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Table 2 Illustrative quotations from interviews

From: Evaluation of a novel intervention to reduce burnout in doctors-in-training using self-care and digital wellbeing strategies: a mixed-methods pilot

Theme Illustrative Quotation
1: Opportunity for reflection and to prioritise wellbeing “I think there is still, sometimes, difficulty communicating with your colleagues. I think there is still a sense of machoism about it” (P19)
“What I found useful is that someone, anyone, is just acknowledging the stresses that are there” (P5)
“I think about how you need to stop and think about yourself as well and don’t think about the patients only” (P1)
Normally you just carry on because there’s no time to think about it” (P2)
“When I’m not at work I spend a lot of time absolutely exhausted so I don’t stop and think about things. It’s not that I couldn’t, I just don’t have the energy for it. I just sit and watch TV or whatever” (P17)
“I think it makes you reflect on yourself. It made me realise better that the weeks when I feel really crap are the weeks when I don’t put any care attention at all on my balance. So that’s probably the main thing I learnt about myself” (P17).
“It, sort of, prompted me to think about myself and certain things and what I wanted to change and what may be contributing to some of my stresses” (P2).
2: Sharing and hearing experiences of others “I think it was like a safety room where you can actually express yourself and no one’s going to judge you or take whatever you’re saying and take it somewhere else” (P1)
“You know, there’s an expectation that we are supposed to be very resilient and just be able to cope with whatever…. I can probably identify five doctors who’ve committed suicide. And actually, you know, I feel nobody should have to allow themselves to get to that point in life without being able to talk and look for help. And so I think it was really important… that we had that opportunity to talk about our own personal experiences with others. Because what you quickly realise is that actually everyone’s saying we could all relate to, we’ve all experienced it, even when we’ve had to put on a tough face at work and pretend the abnormal is normal” (P20).
3: Workshop content:
“The most useful stuff I found, about being aware of what the stresses can be and how to manage it” (P2)
“I actually really liked the meditation techniques. I thought they were really helpful” (P9).
“I was actually doing quite a bit of work myself. You know, like self-help material reading. So, I didn’t find that aspect as helpful. But … I think the definitions were helpful. Kind of understanding what it actually means to be compassionate towards yourself, and what does wellbeing mean.” (P21).
3: Workshop content: Microboundaries “So, when I am at home it’s quite stressful because I’ll get an email through about work stuff… So, yes I think the concept of having separate emails. And what I’ve done differently as a result is, I don’t necessarily open the ones that don’t look that kind of acute, I suppose” (P4).
“Just showing us how to turn off notifications or set them for, you know, not to be on between 9 and 5 or whatever, that was the most useful bit I think” (P5).
4: Self-care goals and outcomes; enablers and barriers to implementation I’m calmer and I feel like I’m bringing back that equilibrium that I had before…and being cheerful and improving how you feel about yourself” (P1).
“I really did take away that job, and setting own goals, and making it a SMART goal. And making us actively aim for something, and put it into action. That was quite helpful, because I felt motivated to see that through” (P21).
“I think it is [mindfulness] very relaxing and I think it has been making it easier for me to get to sleep. The times I have found it difficult is when I have been doing night shift, obviously, because you get out of your routine” (P12).
“So, the self-care one was to join up with an exercise class. So, I had every intention, I did my research, found the exercise class I wanted to go to. It’s on Thursday evenings. My timetable changes, I now can’t go” (P5).
“So I said I want to be more active, and I want to go to the gym more often…but it’s that I haven’t been able to do it over some months before that because I’d had exams, etc.” (P9).
5: Microboundary goals and outcomes; enablers and barriers to implementation “It sort of made me put myself in control of my time and space” (P20); “My time at work is more productive…I’m much more efficient in my administrative time now” (P5)’.
“For me if I tried to make too many changes I’d just forget about all this. Whereas if I committed to one and focused on that fully…then I have a higher likelihood of achieving that rather than try to do too many at once” (P2).
“Because it’s quick, isn’t it, it doesn’t require a big-time commitment” (P5).
I feel like I should be available [out of hours] if there’s something important” (P12).
“My consultant 1 day had a huge upset with me, because I wasn’t responding to my mobile phone, she was texting or calling me or whatever at work but I was in teaching. But if I turned off the notification, you know, I can’t really go around to my consultant and say, hey, just… I’m letting you know this is what I’m doing. She’ll be saying, well no, you should keep them on and you should ignore all the personal messages. But that’s incredibly hard to do” (P5).
6. Future intentions “I mean, if I’ve done it for the last few weeks now, it’s easy now I’ve got into to the habit” (P1).
“I think I’m going to just talk to a few more people. And maybe even just get some psychotherapy for it, to be honest. So just generally, because it’s… I think it’s still an on-going thing. You know doctors always tend to be very self-critical” (P21)
“I think it’s more about the general concept that I’d like to continue. I’d like to think that when I’m a consultant that I’d like to value a lot of these things and I’ll make it known to my juniors I hope. And my team that it’s really needed” (P4).
7. Improvements for future workshops It would’ve been useful to have an extra ten, 15 min so that anyone who wants to do that [implement the changes immediately] maybe stays at the end and gets some support, like, I suppose tech support to try and just do that” (P5).
“I think the online thing is even better because then no one has to commute somewhere. They can do it at their own time, over the weekend or maybe midnight” (P1)