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Suliman S, Allen M, Chivese T, de Rijk AE, Koopmans R, Könings KD. Is medical training solely to blame? Generational influences on the mental health of our medical trainees. MEDICAL EDUCATION ONLINE 2024; 29:2329404. [PMID: 38488138 PMCID: PMC10946265 DOI: 10.1080/10872981.2024.2329404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/07/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION The negative impact of medical training on trainee mental health continues to be a concern. Situated within a sociocultural milieu, Generation Z and Generation Y, defined by their highly involved parents and the widespread use of technology, currently dominate undergraduate and graduate medical education respectively. It is necessary to explore medical trainees' generational characteristics and job-related factors related to stress, burnout, depression, and resilience. This might provide different perspectives and potential solutions to medical trainees' mental health. METHODS A cross-sectional study was conducted among medical trainees (students and residents) from two institutions in Qatar. A self-administered online survey included measures for trainees' social media overuse, their parent's parenting style, the educational support by the clinical teacher, job (demands, control, and support), and work-life balance and their relation with their stress, burnout, depression, and resilience. Relationships were tested with multiple linear regression analyses. RESULTS Of the 326 medical trainees who responded, 142 (44%) trainees - 93 students and 49 residents - completed all items and were included in the analysis. Social media overuse and inability to maintain a work-life balance were associated with higher levels of stress, depression, and student burnout. Higher levels of job support were associated with lower levels of stress, depression, and resident burnout, and a higher level of resilience. Job control was associated with lower burnout levels. Parenting style was unrelated to trainees' mental health. DISCUSSION The two generations 'Y' and 'Z' dominating current medical training showed more stress-related complaints when there is evidence of social media overuse and failure to maintain a work-life balance, while job support counterbalances this, whereas parenting style showed no effect. Measures to enhance medical trainees' mental health may include education about the wise use of social media, encouraging spending more quality social time, and enhancing job support and job control.
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Affiliation(s)
- Shireen Suliman
- Medical Education, Hamad Medical Corporation, Doha, Qatar
- College of Medicine, QU Health, Qatar University, Doha, Qatar
- Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - Margaret Allen
- Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Tawanda Chivese
- Department of Population Medicine, Qatar University, Doha, Qatar
| | - Angelique E. de Rijk
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Richard Koopmans
- Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Karen D. Könings
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
- School of Health Sciences, University of East Anglia, Norwich, UK
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Lawrence EC, Sheridan C, Hurtado A, Lee WW, Lizotte-Waniewski M, Rea M, Zehle C. A Guiding Model for Undergraduate Medical Education Well-Being Programs. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:946-952. [PMID: 38722282 DOI: 10.1097/acm.0000000000005755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
ABSTRACT Most medical schools have instituted undergraduate medical education (UME) well-being programs in recent years in response to high rates of medical student distress, but there is currently significant variability in the structure of UME well-being programs and limited guidance on how to best structure such programs to achieve success. In this article, the authors, all leaders of medical student well-being programs at their home institutions and members of the Association of American Medical Colleges Group on Student Affairs Committee on Student Affairs Working Group on Medical Student Well-Being between 2019 and 2023 offer guidance to the national community on how best to structure a UME well-being program. They use the current literature and their professional experiences leading well-being efforts at 7 different institutions to review the case for addressing medical student well-being, propose a guiding model, and make recommendations for strategies to implement this model.The proposed guiding model emphasizes the importance of the learning environment and efficiency of learning to medical student well-being, as well as personal resilience. Based on this model, the authors recommend specific and tangible well-being strategies to implement systemic interventions to improve the learning environment, efficiency of learning, and personal resilience, including formalizing the well-being program; hiring qualified, dedicated, and empowered well-being leadership with clear responsibilities; acting as a central hub for resources and as a liaison with mental health care; and establishing robust program evaluation methods.
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Melo VD, Saifuddin H, Peng LT, Wolanskyj-Spinner AP, Marshall AL, Leep Hunderfund AN. Signs, Sources, Coping Strategies, and Suggested Interventions for Burnout Among Preclerkship Students at a U.S. Medical School: A Qualitative Focus Group Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:987-996. [PMID: 38648293 DOI: 10.1097/acm.0000000000005744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE Research suggests that burnout can begin early in medical school, yet burnout among preclerkship students remains underexplored. This study aimed to characterize burnout signs, sources, coping strategies, and potential interventions among preclerkship students at one U.S. medical school. METHOD The authors conducted a qualitative study of preclerkship students at Mayo Clinic Alix School of Medicine (MCASOM) in June 2019. Participants completed 2 Maslach Burnout Inventory (MBI) items (measuring frequency of emotional exhaustion and depersonalization) and 2 free-text questions on burnout before participating in 1 of 3 semistructured focus groups. Focus group questions were derived from a literature review on medical student burnout with input from the MCASOM Student Life and Wellness Committee. Group discussions were recorded, transcribed, coded inductively, and analyzed iteratively (along with free-text comments) using a general inductive approach from a constructivist perspective. RESULTS Eighteen of 111 eligible students (16%) participated, with 5/18 (28%) reporting weekly emotional exhaustion and/or depersonalization on MBI items. Analysis of focus group transcripts showed that most students had experienced burnout symptoms during their first or second year, corresponding with school-related stressors and manifesting in cognitive-emotional, physical, and verbal-behavioral ways. Students identified systemic, institutional, and individual burnout drivers and discussed how these drivers interacted (e.g., high standards of excellence at the system level interacted with anxiety and maladaptive thinking at the individual level, creating pressure to always do more). Students used various coping strategies (e.g., self-care, peer support, reframing, and compartmentalization) but emphasized limitations of these strategies and recommended interventions directed toward systemic and institutional burnout drivers. CONCLUSIONS This study offers insights into burnout signs and sources among preclerkship medical students that can inform future large-scale studies. Results suggest that burnout emerges from dynamic interactions among systemic, institutional, and individual factors and may benefit from multipronged interventions.
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Alsheikh S, AlGhofili H, Altoijry A, AlMuhanna G, Alanezi T, Almogren M, Iqbal K. An integrated vascular surgery residency program would increase interest among Saudi medical students in a career in vascular surgery. BMC MEDICAL EDUCATION 2024; 24:903. [PMID: 39174948 PMCID: PMC11342686 DOI: 10.1186/s12909-024-05928-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 08/20/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND AND OBJECTIVES Considering the absence of integrated vascular surgery residency programs in Saudi Arabia, and the need for planning training pathways, we aim to identify how many medical students are interested in vascular surgery, and the factors affecting students' opinions on pursuing vascular surgery. MATERIALS AND METHODS A cross-sectional study was conducted using an online questionnaire that was distributed to medical students nationwide via social media and email. Data were collected from 13 February 2022 to 1 March 2022. RESULTS A total of 408 students participated. Among them, 152 students were interested in general surgery, of which 103 were considering vascular surgery as a possible future fellowship. However, only 29 out of 408 (7.1%) students picked vascular surgery as their 1st choice. The main motivating factors for students to pursue vascular surgery as a career were: an interest in vascular cases (cardiovascular science), the use of emerging technologies, and the endovascular capabilities of vascular surgeons. The negative factors were simply a preference for another specialty, followed by a lack of experience in vascular surgery. CONCLUSION This study reveals that only 7.1% of students consider vascular surgery their first choice. Both the lack of vascular surgeons and students' experience in vascular surgery affected awareness levels. Interaction with vascular surgeons through virtual rotations for under-served medical schools and the introduction of vascular sciences within the cardiology blocks during basic science years are recommended strategies.
