Early career professional resilience: interdisciplinary insights to inform Practice Education

Pete Nelson, Social WorkRichard Martin, Social Work Mark Boylan, EducationHeidi Probst, Radiotherapy

Sheffield Hallam University

Teacher Education, Radiation Therapy, Social Work

Teacher education - post graduate plus undergraduate, particularly in Primary, 2 or 3 placements, now schools direct, 120 days in school, school based 'mentor'Radiation therapy – undergraduate training, heavy clinical placement component, PG training is to develop advanced practice in qualified practitionersSocial Work – undergraduate and postgraduate qualifying training, Requirement for 200 days in placement for both usually over two placements which must include statutory social work experience

Resilience as an interdisciplinary issue

Teacher Education - high percentage of new teachers leave in the first five years, high levels of stress.

Radiation therapy - In a recent national survey over a third of the radiotherapy workforce were identified as suffering from burnout (Hutton et al.,2012). High attrition on UG Rad Onc courses nationally

Social Work- poor professional retention particularly in children and families social work and child protection, evidence of early career drop out with an overall practice longevity of 8 years

Policy responses

Belief: Resilience is stable and inhering

Response - measure resilience and use as a selection criteria Teach First, and now Front Line (Social Work) - using psychometric tests. An admissions criteria in Education

Belief: Resilience is developmental

Developmental approach - Society of Radiographers (2013), recommendation "Preparation for placement must be realistic and include VERT-based practical skills, relationship skills and emotional resilience"

The Resilience Literature and the Knowledge gap

Models of resilience - often from psychometric studies describe how different factors relate to each other e.g. coping, wellbeing, emotional intelligence, positive emotions. Strong internal validity but may lack external validity. Roots of resilience studies in child development, lack of theorisation of resilience in professional contextsLittle research with multiple perspectives across disciplinesLimited research on interventions or ways of developing resilience on vocational coursesReferences:Beltman, S., Mansfield, C. & Price, A. (2011). Thriving not just surviving: a review of research on teacher resilience. Educational Research Review, 6, 185-207; Carson, E. King, S., & Papatraianou, L. (2011). Resilience in social workers: the role of informal learning in the workplace. Practice: Social Work in Action, 23:5, 276-278; Dunn, L., Iglewicz A., Moutier, C. (2008). A conceptual model of medical student well being: promoting resilience and preventing burn out. Academic Psychiatry, 32:1, 44-53.

Some resilience dimensions/issues

• Bounce back from adversity coping with ◄▬►continual demands

• Personal/individual organizational◄▬►• Relatively stable situated◄▬►• Fixed learnable◄▬►• Disengaged 'surviving' engaged/ ◄▬►

professional

Initial definition

Professional resilience is what supports people to stay in the

profession and to stay professional

What being professional means is contested and by using the term professional we are contributing to that contestation in viewing

professional as involving emotional and moral engagement

Research Aim

To develop the basis for a research informed creative curriculum and pedagogy that supports and develops professional resilience during early career education in professions involving emotional labour and moral challenge.

Research Questions

• What supports and hinders the development of professional resilience in radiotherapy, social work and teacher education?

• What creative pedagogical approaches may help to develop professional resilience?

• What are appropriate methodologies for researching professional resilience?

Methodology

• A fixed mixed method design incorporating survey research, qualitative interpretive interviews and creative innovative approaches

• Creative innovative approaches- co-operative inquiry

Activities

The activity - staff and students

Common pictures - 1Staff – he pictures mountains with a road – described the pleasure of running on very straight boring roads as it gives you time to think and a metaphor for what keeps him going when he may be having a difficult time

Student – Represents reflection. The car in the road may represent a mental breakdown. Might not enjoy reflecting but it can be a useful toolGender an issue – men are expected to be tough – a reflection diary can seem a bit girly but reflection can be usefulI can talk but I hate reflection – I wouldn’t write a diary but I can reflect in my head.

Can resilience be developed?

