Multiple meanings of resilience: Health professionals’ experiences of a
dual element training intervention designed to help them prepare for
coping with error.
Abstract
Rationale, aims and objectives: Consistent data demonstrates negative
psychological effects of caregiving on front-line health professionals.
Evidence that psychological resilience factors can help minimise
distress and the potential for low-cost interventions have created
interest in resilience-based development programmes; yet evidence of
perceived value amongst health professionals is lacking. This study
explored health professionals’ experiences and perceptions of a novel,
resilience-based intervention designed to pro-actively prepare staff for
coping with error; to investigate their perceptions of what resilience
meant to them, the relevance of the intervention, and impact of
participation on ability to cope with error. Method: Semi-structured
interviews 4-6 weeks post intervention with 23 randomly selected
participants from seven cohorts (midwives, paediatricians,
obstetrians/gynaecologists, paramedics) and trainees (physician
associates, mammographers, sonographers). Thematic analysis of interview
data. Findings: Participants reported various interpretations of, and a
shift in perception regarding what the concept of psychological
resilience meant to them and their practice. These included for example,
resilience as a positive or negative concept and their awareness and
response to a range of personal, organisational and system factors
influencing personal resilience. They valued the prophylactic,
clinically relevant, interactive and applied nature of the intervention;
having developed and applied valuable skills beyond the context of
involvement in error, noting that individuals needed to be willing to
explore their own coping mechanisms and human fallibility to gain
maximum benefit. There was also consensus that whilst proactively
developing individual level psychological resilience is important, so
too is addressing the organisational and system factors that affect
staff resilience which are outside individual staff control. Conclusion:
Enhancing resilience appears to be considered useful in supporting staff
to prepare for coping with error and the wider emotional burden of
clinical work, but such interventions require integration into wider
system approaches to reduce the burden of clinical work for health
professionals.