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Teaching and Learning Resilience: Building Adaptive Capacity for Rural Practice. A Report and Subsequent Analysis of a Workshop Conducted at the Rural Medical Educators Conference, Savannah, Georgia, May 18, 2010


  • Randall Longenecker MD,

    1. Professor, Assistant Dean for Rural Medical Education, and Program Director, Ohio State University Rural Residency Program, Ohio State University, Columbus, Ohio
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  • Therese Zink MD, MPH,

    1. Professor, Department of Family Medicine and Community Health, and Associate Director of Research and Evaluation, Rural Physician Associate Program, University of Minnesota, Minneapolis, Minnesota
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  • Joseph Florence MD

    1. Professor and Director of Rural Programs, East Tennessee State University Department of Family Medicine, Johnson City, Tennessee
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  • The authors gratefully acknowledge the group of rural medical educators, administrators, and students for their participation in the workshop. For further information, contact: Therese Zink, MD, MPH, Department of Family Medicine and Community Health, University of Minnesota Medical School 421 Delaware Street SE, MMC 81, Minneapolis, MN 55455; e-mail


Abstract Purpose: Resilience, the capacity to endure and overcome hardship, has been suggested as a basic competency for rural medical practice. Unfortunately for physician educators, the medical education literature offers only limited guidance for nurturing this adaptive capacity. We describe the process and subsequent analysis of a daylong curriculum development workshop conducted at the annual meeting of Rural Medical Educators in 2010.

Methods: Fifty administrator, faculty and student attendees reflected individually and worked in groups to construct key curricular components and modalities for teaching this competency. Prior to the meeting, participants were asked to submit a personal story about resilience. The 22 narratives received were distributed across 8 groups and provided the grist for the small group discussions, in which each group identified key concepts for teaching and learning about resilience, constructed a concept map, and developed a curriculum that was presented to all session participants. Concept maps, curriculum outlines and notes taken during the presentations were analyzed using content analysis techniques.

Findings: Data highlight the importance of (1) embracing hardship as an opportunity for growth, (2) viewing resilience as both an individual and community property, (3) pursuing adaptability more than hardiness, and (4) setting a lifelong pattern of learning this competency in practice. Specific teaching modalities are suggested including individual reflective time and group activities.

Conclusions: To our knowledge this represents a first effort to define and develop a medical curriculum for teaching resiliency in rural predoctoral and residency education.