Context / probleemstelling of aanleiding

Probleemstelling (inclusief theoretische onderbouwing en onderzoeksvraag/vragen):

Professional fulfillment is crucial for a sustainable, well-functioning workforce of resident physicians and can be facilitated by “cultures of wellness” in post-graduate medical education (PGME). Culture of wellness refers to a set of shared norms and values, attitudes and behaviors that promote personal and professional growth as well as physician well-being. A largely overlooked contributor to cultures of wellness is residents’ perceived appreciation. That feeling appreciated helps residents to feel fulfilled and stimulates performance is known, but it is unclear when residents feel appreciated, how this manifests and which underlying processes eventually increase performance and fulfillment levels. This study therefore addresses the following research questions: (i) How is appreciation at work experienced by residents? and (ii) How do they perceive appreciation in relation to their professional fulfillment and performance?

Methode:

Guided by an interpretative phenomenological approach, we purposively sampled 12 residents from various specialties, educational years and educational regions in the Netherlands; data saturation was reached. In semi-structured interviews we explored residents’ individual experiences with appreciation at work. During the interviews, the participants were asked to extensively dwell upon their individual experiences. They were encouraged to illustrate specific situations. Interviews lasted approximately 45-60 minutes. Template analysis, following an iterative process, was used to analyze the data.

Resultaten (en conclusie):

Residents experienced appreciation as ‘being seen and heard as a unique person’ and further described their experiences using three narratives. As a learner, residents felt appreciated when their competencies were (implicitly) acknowledged, when supervisors created room for individual growth, were engaged in residents’ future careers and offered support. As a physician and colleague, residents felt appreciated when they experienced meaningful patient-contact, high levels of collegiality and successes at work, such as pleasant collaborations with colleagues. As an employee, residents felt appreciated when their (extra) efforts were seen and rewarded, when both work and education were properly facilitated in the department and when their well-being was prioritized. The dominant narrative could vary based on multiple contextual and personal factors, but feeling ‘seen and heard’ could impact residents’ mental health, fuel an upward spiral to becoming a self-confident and committed professional and stimulate residents’ professional fulfillment; altogether eventually impacting the quality of care they were able to provide.

Discussie (beschouwing resultaten en conclusie in het kader van de theorie):

First, this study underpinned the importance of collegiality for the experience of appreciation and shows that the effects of collegiality go beyond feelings of social support and community; it is often in the personal interactions with their colleagues as such where, for residents, a feeling of appreciation arises.. Additionally, we found that paying attention to residents’ well-being makes them feel cared for and appreciated. We argue that prioritizing the well-being of residents and investing in collegiality are crucial strategies in establishing an organizational culture of wellness.

This study raises awareness about the importance of feeling valued at work for residents. The insights presented in this study may be used to reflect on existing national and organizational recognition and reward initiatives. Additionally, PGME programs could use those insights to develop a support tool or training for faculty. By focusing on appreciating junior physicians, we may – by boosting their fulfillment – possibly contribute to alleviate the current well-being and retention crisis in PGME.

Referenties:

Menon NK, Trockel M. Creating a Culture of Wellness. The Art and Science of Physician Wellbeing: Springer; 2019. p. 19-32.