Using Photovoice to Explore Family Medicine Residents' Burnout Experiences and Resiliency Strategies

Physician burnout is well described in the literature. In response, experts are now shifting to try to understand physician resiliency. We sought to better understand burnout and resiliency from the perspective of family medicine residents through the qualitative analysis of photographs and discussion.

We used Photovoice, a qualitative research method, to understand how residents describe and cope with burnout. Faculty assigned residents at a Midwest family medicine residency program to take photographs and provide captions that reflected personal experiences of burnout and resilience. Residents viewed the collective photographs and discussed their impact during three audio-recorded small-group sessions. Researchers qualitatively analyzed the captions and recordings using a hermeneutic phenomenology approach, and analyzed the visual content of the photographs using a standardized rubric.

We identified six themes for the resident description of burnout: basic needs deficiency, physical exhaustion, self-neglect, personal depletion, being overwhelmed, and feeling like an outsider. Six themes were also identified for cultivating resilience: self-care, nurturing relationships, seeking the comforts of home, escaping to refuel, self-reflection, and identifying strengths from adversities. Resilience pictures were more likely to have been taken in a natural setting; burnout photographs were duller in color.

Family medicine residents experience burnout in specific, unique ways, and are able to identify common sources of resilience. Family medicine educators can use the Photovoice methodology to help residents capture their personal experiences of burnout, share their experiences with peers, and discover sources of resilience.