Abstract
Objective
Resident morale is an important yet poorly understood aspect of the residency training experience. Despite implications for program quality, resident satisfaction, patient care, and recruitment, little is known about the variables influencing this complex phenomenon. This study sought to identify important factors affecting morale in psychiatry residency training.
Methods
The authors conducted four semi-structured focus groups at a moderately sized, urban, psychiatry residency program during the 2013–2014 academic year. They used qualitative data analysis techniques, including grounded theory and content analysis, to identify key themes affecting resident morale across training levels.
Results
Twenty-seven residents participated in the focus groups with equal distribution across post-graduate years (PGY) 1–4. Five major conceptual categories affecting resident morale emerged: Sense of Community, Individual Motivators, Clinical Work, Feeling Cared For, and Trust in the Administration.
Conclusions
Morale is an important topic in residency education. The qualitative results suggest that factors related to a Sense of Community and Individual Motivators generally enhanced resident morale whereas factors related to a lack of Feeling Cared For and Trust in the Administration tended to contribute to lower morale. The authors describe the possible interventions to promote stronger program morale suggested by these findings.
References
Yudkowsky R, Elliott R, Schwartz A. Two perspectives on the indicators of quality in psychiatry residencies: program directors’ and residents’. Acad Med. 2002;77(1):57–64.
Elliott R, Yudkowsky R, Vogel R. Quality in psychiatric training. Acad Psychiatry. 2000;24(1):41–6.
Haupt DN et al. Psychiatry/medicine: a comparison of factors in resident role satisfaction. J Psychiatr Educ. 1987;11(2):78–86.
Ellencweig N, Weizman A, Fischel T. Factors determining satisfaction in psychiatry training in Israel. Acad Psychiatry. 2009;33(2):169–73.
Simmonds ACT et al. Factors important to students in selecting a residency program. Acad Med. 1990;65(10):640–3.
Levy BR, Schrage H. Residency applicants in psychiatry: factors influencing program choice. Acad Psychiatry. 1996;20(2):76–81.
Nagler A et al. To match or not: factors influencing resident choice of graduate medical education program. J Grad Med Educ. 2012;4(2):159–64.
Johnson S et al. Morale in the English mental health workforce: questionnaire survey. Br J Psychiatry. 2012;201:239–46.
Grieve S. Measuring morale—does practice area deprivation affect doctors’ well-being? Br J Gen Pract. 1997;47(422):547–52.
Cutler JL et al. Discrediting the notion “working with ‘crazies’ will make you ‘crazy’”: addressing stigma and enhancing empathy in medical student education. Adv Health Sci Educ Theory Pract. 2009;14(4):487–502.
Punch K. Section 10.5: Grounded theory analysis, in introduction to social research: quantitative and qualitative approaches. London: Sage Publications; 1998. p. 210–21.
Punch K. Section 8.5: Grounded theory, in introduction to social research: quantitative and qualitative approaches. London: Sage Publications; 1998. p. 162–73.
Herzberg F. One more time: how do you motivate employees? 1968. Harv Bus Rev. 2003;81(1):87–96.
Mitchell SBM. Freud and beyond: a history of modern psychoanalytic thought. New York: Basic Books; 1995.
Fried FE, Doherty EG, Coyne L. Psychiatric residents: a survey of training needs, satisfactions, and social attitudes. Am J Psychiatr. 1973;130:1342–5. 0002-953X (Print).
Skodol AE, Maxmen JS. Role satisfaction among psychiatric residents. Compr Psychiatry. 1981;22(2):174–8.
Acknowledgments
The authors gratefully acknowledge the participation of all the focus group participants.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The study was approved by Institutional Review Board at the New York State Psychiatric Institute.
Author Disclosures
On behalf of all authors, the corresponding author states that there are no conflicts of interest.
Funding Source
This study received no funding.
Rights and permissions
About this article
Cite this article
Caravella, R.A., Robinson, L.A., Wilets, I. et al. A Qualitative Study of Factors Affecting Morale in Psychiatry Residency Training. Acad Psychiatry 40, 776–782 (2016). https://doi.org/10.1007/s40596-016-0567-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40596-016-0567-2