Thriving in Neurology Residency: An Appreciative Inquiry Approach

Enhancing resident well-being has become a top priority for medical educators as awareness of physician burnout continues to grow. Although substantial effort has been made to understand contributors to resident burnout and develop effective interventions, relatively little is known about what characterizes the opposite of burnout-that is, thriving in medical training. This phenomenologic qualitative study applies appreciative inquiry as an interview technique with the aim of characterizing self-identified experiences of thriving among residents in the Yale Neurology program.

Eight residents across all years of training in a single neurology residency participated in semi-structured appreciative interviews to identify experiences of thriving during neurology training. These interviews were transcribed and qualitatively analyzed with a phenomenologic perspective for common themes.

Numerous themes emerged spanning personal, interpersonal, and organizational domains. Whereas some of these themes were congruent with established foundations of well-being and adult learning theory, others revealed the crucial contributions of stress and challenge to thriving. One of the strongest emergent themes was the tendency of residents to thrive during autonomous, high-challenge, high-stress situations, provided that adequate support was present and psychological safety was ensured.

These findings resonate with phenomena studied in positive psychology that are not being widely applied in medical education. To the degree that conclusions are transferable to other training contexts, this study suggests an opportunity for medical educators to harness the positive aspects of stress and challenge in a supportive way that facilitates trainee well-being through experiences of thriving.