Abstract

Introduction: Owing to the growing demands, high levels of expectations and increasing stress experienced by many clinicians, alarming rates of burnout and depression threaten their wellbeing. Studies on physicians’ suicide collectively show moderate (men) to high (women) elevated suicide rate ratios. More than half of UK doctors report significant symptoms of burnout - a rate more than twice that among professionals in other fields.

There is an urgent need for more research examining the psychological well-being of healthcare professionals as it plays a fundamental role in recruitment and retention and has a direct impact on patient safety. We aim to assess the effectiveness of reflection rounds in improving resilience in healthcare professionals.

Methods: Between October 2017 and April 2018, a two-group non-randomized controlled trial design evaluated the effect of surgical reflection rounds (SRR) on a study vs control group of healthcare workers at a teaching hospital in London. 98 participants were interviewed using a Conor-Davidson Resilience Questionnaire (CD-RISC10). Data analysis was performed by descriptive statistics, independent-sample t test, one-way ANOVA, and regression analyses. Wilcoxon signed rank test was used to compare scores on the pre- and post SSR CD-RISC questionnaires. Results were considered to be significant at p < 0.05.

Results: 120 participants were included (response rate = 81.67%). There were 44 healthcare workers in the SRR cohort and they were matched with 44 control healthcare workers who did not participate. The majority (68%) were female. Most of them were junior doctors (64%). Respondents were mostly junior doctors equal or below 39 years of age (70%). The mean baseline resilience score was 75.9 (SD 6.0, range 40 - 110). In multivariate analysis, only marital status, age group, and seniority remained significantly associated with resilience level. The mean CDRISC score in the SRR group was 88.62 +/- 9.32 compared to 83.14 +/- 8.59 in the control group after 6 months. This result was statistically significant.

Conclusion: There is a need for effective evidence based strategies to improve resilience in clinical populations, thereby positively impacting on patient safety. Our study demonstrates surgical reflection rounds can be effective in building resilience amongst our staff.

Keywords: Resilience; Staff Well-Being; Professional Burnout

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