The importance of developing meaningfulness and manageability for resilience in rural doctors

Introduction: Retention of rural doctors is a problem in many countries. A previous study has identified resilience as a factor associated with longer retention. However, this needs a deeper study to understand what local and personal factors are at play. Studies suggest resilience can be developed during training. We propose that a better understanding of factors associated with resilience might assist in training students for rural practice and increase retention. 

Aim: This study aimed to understand the differences in resilience development between the more and the less resilient rural doctors. A secondary purpose was to identify how to assist this developmental process through health professional education.

Methods: This study employed a mixed-method design and was part of a more extensive study aiming to develop rural doctors’ resilience in a low-resource setting. A prior survey assessed rural doctors’ resilience levels. This study sampled high-level and low-level resilience participants to be interviewed. A total of 22 rural doctors participated in the individual semi-structured interviews. The interviews were analyzed qualitatively based on Richardson’s Resilience Model and the six resilience dimensions looking for factors that explained high or low resilience. 

Results: Two important themes emerged during the qualitative analysis: ‘meaningfulness’ and ‘manageability.’ The different responses of high and low-resilient participants can be explained through cases. 

Conclusions: The participants’ perceived meaningfulness and manageability of the stressor determine the responses. We suggest that teachers may better construct students’ resilience by focussing on assisting them in finding meaning and developing a sense of manageability.