Recommendations:
Whilst specialist knowledge and facilitation skills are required by
those delivering a resilience-based coaching programme like this, its
potential as a cost-effective and scalable intervention is great given
the size of the healthcare workforce who could benefit. Scalability is
possible without losing intervention fidelity, using controlled
‘manualisation’ of the intervention and a ‘train the trainer’ model.
This approach could enable specialist up-skilling of mental health
professionals and other experienced facilitators with transferable
psychological care skills and specialist Cognitive Behavioural Therapy
training to provide a critical mass of appropriately trained and
supported facilitators to enable widespread availability of the
intervention.
The wider applications of resilience-based coaching interventions such
as the one explored here also offer great potential as a relatively
low-cost, scalable means of supporting the general well-being,
psychological resilience and coping mechanisms of health professionals
dealing with the inherent, non-error related challenges of their
everyday work.
Health systems and organisations seeking to garner the gains of
resilience-based programmes must first address negative connotations
associated with such interventions by distinguishing the role of
resilience in the context of system inadequacies. Despite evidence of
resilience-based interventions working to support health professionals
in managing clinical work, the reluctance of some staff to engage with
resilience training due to its misapplication in many healthcare
contexts, prohibits effective implementation. Future resilience-based
interventions should therefore take account of previous critiques
regarding individual versus system change and focus on the prophylactic
application of practical, evidence based self-management and support
strategies of relevance to specific aspects of clinical working, which
are highly valued by staff, if they are to maximise staff engagement and
impact in practice. Most importantly, to be truly effective, developing
staff capability around resilience requires more than just delivering
training, but must also involve system change. Examples should include
changes to the current predominantly individual focus of
resilience-based intervention design and incident investigation that are
largely outside the control of individual health professionals.