title: Resilience of internal medicine house staff and its association with distress and empathy in an oncology setting.
abstract: BACKGROUND
  Resilience is a beneficial trait for resident physicians who are exposed to adversity through their work with patients. Inpatient hematology-oncology produces vicarious trauma for physicians in training. Physician distress and empathy influence patient care and may be associated with respectively lower and greater levels of resilience.
  
  
  METHODS
  We collected measures of resilience (Connor-Davidson Resilience Scale), distress (Impact of Events Scale - Revised), and rotation-specific information (e.g., number of death encounters, death stress, and meaning) at the end of a routine hematology-oncology ward rotation. Empathy (Interpersonal Reactivity Index) was measured both before and after the rotation.
  
  
  RESULTS
  Fifty-six out of 96 residents completed the study with an overall response rate of 58%. Resilience was negatively correlated with distress (r = -0.306, p = 0.023) but not with empathy (r = 0.172, p = 0.204) and nor with change in empathy over the course of the rotation (r = -0.122, p = 0.374). When separated by sex, male resilience was negatively correlated with distress (r = -0.389, p = 0.04), but female resilience was not. Resident distress levels were in a clinically significant (76%) or posttraumatic stress disorder range (17%), and resident empathy decreased during the rotation (p = 0.018). Resilience levels were similar in those who reported that death events were the most stressful experiences of the rotation and those who derived a sense of meaning from working with dying patients.
  
  
  CONCLUSIONS
  Resident physicians experienced clinically relevant distress and a decrease in empathy. Resilient resident physicians were less likely to experience distress. This study provides evidence for the salutary effects of resilience on physician distress. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Division of Network Medicine Services, Department of Medicine, Memorial Sloan Kettering Cancer Center, West Harrison, NY, USA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: McFarland
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Roth
mesh_terms: D000328:Adult; D003643:Death; D004645:Empathy; D005260:Female; D006801:Humans; D007388:Internal Medicine; D007396:Internship and Residency; D008297:Male; D008495:Medical Oncology; D008875:Middle Aged; D005791:Patient Care; D010820:Physicians; D055500:Resilience, Psychological; D013313:Stress Disorders, Post-Traumatic; D013315:Stress, Psychological
keywords: Cancer; Distress; Empathy; Medical Education; Oncology; Resilience