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A realist review of programs fostering the resilience of healthcare students: What works, for whom and why?

Halimi SN 1 , Rowett D 2 , Luetsch K 3

Affiliations 

  • 1 School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland, 4102, Australia; Kulliyyah of Pharmacy, International Islamic University Malaysia, Malaysia. Electronic address: [email protected]
  • 2 School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, 5000, Australia. Electronic address: [email protected]
  • 3 School of Pharmacy, The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland, 4102, Australia. Electronic address: [email protected]
Res Social Adm Pharm, 2025 Jan;21(1):22-31.
PMID: 39406627 DOI: 10.1016/j.sapharm.2024.10.006

Abstract

BACKGROUND: Various programs aimed at fostering the resilience of students have been implemented into healthcare undergraduate and postgraduate educational courses and degree programs. Which of these increase their participants' resilience under which circumstances, for whom and why remains uncertain.

METHODS: A realist review of articles reporting program outcomes as measures of resilience through the use of via validated psychometric surveys was conducted to investigate which contexts favour the development of resilience of healthcare and health sciences students and which mechanisms have to be activated to achieve this outcome.

RESULTS: Thirteen Context-Mechanism-Outcome Configurations were synthesised from data presented in 43 articles. These were combined with theories explaining the theoretical and psychological frameworks underpinning programs to develop a program theory of how and why resilience fostering programs work. Contexts which favour the development of resilience were the use of validated psychological frameworks as program foundation, e.g. Cognitive Behavioural Therapy, mindfulness-based training. Expert facilitation, longitudinal integration into curricula, flexible and multi-modal design and delivery, and opportunities for students to apply and practice resilience-building strategies also created favourable contexts. Meeting students' or practitioners' needs activated mechanisms of trust, engagement and recognition of a program's value and real-world benefits. An increase in resilience was achieved by students developing reflective skills, metacognitive awareness and positive habits of mind.

CONCLUSION: The program theory established via a realist review provides guidance on how the individual resilience of healthcare students can be fostered throughout their undergraduate, postgraduate degrees and early practice, potentially supporting them to flourish and remain long-term in their chosen professional roles.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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