Abstract
BackgroundResilience can be defined as the ability to rebound from adversity and overcome difficult circumstances. General Practice (GP) registrars face many challenges in transitioning into general practice, and additional stressors and pressures apply for those choosing a career in rural practice. At this time of international rural generalist medical workforce shortages, it is important to focus on the needs of rural GP registrars and how to support them to become resilient health care providers. This study sought to explore GP registrars’ perceptions of their resilience and strategies they used to maintain resilience in rural general practice.MethodsIn this qualitative interpretive research, semi-structured interviews were recorded, transcribed and analysed using an inductive approach. Initial coding resulted in a coding framework which was refined using constant comparison and negative case analysis. Authors developed consensus around the final conceptual model. Eighteen GP registrars from: Australian College of Rural and Remote Medicine Independent Pathway, and three GP regional training programs with rural training posts.ResultsSix main themes emerged from the data. Firstly, rural GP registrars described four dichotomous tensions they faced: clinical caution versus clinical courage; flexibility versus persistence; reflective practice versus task-focused practice; and personal connections versus professional commitment. Further themes included: personal skills for balance which facilitated resilience including optimistic attitude, self-reflection and metacognition; and finally GP registrars recognised the role of their supervisors in supporting and stretching them to enhance their clinical resilience.ConclusionResilience is maintained as on a wobble board by balancing professional tensions within acceptable limits. These limits are unique to each individual, and may be expanded through personal growth and professional development as part of rural general practice training.
Highlights
Resilience can be defined as the ability to rebound from adversity and overcome difficult circumstances
As part of a larger study, General Practice (GP) registrars from the Australian College of Rural and Remote Medicine Independent pathway and three regional training providers funded by GPET completed self-report questionnaires on their personality and resilience [9]
14 were Australian-born, eight had a rural origin, and 16 were married or partnered with half of the partners relocating to rural areas with the GP registrar
Summary
Resilience can be defined as the ability to rebound from adversity and overcome difficult circumstances. General Practice (GP) registrars face many challenges in transitioning into general practice, and additional stressors and pressures apply for those choosing a career in rural practice At this time of international rural generalist medical workforce shortages, it is important to focus on the needs of rural GP registrars and how to support them to become resilient health care providers. General Practice (GP) registrars have a challenging role as they transition from the tertiary hospital environments of their early postgraduate employment to the community contexts of primary and more independent secondary care. This transition involves learning to manage clinical uncertainty, patient expectations, and junior doctors becoming more independently accountable for their medical decisions. Distances are great between the small towns and rural centres with low population density limiting capacity for civic amenities and sustainable secondary and tertiary health services
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