The role of the doctor, although challenging, is one in which many practitioners thrive. However, in the changing landscape of the NHS the prevalence of occupational illness, including burnout, is high. With widespread doctor distress and the negative associated consequences for both the doctor and their patients, there is a now a consensus that organisational change is essential, to ensure the sustainability of the NHS workforce. Resilience training, which provides doctors with a space for reflection and learning self-regulation skills has potential for mitigating some of the impact of occupational stress. This report presents an evaluation of the Westminster REFRAME workshop, a half day, intensive resilience-training programme that has been provided for doctors and other medical staff over the academic year 2018/19.
Westminster REFRAME workshops were provided for staff at Guy’s and St Thomas’ Hospital across three groups: doctors in their foundation years (FYs), those in the junior doctors’ leadership group (JDLG) and mixed groups (various healthcare professionals working at the hospital who voluntarily signed up to attend the workshop). All attendees were invited to take part in the evaluation. Questionnaires were used to collect quantitative and qualitative data from participants at three time points: immediately prior to the workshop (baseline), immediately after the workshop (post workshop), and two months after the workshop (follow-up). Outcome measures collected included perceived stress and positive well-being. Additionally, participants were asked to rate six statements about the workshop (e.g. ‘the workshop was useful to me’; ‘the ideas and concepts were communicated clearly’). Open-ended questions collected written data regarding participants’ experiences and perceptions of the workshop.
• One hundred and twenty junior doctors and other healthcare professionals from Guys and St Thomas’ hospital attended REFRAME workshops in this time period. Eighty-eight participants completed questionnaires immediately pre and post workshop. However, only 13 2-month follow-up questionnaires were completed.
• Participants reported elevated stress levels before the workshop (follow-up data was unavailable).
• All three groups of participants (FY doctors, the JDLG and ‘mixed groups’) had similar stress and well-being scores. However, the mixed groups had the poorest scores for both stress and well-being, suggesting that those who self-refer are most in need of support.
• Seventy-seven percent of all participants agreed that the workshop was useful. Eighty-one percent said that the topics covered would be useful for work, and 72% said that they intended to use some of the techniques they had learnt, including breathing techniques and mindfulness.
• The needs of the FY group may not be as well met compared with the JDLG and mixed groups: FYs tended to score the workshops a little more poorly than the JDLD and mixed groups.
• Participants reported that they found the interactive elements of the session engaging, in particular the practical aspects were found to be highly useful and enjoyable. It was noted that the friendly and welcoming manner created an open atmosphere that helped to facilitate sharing among the attendees.
• Participants had various ideas for improvement, with a key theme being the inclusion of further evidence-based techniques for improving resilience.
“Gentle - calm, evidence-based data presented, pragmatic”
“Friendly and relaxed”
“Interactive. Using different modalities. Very engaging”
“A chance to stop and engage with this important topic”
“I've become more aware of the shortcomings and the ways to improve them. I've also learned about awareness of breathing techniques and how to put this into practise”
“Opportunity to evaluate areas of strength and weakness and consider practical steps going forward”
“Reminded me to do things I've been meaning to”
“Fact that it exists suggests that being a junior doctor is stressful and that recognition makes me feel better about being stressed at times”
Westminster REFRAME has continued to be valued by Guy’s and St Thomas’ Hospital staff and trainee doctors. Overall, the healthcare professionals who participated in the Westminster REFRAME workshop reported finding their session appropriate and acceptable, indicating that they intended to use the tools and techniques taught and practiced. Results from this evaluation demonstrate the potential for the REFRAME workshop to help healthcare professionals cope better with the impact of occupational strains and improve their resilience. Further evaluation and follow-up with larger samples will aim to provide evidence for the effectiveness of this workshop at individual and organisational levels.