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Open Access Publications from the University of California

“Everybody in this room can understand”: A Qualitative Exploration of Peer Support during Residency Training

Creative Commons 'BY' version 4.0 license

Learning Objective: To better understand the nature of support offered through residency peer support programs and to explore trainee perceptions of the benefits, potential harms, and optimal characteristics of peer support.

Background: Though peer support groups are often utilized during residency training, the dynamics, content, and impact of social support offered through peer support are poorly understood.

Objective: To explore trainee perceptions of the benefits, drawbacks, and optimal membership and facilitation of peer support groups.

Methods: After engaging in a peer support program at an emergency medicine residency program, fifteen residents and four group facilitators participated in four focus groups in 2018. Interview questions explored the dynamics of group interactions, types of support offered, and psychological impacts of participation. The authors conducted a reflexive thematic analysis of data, performing iterative coding and organization of interview transcripts.

Results: Discussions with experienced senior residents and alumni normalized residents’ workplace struggles and provided them with insights into the trajectory of their residency experiences. Vulnerable group dialogue was enhanced by the use of “insider” participants, however participants acknowledged the potential contributions of mental health professionals. Though groups occasionally utilized maladaptive coping strategies and lacked actual solutions, they also enhanced residents’ sense of belonging, willingness to share personal struggles, and ability to “reset” in the clinical environment. Results of our reflexive thematic analysis are described with representative quotes in Table 1.

Conclusions: Participants offered insights into the benefits and drawbacks of peer support as well as optimal peer group composition and facilitation. Support groups may be more effective if they engage a complementary model of alumni and psychologist facilitators, avoid fatalism, and aim to foster intimate connections among residents. These findings can inform the development of future initiatives aiming to create a safe space for trainees to discuss workplace stressors.

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