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Affiliation(s)
- Sultan Alsheikh
- Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Hesham AlGhofili
- Vascular Surgery Department, King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi Arabia
- Division of Vascular Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Abdulmajeed Altoijry
- Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ghada AlMuhanna
- Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Tariq Alanezi
- Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mogren Almogren
- Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Vascular Surgery, Department of Surgery, King Fahad Military Medical Complex, Dhahran, Saudi Arabia
| | - Kaisor Iqbal
- Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Zhang X, Yu L, Chen Y, Fu Z, Zhang F, Li Z, Wu Q. Career adaptability and career coping styles among Chinese medicine specialty students during the COVID-19: The mediating role of career decision-making self-efficacy. Heliyon 2024; 10:e34578. [PMID: 39157377 PMCID: PMC11327504 DOI: 10.1016/j.heliyon.2024.e34578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 07/11/2024] [Accepted: 07/11/2024] [Indexed: 08/20/2024] Open
Abstract
Over the past decade, the attrition rate of Chinese medical graduates has remained high, and the COVID-19 pandemic has exacerbated this situation. Medicine specialty students are the main force of the future healthcare industry. The career choices and career confidence of those entering the healthcare industry will have a huge influence on the quality of future healthcare provision. Considering the possible emergence of public health emergencies such as COVID-19 in the future, helping students develop good career adaptability will contribute to their future career development. However, the relationship between career adaptability, career coping styles and career decision-making self-efficacy remains unclear during the COVID-19. This study aims to examine the interconnections amongst career coping styles, career adaptability and career decision-making self-efficacy among Chinese medicine specialty students and the mediating role of career decision-making self-efficacy. Questionnaire survey was conducted on 747 medicine specialty students from China. The results showed that positive coping style has a significant positive correlation with career decision-making self-efficacy, career adaptability, and their sub-dimensions. There was a partial mediating effect of career decision self-efficacy between the predictor variable positive coping style and the outcome variable career adaptability. By promoting the level of positive coping style or career decision-making self-efficacy among medicine specialty students, the career adaptability can be directly or indirectly enhanced. This survey will help to guide future medical education decisions during a similar pandemic to prevent further loss of healthcare professionals in the medical service.
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Affiliation(s)
- Xiaobin Zhang
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, 999078, China
- School of Basic Medical Sciences, Putian University, Putian, 351100, China
| | - Lili Yu
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, 999078, China
- The State Key Laboratory for Quality Research in Chinese Medicines of the Macau University of Science and Technology, Macao, 999078, China
- Zhuhai MUST Science and Technology Research Institute, Zhuhai, 519000, China
| | - Yuying Chen
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, 999078, China
| | - Zongmei Fu
- School of Foreign Languages, Southwestern University of Finance and Economics, Chengdu, 611130, China
| | - Fangfang Zhang
- Zhuhai Center for Maternal and Child Health Care, Zhuhai, 519001, China
| | - Zhongcheng Li
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, 999078, China
| | - Qibiao Wu
- Faculty of Chinese Medicine, Macau University of Science and Technology, Macao, 999078, China
- The State Key Laboratory for Quality Research in Chinese Medicines of the Macau University of Science and Technology, Macao, 999078, China
- Zhuhai MUST Science and Technology Research Institute, Zhuhai, 519000, China
- Guangdong-Hong Kong-Macao Joint Laboratory for Contaminants Exposure and Health, Guangdong University of Technology, Guangzhou, 510000, China
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Michalec B, Cuddy MM, Price Y, Hafferty FW. U.S. physician burnout and the proletarianization of U.S. doctors: A theoretical reframing. Soc Sci Med 2024; 358:117224. [PMID: 39173293 DOI: 10.1016/j.socscimed.2024.117224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 08/06/2024] [Accepted: 08/09/2024] [Indexed: 08/24/2024]
Abstract
We delve into the escalating issue of U.S. physician burnout, arguing its roots lie in the proletarianization of the U.S. medical profession-a transition driven by the loss of autonomy and control under the shadow of capitalist systems. This process, aligned with Marx's concept of proletarianization, sees physicians morph from independent practitioners to exploited workers within a wage-labor system controlled by a corporatized U.S. healthcare system. We contend that contemporary factors attributed to U.S. physician burnout-loss of control, emphasis on productivity, increased clerical demands, and a diminishing sense of work's meaning-are not novel but deeply ingrained in the medical profession's socio-historical fabric. By juxtaposing burnout with proletarianization, we highlight macro-level sources of strain and advocate for reevaluating physician work through Marxist theory and, in turn, extend the argument that addressing burnout necessitates moving beyond individual or organizational solutions to encompass broader socio-economic structures as seen through the lens of work exploitation. We conclude by discussing "class consciousness" among U.S. physicians and posit that collective awareness and action could pave the way for substantial reforms for the practice of medicine, the organization of medicine as a profession, and the burnout epidemic among U.S. physicians.
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Affiliation(s)
- Barret Michalec
- Center for Advancing Interprofessional Practice, Education & Research (CAIPER), Edson College, Arizona State University, Phoenix, AZ, USA.
| | - Monica M Cuddy
- National Board of Medical Examiners (NBME), Philadelphia, PA, USA
| | - Yvonne Price
- Center for Advancing Interprofessional Practice, Education & Research (CAIPER), Edson College, Arizona State University, Phoenix, AZ, USA
| | - Frederic W Hafferty
- Center for Professionalism and the Future of Medicine, Accreditation Council for Graduate Medical Education (ACGME), Chicago, IL, USA
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Çelik C, Ata U, Kamalak M, Saka NE. Relationship between forensic medicine education, stress factors, and mobbing perception from the perspective of specialists in Turkey's universities. J Forensic Leg Med 2024; 106:102729. [PMID: 39137514 DOI: 10.1016/j.jflm.2024.102729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 06/24/2024] [Accepted: 07/23/2024] [Indexed: 08/15/2024]
Abstract
INTRODUCTION The current situation needs to be presented with scientific data to ensure and improve the quality of specialist training. This study examined the quality of education, instructor competence, stress factors, mobbing, and their interconnections in the domain of forensic medicine specialty education in Turkey. MATERIALS AND METHODS This cross-sectional study was conducted through an anonymous, web-based survey targeting forensic medicine specialists who have completed their specialist training in university forensic medicine departments within the last three years. The survey consisted of questions regarding issues included in the core education curriculum, educator characteristics, and perceptions of stress and mobbing. Based on the responses provided, the relationships between these factors were statistically analysed. RESULTS 72.7 % of the study population completed the survey. Nearly half of the participants (46.3 %) did not consider the number of instructors adequate. The quality of instructors (scientific competence, educational and teaching skills, interpersonal relations, accessibility, management, and problem-solving abilities) was determined to be partially sufficient (mean = 3.36). Approximately one-third of the respondents indicated that instructors made the greatest contribution to their specialist training, whereas the proportion of those who said otherwise was much higher. Education received for topics included in the core curriculum was partially sufficient level (mean = 3.04). It was observed that there was a significant relationship between the instructor characteristics, sufficiency score of the taught topics, and perception of mobbing (p < 0.01). The sufficiency scores of instructor characteristics had a 1.02-fold impact on sufficiency ratings of the topics covered in residency training. Among the respondents, 76.9 % reported encountering stress factors during their specialty training, with the most frequently exposed stress factor (52.2 %) being disorganisation within the training program. Among the participants, 22.8 % reported experiencing mobbing. CONCLUSIONS Education and instructor qualifications were correlated; however, stress factors and mobbing adversely affected education. A close association was observed between education, instructors, stressors, and mobbing. Thus independent and objective auditors tasked with verifying whether institutions meet the established educational standards need to be established.
