Reflect and rehydrate: improving junior doctor wellbeing and promotion of coping skills through peer-led education and support
Introduction
Research in 2017 by the Royal College of Anaesthetists identified that junior doctors feel their work has a direct negative impact on their mental health.1 Research including by Balint et al,2 and more recently The King’s Fund,3 has repeatedly shown that reflection circles and Balint groups improve healthcare professionals’ mental health outcomes. The foundation programme provides supervisor support, but there is no formal peer-based support platform.
Our goal was to identify whether formal reflection circles named ‘Reflect and rehydrate’ (R&R) sessions could improve and aid development of coping mechanisms for foundation doctors in a structured, confidential environment.
Methods
We created questionnaires to assess foundation year 1 (FY1) anxieties and approaches to coping, and disseminated them to current FY1 doctors and final-year medical students.
Structured R&R sessions were chaired in a confidential, peer-supported setting. Chairpersons presented reflection-based cases, encouraging participants to share experiences, allowing spontaneous reflection. Topics ranged from difficult patient encounters to unexpected death. After sessions, feedback was gathered via questionnaires. A proforma was created to encourage the model to be replicated elsewhere.
Results and discussion
Final-year students reported that support from current foundation doctors would be the most helpful to prepare for coping with FY1. Current FY1 doctors reported that they felt the best wellbeing support came from their peers. Participant feedback from R&R sessions was excellent, improving as the sessions developed.
Recurrent feedback themes included participants feeling at ease in the confidential, relaxed setting, comfortable to share experiences. Participants learned from the shared experiences of others and felt encouraged that others had had similar experiences, while the sessions directly improved their coping strategies. The impact has been huge: the sessions are now a regular fixture in the FY1 schedule at South Warwickshire NHS Foundation Trust, with interest from several other groups including newly qualified nurses, administration teams and allied health professionals.
Conclusion
We acknowledge that factors contributing to mental wellbeing are multifactorial and complex. However, there is evidence of improvement in coping abilities through R&R sessions. We believe that further propagating this model nationwide can only be beneficial overall to wellbeing and, importantly, impacting on clinical practice and improving patient safety, as healthy junior doctors make for efficient and safe patient care.
- © Royal College of Physicians 2019. All rights reserved.
References
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- Royal College of Anaesthetists
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- Balint M.
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- The King’s Fund
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