A New Description of a Healthcare Professional’s Resilience, Incorporating an Eastern Philosophical Perspectives of Self-definition. How to Bridge the Gap between Independent and Interdependent Self-definition in Medical Education

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Shizuma Tsuchiya
Yusuke Takamiya
Linda Snell


Teaching about resilience is one of the biggest challenges in medical education. One of the problems is that medical educators might still ascribe to the individualistic self-definition mainly promoted in the North American society. This definition includes characteristics such as “enduring ongoing hardship,” “thriving on challenges,” “being healthy,” and “being stronger,” which may raise hidden expectations that a healthcare professional’s personality should be strong enough to bounce back to his or her original condition even in a psychologically demanding situation.

Psychological theorists describe two broad modes of self-definition in two different cultures: independent self-definition in North American individualism and interdependent self-definition in East Asian collectivism. Despite this seemingly stereotypical discussion on the characteristics of self-definition, a discussion of the two types of self-definition can still encourage medical educators to propose a broader model of resilience in medical education. More specifically, a person using an independent self-definition may become be a complete, whole, autonomous entity, without others, and thus tends to achieve more and become more productive in a competitive society. In contrast, a person using an interdependent self-definition is more likely to be open to another aspect of the context and thus might be able to find and value the self in different ways even in the same context. However, these two self-definitions may not be dichotomous or mutually exclusive but occur in varying ratios in any one individual, particularly as trends of increased globalization, immigration, and technology call for changes in an individual’s value systems in countries.

From this standpoint, this review proposes a new definition of resilience in medical education, which is ‘a person’s capacity to be aware of the aspects of the self differently identified in each context, and to consciously value oneself and others in the context’.

This is the first article that incorporates the concept of the two self-definitions into resilience education in healthcare. The proposed definition may provide a broader model of resilience in a healthcare professional for educators as well as trainees in medical education.

Article Details

How to Cite
Tsuchiya, S., Takamiya, Y., & Snell, L. (2017). A New Description of a Healthcare Professional’s Resilience, Incorporating an Eastern Philosophical Perspectives of Self-definition. How to Bridge the Gap between Independent and Interdependent Self-definition in Medical Education. The International Journal of Whole Person Care, 4(1). https://doi.org/10.26443/ijwpc.v4i1.124
Theoretical Papers
Author Biography

Shizuma Tsuchiya, MA in Educational Psychology, Health Professions Education, McGill University, Montreal, Quebec, Canada & Senior Lecturer, Department of Internal Medicine (Oncology/Palliative Care) at Showa University Northern Yokohama Hospital, Kanagawa, Japan

Lecturer, Department of the Internal Medicine, Showa University Northern Yokohama Hospital

Master of Arts in Health Professions Education, Educational Psychology, McGill University


Markus HR, Kitayama S. Culture and the self: implications for cognition, emotion, and motivation. Psychol Rev. 1991;98(2):224–53.

Stewart MA. Effective physician-patient communication and health outcomes: a review. Can Med Assoc J . 1995;152(9):1423–33.

Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U. S. and Canadian medical students. Acad Med. 2006 Apr;81(4):354-73.

Lambert VA, Lambert CE, Itano J, et al. Cross-cultural comparison of workplace stressors, ways of coping and demographic characteristics as predictors of physical and mental health among hospital nurses in Japan, Thailand, South Korea and the USA (Hawaii). Int J Nurs Stud. 2004;41(6):671–84.

Van Mol MMC, Kompanje EJO, Benoit DD, et al. The prevalence of compassion fatigue and burnout among healthcare professionals in intensive care units: A systematic review. PLoS ONE. 2015;10(8):1–22.

Hall LH, Johnson J, Watt I, et al. Healthcare staff wellbeing, burnout, and patient safety: A systematic review. PLoS ONE. 2016;11(7):1–12.

McCann CM, Beddoe E, Mccormick K., et al. Resilience in the health professions. A review of recent literature. International Journal of Wellbeing. 2013;3:60–81.

Rogers D. Which educational interventions improve healthcare professionals’ resilience? Med Teach. 2016 Dec;38(12):1236-41.

Okie S. Ahead of burnout. N Engl J Med. 2008;359(22):2305–9.

Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377–85.

Walker C, Gleaves A, Grey J. Can students within higher education learn to be resilient and, educationally speaking, does it matter? Educ Studies; 2006;32(3):251–64.

Howe A, Smajdor A, Stöckl A. Towards an understanding of resilience and its relevance to medical training. Med Educ. 2012;46(4):349–56.

Epstein RM, Krasner MS. Physician resilience: What it means, why it matters, and how to promote it. Acad Med. 2013;88(3):301–3.

Wang MC, Haertel GD, Wahlberg HJ. Educational resilience in inner cities. In: Wang MC, Gordon EW (editors). Educational Resilience in Inner-city America. Challenges and Prospects. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc; 1994. p. 45–72.

Sampson EE. The challenge of social change for psychology. Globalization and psychology’s theory of the person. Am Psychol; 1989;44(6):914–21.

Nisbett RE, Masuda T. Culture and point of view. Proc Natl Acad Sci. 2003;100(19):11163–70.

Matsumoto D. Culture and self. An empirical assessment of Markus and Kitayama’s theory of independent and interdependent self-construals. Asian J Soc Psychol. 1999;2(3):289–310.

Wilkinson R. Nishida and Western Philosophy. New York, NY: Routledge; 2009.

Nishida K, Abe M, Ives C. An inquiry into the good. New Haven: Yale University Press; 1990.

Maraldo JC. Nishida Kitarō [Internet]. The Stanford Encyclopedia of Philosophy (Winter 2015 Edition), Edward N. Zalta (ed.). [cited 2016 Dec 20]. Available from: https://plato.stanford.edu/archives/win2015/entries/nishida-kitaro/.

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