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Affiliation(s)
- Cemil Çelik
- Department of Forensic Medicine, Council of Forensic Medicine, Kahramanmaraş, Turkey.
| | - Uğur Ata
- Department of Forensic Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Murat Kamalak
- Forensic Medicine, Council of Forensic Medicine, Gaziantep, Turkey
| | - Naile Esra Saka
- Department of Forensic Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
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Dhachpramuk D, Sonjaipanich S, Theppiban S, In-Iw S. Exercise, mental well-being and burnout in Thai medical students in 2020-2021: an online cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:837. [PMID: 39095768 PMCID: PMC11297641 DOI: 10.1186/s12909-024-05843-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 07/30/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Within the Thai medical curriculum, its rigorous education framework, demanding schedules and high academic standards can contribute to psychological distress. Regular physical activity has consistently shown positive effects on mental health. The aim of the study was to investigate the association between exercise and psychological well-being, including depression, anxiety, and burnout, in Thai medical students, and factors related to insufficient exercise and depression. METHODS The cross-sectional study was conducted among medical students in the university hospital during 2020-2021. Participants completed self-administered questionnaires consisting of demographic data, Godin-Shephard Leisure-Time Physical Activity Questionnaire, depression screening (9Q), Thai General Health Question-28 (4 domains: somatic symptoms, anxiety and insomnia, social dysfunction, severe depression), and Maslach burnout inventory (Emotional exhaustion (EE), Depersonalization (DP), Reduced Personal Achievement (rPA). RESULTS Of the 404 participants, 50.5% were women, the mean age (SD) was 21.06 (1.8) years, and 52% were in clinical years. The prevalence of insufficient exercise was 59.6%, depression (30.2%), somatic symptoms (27.7%), anxiety (30.7%), insomnia (89.4%), social dysfunction (89.4%), high level of EE (32.4%), DP (21%), and rPA (56.7%). Insufficient exercise was associated with moderate to severe depression (OR 2.89, 95% CI 1.16-7.25), anxiety and insomnia (OR 1.56, 95% CI 1.01-2.43), social dysfunction (OR 2.51, 95% CI 1.31-4.78), burnout in part due to high rPA (OR 2.4, 95% CI 1.4-4.13), and study in clinical years (OR 1.91, 95% CI 1.28-2.87). After adjusted significant factors, only studying in the clinical year, social dysfunction, and burnout in part of rPA were related to insufficient exercise. CONCLUSIONS High rates of insufficient exercise, psychological challenges, and burnout were prevalent among medical students. To effectively address these issues, medical school should advise students to participate in regular exercise, promoting mental well-being and healthier lifestyles.
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Affiliation(s)
- Dhachdanai Dhachpramuk
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suprapath Sonjaipanich
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supparat Theppiban
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Supinya In-Iw
- Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Webber CJ, Hess JJ, Weaver E, Buckley R, Swan RR, Gholar VM, Schumacher JA, Black R, Whitey M, Stewart JL, Terhune KP. Welcome to Nashville, Welcome to Jackson-Reimagining Residency Orientation. J Grad Med Educ 2024; 16:411-414. [PMID: 39148872 PMCID: PMC11324160 DOI: 10.4300/jgme-d-24-00157.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/17/2024] Open
Affiliation(s)
- Chase J. Webber
- Chase J. Webber, DO, FACP, is Associate Professor of Clinical Medicine and Biomedical Informatics, and Associate Director, Center for Advanced Mobile Healthcare Learning, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jennifer J. Hess
- Jennifer J. Hess, MD, is Assistant Professor, Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eleanor Weaver
- Eleanor Weaver, MD, is Assistant Professor of Medicine, Section of Hospital Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ryan Buckley
- Ryan Buckley, MD, is Associate Professor of Clinical Internal Medicine, and Director, Medical Innovators Development Program, Vanderbilt University School of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Rebecca R. Swan
- Rebecca R. Swan, MD, is Vice Chair for Education, Department of Pediatrics, and Assistant Dean, Graduate Medical Education, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Victoria M. Gholar
- Victoria M. Gholar, DNP, RN, PMH-BC, is Assistant Dean for Student Affairs, John D. Bower School of Population Health, and Executive Director, Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Julie A. Schumacher
- Julie A. Schumacher, PhD, is Professor and Vice Chair for Education, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Reena Black
- Reena Black, MBA, C-TAGME, is Senior Program Manager, Graduate Medical Education, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Megan Whitey
- Megan Whitey, C-TAGME, is Lead Program Manager, Graduate Medical Education, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jimmy L. Stewart
- Jimmy L. Stewart, MD, is Professor and Associate Dean for Graduate Medical Education, University of Mississippi Medical Center, Jackson, Mississippi, USA; and
| | - Kyla P. Terhune
- Kyla P. Terhune, MD, MBA, is Professor and Associate Dean for Graduate Medical Education, Vanderbilt School of Medicine, Nashville, Tennessee, USA
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Merino-Soto C, Angulo-Ramos M, Llaja-Rojas V, Chans GM. Academic performance, emotional intelligence, and academic burnout: A cross-sectional study of a mediational effect in nursing students. NURSE EDUCATION TODAY 2024; 139:106221. [PMID: 38691900 DOI: 10.1016/j.nedt.2024.106221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 04/06/2024] [Accepted: 04/17/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Course failure arises as the ultimate result of students' declining academic performance in the face of high course demands. It can eventually lead to dropout and academic dissatisfaction. Emotional intelligence may play an essential role in decreasing the emotional effects of stress, such as academic burnout in nursing students. However, emotional intelligence is conceptualized multidimensionally, and each of its attributes may have a different impact on burnout reduction. OBJECTIVE To explore the dimensions of emotional intelligence that may mediate the association between academic performance (course failure) and academic burnout in nursing students. DESIGN The design was cross-sectional, with survey-based data collection. SETTINGS Educational setting, undergraduate nursing students at a private university in Metropolitan Lima, Peru. PARTICIPANTS 154 students (77.3 % female) with a mean age of 25.9 years. METHODS A multiple mediation strategy was used, using the Wong-Law Emotional Intelligence Scale. Four emotional intelligence attributes (self-emotional appraisal, others' emotional appraisal, use of emotion, and regulation of emotion) were evaluated in the relationship of failed courses (dichotomous variable: yes/no) and academic burnout (single item based on physical and emotional exhaustion). The structural equation modeling framework was used. RESULTS Course failure (academic performance) positively affects academic burnout. Regulation of emotion is the only dimension of emotional intelligence mediating between course failure and academic burnout. The proportion of the mediating effect was 0.315, while the rest was around zero. Statistically significant gender differences were detected concerning burnout, with men scoring moderately higher than women. CONCLUSIONS The results indicate that the regulation of emotion may have a relevant role in reducing burnout compared to other emotional intelligence attributes. These regulatory skills are important for developing health care and positive patient relationships. Interventions focused on the regulatory characteristics of emotions and distinguishing different attributes of emotional intelligence while exploring its mediating effect should be strengthened. These implications are linked to the growing call to include EI in university education.
