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

Abstract

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.

Keywords:

• Resilience development
• rural doctor
• Indonesia

Acknowledgment

The authors would like to thank all rural doctors who participated in the study.

Authors’ contributions

All authors (NH, GRR, MC, MAK, JA, LS) have made substantive intellectual contributions to this study. NH, GRR, MC, JA, LS designed the study. NH and MAK collected and analyzed the data. NH wrote the first manuscript draft in discussion with MAK. GRR, MC, JA, LS reviewed and revised the manuscript. All authors approved the manuscript.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Manageability: Capability to manage challenging circumstances.

Meaningfulness: The process of finding meaning within challenging circumstances.

Resilience: The ability to rebound from stress and adversities.

Additional information

Funding

This work was supported by The Indonesian Ministry of Research Technology and Higher Education and The University of Gadjah Mada (grant number 2110/UN1/DITLIT/DIT-LIT/PT/2020 and 3190/UN1/DITLIT/DIT-LIT/PT/2021, respectively).

Notes on contributors

Nicholas E. Handoyo

Nicholas E. Handoyo, MMedEd, is a senior lecturer at Universitas Nusa Cendana, Indonesia.

Mora Claramita

Mora Claramita, MHPE, PhD, is a professor in Medical Education, Universitas Gadjah Mada, Indonesia.

Marselino K. P. Abdi Keraf

Marselino K. P. Abdi Keraf, MSi, MPsi, Psikolog, is a senior lecturer at Universitas Nusa Cendana, Indonesia.

Julie Ash

Julie Ash, PhD, BMBS, Bsc Hons, is an Associate Professor at Adelaide Rural Clinical School, University of Adelaide, South Australia.

Lambert Schuwirth

Lambert Schuwirth, MD, PhD, is a strategic professor in Medical Education, Flinders University, South Australia.

Gandes R. Rahayu

Gandes R. Rahayu, MMedEd, PhD, is a professor in Medical Education, Universitas Gadjah Mada, Indonesia.