1. Can we“teach”resilience?
G Kay

2. What is resilience?
“Resilience is the capacity to respond to stress in a healthy way such that goals are achieved at minimal psychological and physical cost; resilient individuals "bounce back" after challenges while also growing stronger”
(Epstein et Al, Academic Medicine Mar 2013)

3. Another definition…
“Resilience can be defined as the ability to bounce back from setbacks and keep going in the face of tough challenges. Resilience at work can be described as the capability to maintain high performance and positive wellbeing”
(WHO)

4. Do our trainees have resilience?
Looking at personality traits more reliable than assessing single measures of stress or resilience
Four personality traits have strong influence:
Self Directedness
Cooperativeness
Harm avoidance
Persistence

5. Self Directedness
The ability to regulate and adapt behaviour to the demands of a situation in order to achieve personally chosen goals and values
Conscientious
Resourceful
Goal orientated
Accept responsibility for mistakes, learn and move on
Associated with internal locus of control

6. Cooperativeness Accept opinions and behaviours of colleagues
Don’t lose sight of own principles but work out solutions to achieve best outcome for all
Low cooperativeness might suggest poor communication and lack of empathy

7. Harm avoidance
Personality trait characterized by excessive worrying; pessimism; shyness; and being fearful, doubtful, and easily fatigued
Clinicians low in harm avoidance are more decisive and less anxious
Ability to accept uncertainty and risk

8. Persistence
Maintaining behaviour with stamina despite frustration, fatigue or discouragement
High persistence can be associated with perfectionism which can lead to burnout
Aim for healthy level of persistence by identifying and accepting limitations, learning from failures, setting realistic goals

9. Other aspects of resilience for GPs
Attitudes and perspectives – valuing role, maintain interest
Frequency of access to positive emotions
Balance and prioritisation – setting limits, effective approach to CPD
Supportive relationships – personal, professional. Good communication
Practice management style – good staff, effective practice arrangements

10. Discussion points
1. Have you had concerns about a trainee’s resilience? What were the warning signs? How could we identify these trainees early enough to help?
2. How can we help a trainee to enhance their resilience? Any tips from previous experience? What resources might be useful?

11. So how can trainers help?
Awareness of own personality traits
Awareness of trainee’s personality traits
Less didactic and more self directed learning
Help trainees set realistic goals
Give feedback appropriately and help trainees respond
Giving trainees choice and control of learning
Graded exposure to uncertainty and challenges
Positive role-modelling
Unobtrusive monitoring of well-being
Encourage them to look for examples of resilience in others
Encourage housekeeping, awareness of burnout etc