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Affiliation(s)
- César Merino-Soto
- Tecnologico de Monterrey, Institute for the Future of Education, Monterrey 64849, Mexico.
| | | | - Victoria Llaja-Rojas
- Universidad Nacional Mayor de San Marcos, Lima 15081, Peru; Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
| | - Guillermo M Chans
- Tecnologico de Monterrey, Institute for the Future of Education, Monterrey 64849, Mexico; Tecnologico de Monterrey, School of Engineering and Sciences, Mexico City 01389, Mexico.
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Calo M, Judd B, Peiris C. Grit, resilience and growth-mindset interventions in health professional students: A systematic review and meta-analysis. MEDICAL EDUCATION 2024; 58:902-919. [PMID: 38600797 DOI: 10.1111/medu.15391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Grit, resilience and a growth-mindset influence students' ability to positively adapt to the challenges of health professional training. However, it is unclear if interventions can improve these traits. This systematic review aimed to explore if interventions can improve these traits in health professional students (primary) and their impact on academic and/or wellbeing outcomes (secondary). METHODS A comprehensive search of CINAHL, MEDLINE, Eric and Embase was conducted from inception until 15 March 2023. Randomised or non-randomised controlled trials and single-group intervention studies that aimed to improve health professional students' resilience, grit and/or growth-mindset were eligible for inclusion. Two reviewers independently screened studies for inclusion and evaluated quality using the Mixed Methods Appraisal Tool. Post-intervention data from randomised and non-randomised control trials were pooled using a random-effects model to calculate standardised mean differences (SMD) and 95% confidence intervals (CIs). RESULTS Resilience interventions improved resilience by a moderate amount in 13 studies with 990 participants (pooled SMD 0.74, 95%CI 0.03 to 1.46) and a large amount when interventions were greater than one session duration in 10 trials with 740 participants (pooled SMD 0.97, 95%CI 0.08 to 1.85). Grit and growth-mindset interventions improved grit (pooled SMD 0.48, 95%CI -0.05 to 1.00, n = 2) and growth-mindset (pooled SMD 0.25, 95%CI -0.18 to 0.68, n = 2) by a small amount. Resilience interventions decreased perceived stress by a small amount (pooled SMD -0.38, 95%CI -0.62 to -0.14, n = 5). CONCLUSIONS Resilience interventions improve resilience and decrease perceived stress in health professional students. Preliminary evidence suggests grit and growth-mindset interventions may also benefit health professional students. Interventions may be most effective when they are longer than one session and targeted to students with low baseline levels of resilience and grit.
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Affiliation(s)
- Marlena Calo
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Belinda Judd
- Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Casey Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
- Allied Health, The Royal Melbourne Hospital, Melbourne, Australia
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Prentice S, Mullner H, Benson J, Kay M. Family medicine and general practitioner supervisor wellbeing: a literature review. BJGP Open 2024:BJGPO.2023.0230. [PMID: 38479758 DOI: 10.3399/bjgpo.2023.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/14/2023] [Accepted: 12/14/2023] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Research examining general practice supervisor wellbeing has often been conducted within the context of trainee wellbeing and educational outcomes. AIM To consolidate the current literature regarding the wellbeing of GP supervisors through a 'supervisor-wellbeing' lens. DESIGN & SETTING Literature review of original research studies on Embase, Ovid MEDLINE, and Ovid PsycINFO from inception to December 2022. METHOD The Embase, Ovid MEDLINE, and Ovid PsycINFO databases were systematically searched from inception to December 2022. Original research studies were eligible if they explored any aspect of wellbeing or burnout (that is, construct conceptualisations, risk and protective factors, implications, or interventions) among GPs involved in educating GP trainees. Reporting quality of included studies was assessed using the QualSyst tool. Results from included studies were narratively synthesised. RESULTS Data from 26 independent samples were reviewed. Burnout was generally conceptualised using the Leiter and Maslach model. Wellbeing was poorly defined in the literature, largely being conceptualised in personal psychological terms and, to a lesser extent, professional satisfaction. Risk and protective factors were identified and grouped as individual (for example, satisfaction with capacity to teach) and external (for example, autonomy, collegial relationships, resource availability) factors. GP supervisors' wellbeing appeared to affect their job performance and retention. This review identified only two studies evaluating interventions to support GP supervisors' wellbeing. CONCLUSION The present review highlights a lack of conceptual clarity and research examining interventions for GP supervisor wellbeing. It provides guidance for future research designed to maximise the wellbeing of GP supervisors and support the wellbeing of trainees.
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Affiliation(s)
- Shaun Prentice
- School of Psychology, The University of Adelaide, Adelaide, South Australia
- General Practice Training Research Department, Royal Australian College of General Practitioners, Adelaide, South Australia
| | - Helen Mullner
- General Practice Training, Royal Australian College of General Practitioners, Adelaide, South Australia
| | - Jill Benson
- General Practice Training, Royal Australian College of General Practitioners, Adelaide, South Australia
- School of Medicine, The University of Adelaide, Adelaide, Australia
| | - Margaret Kay
- General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Queensland
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Faure T, Weyers I, Voltmer JB, Westermann J, Voltmer E. Test-reduced teaching for stimulation of intrinsic motivation (TRUST): a randomized controlled intervention study. BMC MEDICAL EDUCATION 2024; 24:718. [PMID: 38961382 PMCID: PMC11221006 DOI: 10.1186/s12909-024-05640-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 06/07/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND The anatomy dissection course is a major part of the first two years of the traditional medical curriculum in Germany. The vast amount of content to be learned and the repeated examination is unanimously perceived by students and teachers as a major stress factor that contributes to the increase of psychosocial stress during the first two years of the course of study. Published interventions for specific stress reduction are scarce. METHODS In a randomized, controlled design two intervention groups were compared with a control group (CG) over the whole dissection course (nine measuring points before, during and after first and second semester). The 'Stress Management intervention (IVSM)' targeted at the setting of personal standards, the 'Friendly Feedback intervention (IVFF)' at the context of frequent testing. Quantitative surveys were distributed at nine measuring points. The questionnaire comprised validated instruments and self-developed items regarding stress, positive and negative affect, anxiety, intrinsic and extrinsic motivation, self-efficacy, and perceived performance. RESULTS Out of 195 students inscribed in the dissection course, 166 (85%) agreed to participate in the study. The experience of stress during the dissection course was significantly higher in the CG than in the IVFF. Anxiety and negative affect were lower in students of the IVFF while positive affect, intrinsic motivation, and self-efficacy were higher than in the CG. For anxiety and negative affect in the IVSM this was especially seen at the end of the second semester. The self-perceived increase in both knowledge and preparedness for the first big oral and written examination did not differ between the study groups. About three quarters of the participants would choose the intervention 'Friendly Feedback' if given the choice. CONCLUSIONS Replacing formal tests with friendly feedback has proven to be an effective measure to reduce stress and negative affect and foster positive affect, self-efficacy, and intrinsic motivation, while it did not impair self-perceived academic performance.
