Levels of Resilience Are Correlated With Distress and Empathy in Resident Physicians

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Clinically relevant distress and decreased empathy are frequently experienced by resident physicians whose resilience is low when exposed to the trauma of working with patients in the hematology-oncology setting, a study published in Psycho-Oncology has shown.1

Because exposure to adversity and trauma are increased for residents on a hematology-oncology rotation and physician distress and empathy influence patient care, these researchers sought to measure the impact of vicarious trauma on physicians' resilience.

For the study, resilience and distress were measured with the Connor–Davidson Resilience Scale and Impact of Events Scale – Revised, respectively, at the end of a routine hematology-oncology rotation. Rotation-specific information such as number of death encounters, death stress, and meaning were also obtained. Empathy was measured with the Interpersonal Reactivity Index before and after the rotation.

These researchers achieved a 58% overall response rate (56 of 96 residents). Their findings demonstrated that distress had a negative impact on resilience (r = –0.306, P = .023) but empathy did not (r = 0.172, P = .204), nor did change in empathy during the rotation (r = –0.122, P = .374). Resilience among male residents was negatively correlated with distress (r = –0.389, P = .04), but resilience among female residents was not.

Distress levels for residents were in the clinically significant (76%) or posttraumatic stress disorder (17%) range. In addition, resident empathy during the rotation decreased (P = .018).

Resilience levels for those residents who reported death events as the most stressful experiences of the rotation were similar to those of residents who gained a sense of meaning from working with patients at the end of life.

Residents with greater resilience were less likely to experience distress. The researchers conclude that resilience has a beneficial effect on resident physician distress.


1. McFarland DC, Roth A. Resilience of internal medicine house staff and its association with distress and empathy in an oncology setting [published online May 24, 2016]. Psychooncology. doi:10.1002/pon.4165.


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