Seeking Professional Resilience.

Abstract

With close to half of American pediatricians reporting at least 1 symptom of burnout, our professional sustainability is at risk.1 Interventions mitigating burnout have been proposed at both individual and systems levels, with variable success.2 Many interventionists target professional resilience, but few formally integrate resilience theory. Furthermore, many interventionists suggest that resilience is defined by the absence of burnout, but I propose that resilience is more than that. Would we be more successful if we endeavored not only to avoid burnout but also to reclaim the value and meaning behind our professional calling? “Resilience” connotes an ability to maintain physical and emotional well-being in the face of adversity; however, measuring and operationalizing it is complicated.3 Traditional resilience theories fall into 1 of 3 categories: Resilience is either an intrinsic, perhaps immutable trait (eg, grit), a process of coping or adaptation (eg, meaning-making), or an outcome (eg, the absence of burnout).3 Each of these conceptualizations is inherently problematic as it translates to medical professional resilience. Trait definitions fail to incorporate skills and perspectives acquired in training and practice, and process definitions ignore the integration of preexisting personality characteristics that influence how we develop those skills and perspectives. For example, we may need both grit and meaning-making to successfully navigate a medical career. Defining resilience as an outcome does not recognize the potential for change, nor does it integrate concurrent but conflicting measures. A resident on a particularly difficult rotation may feel burnt-out today but may identify important lessons and career-inspiration tomorrow. Which relative outcome or time point defines her … Address correspondence to Abby R. Rosenberg, MD, MS, MA, Cancer and Blood Disorders Center, Seattle Children’s Hospital, 4800 Sand Point Way, M/S MB.8.501, PO Box 5371, Seattle, WA 98145. E-mail: abby.rosenberg{at}seattlechildrens.org