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Affiliation(s)
- Theresa Faure
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Imke Weyers
- Institute for Anatomy, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Jan-Bennet Voltmer
- Department of Psychology/Social Psychology, Distant-Learning University (FernUniversität in Hagen), Universitätsstraße 47, 58097, Hagen, Germany
| | - Jürgen Westermann
- Institute for Anatomy, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Edgar Voltmer
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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Bayot M, Boone A, Godderis L, Lenoir AL. Multidimensional factors of burnout in general practice: a cross sectional survey. BJGP Open 2024; 8:BJGPO.2023.0171. [PMID: 38253400 PMCID: PMC11300977 DOI: 10.3399/bjgpo.2023.0171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/07/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND GPs are particularly vulnerable to job burnout. Tailored prevention and intervention strategies are needed. AIM To investigate organisational, interpersonal, and individual factors contributing to exhaustion and disengagement at work among GPs. DESIGN & SETTING We conducted a cross-sectional study in a sample of Belgian GPs. METHOD A total of 358 doctors (73% females, 301 with complete data) completed an online anonymous questionnaire assessing job burnout, psychosocial characteristics of the work environment, perceived social support in the private domain, emotional competence, and self-compassion. RESULTS GPs reported moderate levels of exhaustion and disengagement. Regression models showed that included factors jointly explained 69% of the variance in exhaustion and 63% in disengagement. Exhaustion was significantly predicted by female sex (β effect size = -0.1), high perceived emotional demands (β = 0.19), as well as low self-compassion (β = -0.14) and low emotional competence (β = 0.09). Disengagement was significantly predicted by low seniority (β = -0.12) and limited opportunities for development (β = -0.16). Both exhaustion and disengagement were predicted by low perceived quality of work (β = -0.19 and -0.14, respectively), meaning of work (β = -0.17 and -0.31, respectively), and role clarity (β = 0.09 and 0.12, respectively), as well as high perceived work-life conflict (β = 0.46 and 0.21, respectively). Moreover, GPs working in a multidisciplinary group reported lower levels of exhaustion and disengagement than those working in a monodisciplinary group or a solo practice, and this difference was associated with factors such as work-life conflict. CONCLUSION Organisational, interpersonal, and intrapersonal factors interact to predict a substantial part of burnout in general practice. The most significant risk factors were perceived work-life conflict and poor meaning of work. Policymakers should work to support more sustainable practices based on the specific needs and constraints reported by GPs.
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Affiliation(s)
- Marie Bayot
- Department of Clinical Sciences, Université de Liège, Liège, Belgium
| | - Anke Boone
- Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Lode Godderis
- Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium
- Idewe, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Anne-Laure Lenoir
- Department of Clinical Sciences, Université de Liège, Liège, Belgium
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Velez C, Gendreau P, Saad N. Medical students' perspectives on a longitudinal wellness curriculum: a qualitative investigation. CANADIAN MEDICAL EDUCATION JOURNAL 2024; 15:26-36. [PMID: 39114788 PMCID: PMC11302752 DOI: 10.36834/cmej.77833] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Introduction There is growing concern about the mental health status of medical students. Medical students are at a higher risk for depression, anxiety, and burnout than non-medical students. The Undergraduate Medical Education (UGME) Office of Medical Learner Affairs at McGill University developed a Longitudinal Wellness Curriculum (LWC) to foster medical students' well-being, self-care, and adaptability. Methods We conducted a qualitative descriptive study to explore students' experiences with the LWC. We conducted three semi-structured focus groups involving a total of 11 medical students. We used thematic framework analysis for data analysis. Results We found four main themes related to participants' engagement with the curriculum: 1) diverse perceptions on curriculum relevance and helpfulness; 2) the benefits of experiential sessions, role model speakers, and supportive staff; 3) insights on student-friendly curriculum scheduling; and 4) the importance of wellness education and systemic interventions in medical education. Conclusions Most participants found the curriculum valuable and supported its integration into the academic curriculum. Experiential and active learning, diverse approaches to wellness, small group sessions, role modeling, and student-centered approaches were preferred methods. Inconvenient curriculum scheduling and skepticism over system-level support were seen as barriers to curriculum engagement and uptake. The findings of our study contribute to the development and implementation of wellness curriculum efforts in medical education.
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Affiliation(s)
- Camila Velez
- Counselling and Psychological Services, Concordia University, Quebec, Canada
| | - Pascale Gendreau
- Office of Medical Learner Affairs, Faculty of Medicine and Health Sciences, McGill University, Quebec, Canada
| | - Nathalie Saad
- Office of Medical Learner Affairs, Faculty of Medicine and Health Sciences, McGill University, Quebec, Canada
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Schaffir J, Sonn T, Sutton JM, Baecher-Lind L, Bhargava R, Chen KT, Fleming A, Morgan HK, Morosky C, Royce C, Sims SM, Stephenson-Famy A. Paving the Way for Medical Students: How Smooth Should the Road Be? JOURNAL OF SURGICAL EDUCATION 2024; 81:896-899. [PMID: 38749813 DOI: 10.1016/j.jsurg.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/26/2024] [Accepted: 03/27/2024] [Indexed: 06/11/2024]
Abstract
Clerkship directors must balance the mental wellbeing of their medical students with the demanding schedule that rotations in procedural specialties such as surgery and obstetrics and gynecology require. In this paper, the Undergraduate Medical Education Committee of the Association of Professors of Obstetrics and Gynecology argues the importance of maintaining adequate clinical exposure for learners. Involving students in overnight call provides additional clinical involvement, improved relationships with the clinical team, and a better perspective on specialist lifestyle. Educators should improve the experience for students by promoting resilience and creating a welcoming learning environment. Preparing medical students for the rigorous requirements of these clerkships allows them to thrive in the learning environment while still providing a realistic preview of the clinical experiences and demands of these specialties.
