title: Medical student resilience strategies: A content analysis of medical students' portfolios.
abstract: BACKGROUND
  Stress and burnout among medical students is a well-recognized concern. A student's ability to employ resilience strategies to self-regulate behaviour is critical to the student's future career as a physician.
  
  
  METHODS
  We retrospectively reviewed a sampling of year 1, 2 and 5 portfolio essays focused on the Personal Development competency and performance milestones, written by 49 students from three different classes in a 5-year programme devoted to training physician investigators. Two medical educators used a framework established by Jensen and colleagues (2008) to identify the nature and prevalence of various resilience strategies (valuing the physician role, self-awareness, personal arena, professional arena, professional support and personal support) medical students reported in portfolio essays.
  
  
  RESULTS
  All students documented at least one strategy in their essays each year. In all years, the most commonly documented strategies were in the personal arena (95.7% of year 1, 98% of year 2 and 87.8% of year 5 portfolios). The least frequently documented strategy in all years was professional support (42.8% of year 1, 38.8% of year 2, and 28.6% of year 5 portfolios). Year 5 portfolios discussed personal support strategies (79.6%) more frequently than year 1 (53.1%) and year 2 (59.2%) portfolios.
  
  
  CONCLUSIONS
  The results suggest that medical students can identify stressors and articulate resilience strategies that can be employed to potentially address them.
authors.affiliation: Cleveland Clinic Department of Anatomic Pathology, Cleveland, OH, USA. praysor@ccf.org.|Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA. praysor@ccf.org.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Prayson
authors.affiliation: Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
authors.forename: S Beth
authors.initials: SB
authors.lastname: Bierer
authors.affiliation: Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Elaine F
authors.initials: EF
authors.lastname: Dannefer
keywords: Personal development; Portfolio assessment; Resilience strategies; Undergraduate medical education