Senior mentors/practice educators/practice training coordinators

Can resilience be developedacademic staff

Strongly agree

Confidence a strong part of resilience - build up people's self esteem

Role models and direct practice - learn from others

Fence sitters/middle group

Can't think of a situation where I have taught resilience

If something can be learnt then there is an element of teaching

Not sure about 'taught' - have to develop that

If we can identify what is stopping people moving forward anything is possible

Disagree

Some people's personalities mean they don't have resilience within them

Experiential learning is what happens helping students see things in a different way to improve resilience

Strongly agree disagree

Agree strongly disagree

Challenges of resilience on placement

Placements are where students have their resilience tested - there are similar themes for all professions although the language differs

• Assessment deadlines: too many at once

• Feedback: negative/too personal/lack of

• Practice Educator: not very good/didn’t get on with/availability of

• Lack of clarity/explanations about performance

• Being under the microscope• Staff sickness/stress• Self doubt• Case discussions• Service users’ distress and

anger• Harsh realities of role

Factors that undermine resilience

• Student preparedness: time management/life experience/misconceptions/lifestyle/family/health

• Not feeling safe to express self doubt/discuss difficulties• Concerns about performance not being adequately

explained/disagreement about this/Being overly monitored

• Placement not sufficiently challenging• Negative experience at the start of placement• Negative attitude of staff/lack of respect/overly

professional

Getting through and keeping going

• Proving that you can do it

• Pick yourself up and get

on with it

• Not losing what I have

worked for

• Focus on what you have

done and count the days

• If you don’t get through

you know the job isn’t for

you

• Steely resolve

• Took it in my stride

• Brush it off

• Powering through

• Too late to turn back

• Not wanting to fail

• A mixed feeling of coping

and struggling

Double edged issues

• Getting through placement does not necessarily develop resilience but learning that developing working relationships with colleagues helps you get through does.

• Positive feedback can be helpful but not if it over inflates a student's self image which cannot then be sustained in the work setting.

• Under and over demanding placements can be got through and not develop resilience

Emerging messagesfor Practice Educators and Organisations

• commitment, values and altruistic purposes support resilience - if professionals cannot enact those commitments values and purposes then

they may leave• leaders who communicate support, and signal appreciation and

understanding of workload issues enhance resilience - they:– give support with difficult cases/clients/patients/classes/pupils – show understanding of transitions and have appropriate expectations

of new professionals– create space for peer talk/support– prioritise team and/or supportive relationships

• develop a culture that avoids judgemental feedback both of trainees and newly qualified professionals and aim for more supportive relationships

• reduce workload

For students• remember or develop a sense of purpose, values and commitment• pay attention to the importance of professional relationships and

teams • engage with reflective practice to enhance self awareness and

understanding of professional life/role• accept not knowing as part of learning• aim for realistic appraisal of self and the profession• develop peer support networks• develop positive qualities, dispositions and skills such as patience,

empathy, emotional awareness• managing work load and maintaining a work-study-life balance• be determined

For HEIs/University tutors

• prepare students for the realities of professional practice

• signal support during placement by regular contact• be available to support with difficult

cases/situations/events/patients/classes• aim for an open, accessible relationship that models

professionalism as engaged and empathetic• address the issue of resilience and related subjects on

courses

For qualified early career professionals

• develop supportive relationships• retain determination and commitment• keep issues in perspective and limit expectations of what is achievable • cultivate equanimity—empathetic distance• work life balance—have some where else to go• strengthen personal qualities, dispositions and skills that support resilience• trust that experience will make the work easier to cope with• take opportunities to increase knowledge and skills

Potential areas for curriculum development in University and Work Place professional education

• Support with placement and transitions• Professionalism, purpose and agency• Strengthening personal qualities• Interpersonal dimension• Expand professional knowledge base• Coping with workload

I remember feeling so stupid and incompetent...you had to pick yourself up and get on with it

As a student you’re constantly in a learning environment where all these people are telling you how you should behave and what attitude you should have

I think you’ve just got to be calm....I’m far more patient in my job. When someone would get cross before I would take it as a personal attack whereas actually that person’s life has fallen

I’m really proud of the job we do…..you really get to know them (patients) andthey get to the end of their treatment and they're so grateful that either you've managed justto get them through to the end or you've managed to deal with problems.

Resilience development

SHU Imagine Professional resilience project 2013 For further enquiries please contact a member of the project team

P. Nelson P.Nelson@shu.ac.ukH. Probst h.probst@shu.ac.ukM. Boylan, edsmsb@exchange.shu.ac.ukR. Martin, r.m.martin@shu.ac.uk