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Affiliation(s)
- Jonathan Schaffir
- Department of Obstetrics and Gynecology The Ohio State University College of Medicine, Columbus Ohio.
| | - Tammy Sonn
- Department of Obstetrics and Gynecology Washington University School of Medicine St. Louis Missouri
| | - Jill M Sutton
- Department of Obstetrics and Gynecology ECU Brody School of Medicine Greenville North Carolina
| | - Laura Baecher-Lind
- Department of Obstetrics and Gynecology Tufts School of Medicine Boston Massachusetts
| | - Rashmi Bhargava
- Department of Obstetrics and Gynecology University of Saskatchewan College of Medicine Regina Saskatchewan
| | - Katherine T Chen
- Department of Obstetrics, Gynecology and Reproductive Science Icahn School of Medicine New York New York
| | - Angela Fleming
- Department of Obstetrics and Gynecology Corewell Health Farmington Hills Michigan
| | - Helen Kang Morgan
- Department of Obstetrics and Gynecology University of Michigan Ann Arbor Michigan
| | - Christopher Morosky
- Department of Obstetrics and Gynecology University of Connecticut School of Medicine Farmington Connecticut
| | - Celeste Royce
- Department of Obstetrics Gynecology and Reproductive Biology, Harvard Medical School Boston Massachusetts
| | - Shireen Madani Sims
- Department of Obstetrics and Gynecology University of Florida College of Medicine Gainesville Florida
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Swenson TL, Ehsanian R, Tran RT, Petersen TR, Kennedy DJ, Roche M, Oppezzo M, Noordsy DL, Fredericson M. The Association Between Well-Being and Empathy in Medical Residents: A Cross-Sectional Survey. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:691-697. [PMID: 38416862 PMCID: PMC11304836 DOI: 10.1089/jicm.2023.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
Objective: To evaluate the extent to which personal well-being may be associated with empathy, while controlling for potential confounders. Settings/Location: Residency programs throughout the United States. Subjects: A total of 407 medical residents from residencies including general medicine, surgery, specialized and diagnostic medicine participated in this study. Outcome Measures: Well-being was measured using the modified existential well-being subscale of the spiritual well-being scale. Empathy was measured using the Jefferson Scale of Empathy. Results: Well-being was found to be positively correlated with empathy when adjusted for possible confounders (p < 0.001). In addition to well-being, other factors noted to be statistically significant contributors to higher empathy scores while controlling for the others included age, gender, year in residency, specialty, and work-hours (p < 0.05 for each). After controlling for these factors, a resident's year in residency was not found to be a statistically significant contributor to empathy score. Conclusions: In this study, well-being was associated with empathy in medical and surgical residents. Empathy is a fundamental component of physician competency, and its development is an essential aspect of medical training. These findings suggest that efforts to increase well-being may promote empathy among medical residents.
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Affiliation(s)
- Theodora L. Swenson
- Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Reza Ehsanian
- Department of Anesthesiology and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | | | - Timothy R. Petersen
- Department of Anesthesiology and Critical Care Medicine, Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - David J. Kennedy
- Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Megan Roche
- Stanford University School of Medicine, Stanford, CA, USA
| | - Marily Oppezzo
- Division of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Douglas L. Noordsy
- Division of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Fredericson
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Zeeman JM, Nana AA, Pickering ES, Harris SC. Assessing Factors That Influence Pharmacy Student Burnout and Identifying Recommendations to Support Student Well-Being. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100741. [PMID: 38885814 DOI: 10.1016/j.ajpe.2024.100741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE Literature indicates concerning rates of burnout and declining well-being among students. Although well-being initiatives have increased, a gap exists in identifying factors that impact pharmacy student well-being. The purpose of this study was to explore the factors students perceive that influence their burnout and identify recommendations to improve student well-being. METHODS First- (PY1), second- (PY2), and third-year (PY3) pharmacy students enrolled in the didactic curriculum were invited to participate in this exploratory study. Focus groups were organized by program year to explore the experiences that may be unique to each group. A semistructured interview format was used to discuss factors contributing to student burnout and fulfillment, as well as solicit recommendations for strategies to improve student well-being. Inductive coding was used to identify themes. RESULTS Twelve students participated in 6 sessions: 1 PY1 interview (n = 1 student), 1 PY2 focus group (n = 2 students) and 1 PY2 interview (n = 1 student), and 3 PY3 focus groups (n = 2-3 students/focus group). Common factors identified as contributing toward burnout included having too little time, overwhelming academic workload, competitive culture, and noncoursework commitments. Factors contributing to student fulfillment included life outside of pharmacy school, well-being resources, and activities aligned with future goals. Participants recommended several strategies to improve student well-being, including curricular changes (eg, course schedule layout, pass/fail grading), culture strategies, and well-being resources. CONCLUSION The findings underscore the impact of workload and competitive culture on student burnout. This study fills a literature gap regarding the factors influencing student burnout and informs strategies for fostering student well-being in pharmacy education.
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Affiliation(s)
- Jacqueline M Zeeman
- University of North Carolina at Chapel Hill, Office of Organizational Effectiveness, Planning, and Assessment, Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Akina A Nana
- University of North Carolina at Chapel Hill, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Emily S Pickering
- University of North Carolina at Chapel Hill, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Suzanne C Harris
- University of North Carolina at Chapel Hill, Well-being and Resiliency, Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA.
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Laeeque SH, Ali M. Teacher Injustice and Classroom Citizenship Behavior of Pakistani Nursing Students: A Moderated Mediation Model. Psychol Rep 2024; 127:1453-1479. [PMID: 36346985 DOI: 10.1177/00332941221138474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
People sometimes limit themselves to doing what is explicitly expected of them and purposely avoid engaging in socially desirable behaviors. Against this background, this study tested a moderated-mediation model based on Conservation of Resources theory and equity theory in academic context through a mixed-methods approach. More specifically, it examined the role of equity sensitivity in influencing the indirect effect of teacher injustice (TI) on classroom citizenship behavior (CCB) through burnout. Results achieved through a four-wave data collected from Pakistani nursing students partially supported the model. They demonstrated that while burnout serves as a mediator in the TI-CCB relationship, the mediation effect is independent of the level of equity sensitivity. A follow-up focus group was also conducted whose findings gave additional details regarding the psychosocial processes underlying the effect of TI on targeted students' attitudes and behaviors. Overall, the study offers theory- and evidence-based insights into the CCB withdrawal process, and provides guidance to education management practice and research.
