Integrating the Fostering of Resilience into Health Care Education: A Systematic Literature Review
Purpose/Hypothesis: People drawn to careers in health care embody character traits that make them competitive applicants to healthcare education programs (HCEP), and simultaneously render them susceptible to sub-optimal mental health habits and burnout. Most healthcare education programs require a full-time commitment from students, encompassing a traditional forty-hour “work week”. This is a valid backdrop when looking at burnout. The fostering of resilience in these student populations has been proposed as a means of combating this problem. The purpose of this review was to examine literature that explored how interventions could positively affect healthcare students’ ability to cope effectively with life stressors and the rigors of their academic programs, and how/if those interventions were integrated into the curricula of various HCEPs. Number of Subjects: N/A Materials and Methods: A systematic review was conducted in Oct. 2018 to examine the PICO question: “What educational interventions or curricular changes have been done to foster resilience in health profession students?” Articles were collected using six databases: Pubmed, PMC, Eric, CINAHL, Scopus and HaPI. Search terms related to “resilience,” “student,” “health profession” and “intervention” were used. An initial search returned 2982 unique articles. Subsequent screenings based on title, inclusion/exclusion criteria, and full text review rendered the scope down to 14 articles, which were then evaluated using the CASP process. The CASP checklist is a ten-question qualitative research analysis tool. All articles except for one had a score greater than 17 (the cut-off score for high-quality articles). Results: 14 articles discussed individual interventions that were provided to students of health profession programs. 35 outcome measures were identified to assess a change after the implementation of the chosen interventions across the 14 studies. Of these 35 outcome measures, thirty-one were self-reported and four were objective measures. Only 6 articles provided a definition of resilience, all of which aligned with the operational definition of this literature review, as defined by Sanderson and Brewer as, “Resilience is the dynamic capacity to overcome adversity, drawing on personal, social and organizational resources, to achieve personal growth and transformation”. All 14 articles yielded positive results as it pertains to resilience and stress-coping mechanisms. Conclusions: Utilizing the current literature on resilience, burnout, and curriculum in health professional education, the authors identified themes of resiliency components that were implemented into some HCEP curricula. Effectiveness could not be established because of the wide variety of implementation and delivery methods; however, the literature indicates overall improvement in student outcomes favor some kind of implementation of interventions addressing student resilience into the HCEP’s curricula. Clinical Relevance: Stress and burnout experienced by the HCEP student population are leading causes of severe negative sequelae, such as depression and high suicide rates. This review of resiliency in HCEPs suggests that there are two important components to consider: Those who are more resilient can avoid (or at least minimize) these sequelae; and resilience is a skill that can be developed. Formal implementation of resiliency-fostering interventions in professional education may be part of the solution.