Network in positive psychology and resilience. Residency is a high-risk time in a physician’s career for depression, stress, and burnout. I chose to focus my talk on resilience.

Doctors tend to deny their problems and are very adept with intellectualization. Therefore it was also very important for this hour to be experiential and involve as much audience participation and personal involvement as possible. To accomplish this I would need to listen to audience responses and be ready and able to adapt my teaching to fit their needs.

My talk was designed to start with a brief introduction to positive psychology followed by a discussion of where the medical profession is with regard to wellbeing. The focus was on the residents reflecting on medicine as a profession with regard to wellbeing and their own personal wellbeing. My educated guess was that I would hear a predominance of negative feedback and the remainder of the talk was designed to pursue three empowering experiential resilience paths:

  • Empowered communication through the positive introduction;
  • Introduction to signature strengths using the Brief Strengths Test (Peterson, C.) with discussion on signature strengths, along with handout material;
  • Introduction to resilient thinking through the ABC Model along with handout material.

Once I introduced myself and briefly reviewed my professional background, I stated my objectives for the talk:

  • To briefly introduce the field of positive psychology;
  • To introduce the concept of resilience, and why resilience is so important in residency;
  • To demonstrate three empowering resilience tools that the residents might begin to use to help strengthen themselves in their day-to-day functioning.

After my introduction to positive psychology we began our discussion on “Where is the medical profession relative to tenants of positive psychology and positive health.”  As I had expected, most of the comments were negative but only generalized to the medical profession.  One female resident stood up and said, “It is impossible to feel good when everyone is telling you you’re screwing up.  Usually, it’s just the attendings (the physicians who teach the residents). Now it’s the patients’ families, too.”

I asked her to tell me more. She related an incident that happened the day before when her patient’s husband told her that his wife’s hospitalization for recovery from curative cancer surgery, performed by the resident’s team, was causing anxiety in his 15-year-old son. When I asked her what she did in response, she said, “I felt sad and left the room.” Other residents acknowledged her situation as one that was well-known to them. “We always get blamed for everything that goes wrong.”

Hearing this example of a thinking trap followed by a non-resilient response I felt that this was an excellent lead-in to the topic of resilient thinking. I decided to adapt my presentation to the learning opportunity presented. The resident was soon able to see that far from being a criticism of the resident or the care the husband’s statement was actually an opportunity to provide additional information, care, and comfort to a family that had just experienced a traumatic illness in a loved one.

By using reality-based and resilient thinking skills, as opposed to thinking traps, the situation took on a totally different meaning. The residents were completely engaged in this discussion and were enthusiastic about trying the model with one another. They were given handouts to remind them of the highlights of the process and the discussion.

As our hour was then drawing to a close I emphasized the importance of how the residents communicate with others makes a huge difference in creating positive relationships with patients and with all relationships of significance.

The talk was received very positively and several residents asked me to return so they could learn more about resilience skills. In my opinion, although I feel the talk went well, one single one-hour talk is not nearly enough time to teach resilience to physicians, which is, unfortunately, not taught in medical school.

Resiliency is a key and necessary part of every physicians’ skill set.

Filed Under: Ill-Being, Positive Health, Resident Education, Resilience

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