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Affiliation(s)
| | - Madeeha Ali
- Business Studies Department, Bahria University, Islamabad, Pakistan
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20
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Neufeld-Kroszynski G, Michael K, Karnieli-Miller O. Associations between medical students' stress, academic burnout and moral courage efficacy. BMC Psychol 2024; 12:296. [PMID: 38802899 PMCID: PMC11129364 DOI: 10.1186/s40359-024-01787-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Medical students, especially during the clinical years, are often exposed to breaches of safety and professionalism. These contradict personal and professional values exposing them to moral distress and to the dilemma of whether and how to act. Acting requires moral courage, i.e., overcoming fear to maintain one's core values and professional obligations. It includes speaking up and "doing the right thing" despite stressors and risks (e.g., humiliation). Acting morally courageously is difficult, and ways to enhance it are needed. Though moral courage efficacy, i.e., individuals' belief in their capability to act morally, might play a significant role, there is little empirical research on the factors contributing to students' moral courage efficacy. Therefore, this study examined the associations between perceived stress, academic burnout, and moral courage efficacy. METHODS A cross-sectional study among 239 medical students who completed self-reported questionnaires measuring perceived stress, academic burnout ('exhaustion,' 'cynicism,' 'reduced professional efficacy'), and moral courage efficacy (toward others' actions and toward self-actions). Data analysis via Pearson's correlations, regression-based PROCESS macro, and independent t-tests for group differences. RESULTS The burnout dimension of 'reduced professional efficacy' mediated the association between perceived stress and moral courage efficacy toward others' actions. The burnout dimensions 'exhaustion' and 'reduced professional efficacy' mediated the association between perceived stress and moral courage efficacy toward self-actions. CONCLUSIONS The results emphasize the importance of promoting medical students' well-being-in terms of stress and burnout-to enhance their moral courage efficacy. Medical education interventions should focus on improving medical students' professional efficacy since it affects both their moral courage efficacy toward others and their self-actions. This can help create a safer and more appropriate medical culture.
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Affiliation(s)
- Galit Neufeld-Kroszynski
- Department of Medical Education, Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, 69778, Israel
| | - Keren Michael
- Department of Human Services, Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Orit Karnieli-Miller
- Department of Medical Education, Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, 69778, Israel.
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Wang Z, Wu P, Hou Y, Guo J, Lin C. The effects of mindfulness-based interventions on alleviating academic burnout in medical students: a systematic review and meta-analysis. BMC Public Health 2024; 24:1414. [PMID: 38802770 PMCID: PMC11129439 DOI: 10.1186/s12889-024-18938-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/23/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Mindfulness-based interventions have been tested to be the effective approach for preventing/reducing burnout in medical students. Therefore, this systematic review and meta-analysis aimed to synthesize the scientific evidence and quantify the pooled effect of MBIs on the burnout syndrome in medical students. METHODS A comprehensive literature search was conducted in the databases, including PubMed, Embase, ERIC, PsycINFO, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), China National knowledge Information Database (CNKI) and WanFang Database from database inception to February 2023 using the terms of "mindfulness", "burnout" and "medical students". Two reviewers independently reviewed the studies, and extracted the data of the eligible studies, as well as assessed the risk of bias. A random-effects model was employed to calculate the standardized mean differences (SMD) with 95% confidence intervals (CI) of overall burnout and its sub-domains of burnout (i.e., emotional exhaustion, cynicism, and academic efficacy). RESULTS Of 316 records in total, nine studies (with 810 medical students) were ultimately included. The four RCT studies demonstrated an overall judgment of some concerns risk of bias, and the overall risk of biases of the five qRCT studies were judged as serious. In term of the SORT, the RCT and qRCT studies were evaluated as level 2 evidence, and the overall strength of recommendation was classified as B (limited-quality patient-oriented evidence). The pooled analysis showed that MBIs were associated with significant small to moderate improvements for medical students' overall burnout (SMD=-0.64; 95% CI [-1.12, -0.16]; P = 0.009) in the included four RCTs, emotional exhaustion (SMD=-0.27; 95% CI [-0.50, -0.03]; P = 0.03) and academic efficacy (SMD = 0.43; 95% CI [0.20, 0.66]; P<0.001) in the four qRCTs. CONCLUSIONS MBIs can serve as an effective approach for reducing burnout symptoms in medical students. Future high-quality studies with a larger sample size and robust randomized controlled trial methodologies should be obtained to reinforce the effectiveness of MBIs for reducing academic burnout in medical students.
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Affiliation(s)
- Zhizhuo Wang
- Department of Rehabilitation Medicine, School of Health, Fujian Medical University, No. 1 Xuefu North Road, University town, Fuzhou, Fujian, 350122, China
| | - Peiyun Wu
- Department of Rehabilitation Medicine, School of Health, Fujian Medical University, No. 1 Xuefu North Road, University town, Fuzhou, Fujian, 350122, China
| | - Yutong Hou
- Department of Rehabilitation Medicine, School of Health, Fujian Medical University, No. 1 Xuefu North Road, University town, Fuzhou, Fujian, 350122, China
| | - Jing Guo
- Department of Pediatrics, School of Pediatrics, Kunming Medical University, No. 1168 Chunrong West Road, Yuhua Street, Kunming, Yunnan, 650504, China
| | - Cheng Lin
- Department of Rehabilitation Medicine, School of Health, Fujian Medical University, No. 1 Xuefu North Road, University town, Fuzhou, Fujian, 350122, China.
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Bennett-Weston A, Keshtkar L, Jones M, Sanders C, Lewis C, Nockels K, Solomon J, Howick J. Interventions to promote medical student well-being: an overview of systematic reviews. BMJ Open 2024; 14:e082910. [PMID: 38724055 PMCID: PMC11086405 DOI: 10.1136/bmjopen-2023-082910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVE To conduct an overview of systematic reviews that explore the effectiveness of interventions to enhance medical student well-being. DESIGN Overview of systematic reviews. DATA SOURCES The Cochrane Library of Systematic Reviews, MEDLINE, APA PsychInfo, CINAHL and Scopus were searched from database inception until 31 May 2023 to identify systematic reviews of interventions to enhance medical student well-being. Ancestry searching and citation chasing were also conducted. DATA EXTRACTION AND SYNTHESIS The Assessing the Methodological Quality of Systematic Reviews V.2 tool was used to appraise the quality of the included reviews. A narrative synthesis was conducted, and the evidence of effectiveness for each intervention was rated. RESULTS 13 reviews (with 94 independent studies and 17 616 students) were included. The reviews covered individual-level and curriculum-level interventions. Individual interventions included mindfulness (n=12), hypnosis (n=6), mental health programmes (n=7), yoga (n=4), cognitive and behavioural interventions (n=1), mind-sound technology (n=1), music-based interventions (n=1), omega-3 supplementation (n=1), electroacupuncture (n=1) and osteopathic manipulative treatment (n=1). The curriculum-level interventions included pass/fail grading (n=4), problem-based curriculum (n=2) and multicomponent curriculum reform (n=2). Most interventions were not supported by sufficient evidence to establish effectiveness. Eleven reviews were rated as having 'critically low' quality, and two reviews were rated as having 'low' quality. CONCLUSIONS Individual-level interventions (mindfulness and mental health programmes) and curriculum-level interventions (pass/fail grading) can improve medical student well-being. These conclusions should be tempered by the low quality of the evidence. Further high-quality research is required to explore additional effective interventions to enhance medical student well-being and the most efficient ways to implement and combine these for maximum benefit.
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Affiliation(s)
- Amber Bennett-Weston
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Leila Keshtkar
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Max Jones
- Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Christopher Sanders
- Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
| | - Cara Lewis
- Dartmouth College, Hanover, New Hampshire, USA
| | - Keith Nockels
- University Library, University of Leicester, Leicester, UK
| | - Josie Solomon
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
- University of Lincoln, Lincoln, UK
| | - Jeremy Howick
- Stoneygate Centre for Empathic Healthcare, Leicester Medical School, University of Leicester College of Life Sciences, Leicester, UK
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Ong NY, Teo FJJ, Ee JZY, Yau CE, Thumboo J, Tan HK, Ng QX. Effectiveness of mindfulness-based interventions on the well-being of healthcare workers: a systematic review and meta-analysis. Gen Psychiatr 2024; 37:e101115. [PMID: 38737894 PMCID: PMC11086195 DOI: 10.1136/gpsych-2023-101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 03/07/2024] [Indexed: 05/14/2024] Open
Abstract
Background Growing evidence attests to the efficacy of mindfulness-based interventions (MBIs), but their effectiveness for healthcare workers remains uncertain. Aims To evaluate the evidence for MBIs in improving healthcare workers' psychological well-being. Methods A systematic literature search was conducted on Medline, Embase, Cumulative Index for Nursing and Allied Health Literature, PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords 'healthcare worker', 'doctor', 'nurse', 'allied health', 'mindfulness', 'wellness', 'workshop' and 'program'. Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion. R V.4.0.3 was used for data analysis, with the standardised mean difference as the primary outcome, employing DerSimonian and Laird's random effects model. Grading of Recommendations, Assessment, Development and Evaluation framework was used to evaluate the quality of evidence. Cochrane's Risk of Bias 2 tool was used to assess the risk of bias in the included studies. Results A total of 27 studies with 2506 participants were included, mostly from the USA, involving various healthcare professions. MBIs such as stress reduction programmes, apps, meditation and training showed small to large effects on anxiety, burnout, stress, depression, psychological distress and job strain outcomes of the participants. Positive effects were also seen in self-compassion, empathy, mindfulness and well-being. However, long-term outcomes (1 month or longer postintervention) varied, and the effects were not consistently sustained. Conclusions MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers. The review also highlights limitations such as intervention heterogeneity, reduced power in specific subgroup analyses and variable study quality. PROSPERO registration number CRD42022353340.
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Affiliation(s)
- Natasha Yixuan Ong
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Finn Jing Jie Teo
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jane Zi Ying Ee
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chun En Yau
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Julian Thumboo
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Health Services Research Unit, Singapore General Hospital, Singapore
- SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Hiang Khoon Tan
- Singhealth Duke-NUS Global Health Institute, Singapore
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
- Division of Surgery and Surgical Oncology, Singapore General Hospital, Singapore
| | - Qin Xiang Ng
- Health Services Research Unit, Singapore General Hospital, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Sánchez J, Lesmes M, Rubio M, Gal B, Tutor AS. Enhancing academic performance and student engagement in health education: insights from Work Station Learning Activities (WSLA). BMC MEDICAL EDUCATION 2024; 24:496. [PMID: 38702656 PMCID: PMC11069291 DOI: 10.1186/s12909-024-05478-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/26/2024] [Indexed: 05/06/2024]
Abstract
Making health science students aware of the importance of basic science knowledge for professional practice is a major educational challenge, especially during the early years of preclinical courses. Here, using an integrated curricular approach, we analyze whether Work Station Learning Activities (WSLA), which combine active learning methodologies for teaching basic science in clinical scenarios, can help to develop deeper learning and student engagement. In order to increase student motivation, we evaluated the effectiveness of WSLA using statistical analyses and an observation tool based on the ICAP (Interactive, Constructive, Active, and Passive) framework, which categorizes learning tasks based on the nature of student engagement. Statistical analyses revealed positive correlations between the different summative evaluations along the development of the activities, indicating the learning process inherent to WSLA progression and affirming the positive influence of WSLA on academic outcomes. Comparing the pre- and post-tests, students scored significantly higher on the post-test (statistically significant p < 0.001). WSLA promotes both constructivist and interactive learning, as validated by its alignment with the ICAP model. The study examines student engagement through systematic observation, revealing a relationship between student engagement and final grades. Students who exhibit constructive learning consistently earn higher grades, emphasizing the positive impact of active engagement. Thus, passive behavior profiles show a significant proportion of fails (40%), while constructive profiles stand out as the sole recipients of the coveted excellent rating. Ultimately, this study contributes to our understanding of the effectiveness of WSLA in promoting active learning and enhancing student engagement within integrated health education curricula. It highlights the importance of active learning behaviors for academic success and suggests avenues for further research to optimize integrated teaching methodologies in medical education.
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Affiliation(s)
- Judit Sánchez
- Departamento de Educación e Innovación Educativa, Universidad Europea de Madrid, Madrid, Spain
| | - Marta Lesmes
- Departamento de Educación e Innovación Educativa, Universidad Europea de Madrid, Madrid, Spain
| | - Margarita Rubio
- Departamento de Medicina, Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, Spain
| | - Beatriz Gal
- Departamento de Ciencias Médicas Básicas, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Urb. Montepríncipe s/n, Madrid, 28668, Spain
| | - Antonio S Tutor
- Departamento de Ciencias Médicas Básicas, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Urb. Montepríncipe s/n, Madrid, 28668, Spain.
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Valestrand EA, Whelan B, Eliassen KER, Schei E. Alienation in the Teaching Hospital: How Physician Non-Greeting Behaviour Impacts Medical Students' Learning and Professional Identity Formation. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:239-249. [PMID: 38638636 PMCID: PMC11025575 DOI: 10.5334/pme.1185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/22/2024] [Indexed: 04/20/2024]
Abstract
Introduction Clinical workplaces offer unrivalled learning opportunities if students get pedagogic and affective support that enables them to confidently participate and learn from clinical activities. If physicians do not greet new students, the learners are deprived of signals of social respect and inclusion. This study explored how physicians' non-greeting behaviour may impact medical students' participation, learning, and professional identity formation in clinical placements. Methods We analysed 16 senior Norwegian medical students' accounts of non-greeting behaviours among their physician supervisors in a reflexive thematic analysis of focus group interview data. Results The main themes were: A) Descriptions of non-greeting. Not being met with conduct signalling rapport, such as eye contact, saying hello, using names, or introducing students at the workplace, was perceived as non-greeting, and occurred across clinical learning contexts. B) Effects on workplace integration. Non-greeting was experienced as a rejection that hurt students' social confidence, created distance from the physician group, and could cause avoidance of certain workplace activities or specific medical specialties. C) Impact on learning. Non-greeting triggered avoidance and passivity, reluctance to ask questions or seek help or feedback, and doubts about their suitability for a medical career. Conclusion Medical students' accounts of being ignored or treated with disdain by physician superiors upon entering the workplace suggest that unintended depersonalising behaviour is ingrained in medical culture. Interaction rituals like brief eye contact, a nod, a "hello", or use of the student's name, can provide essential affective support that helps medical students thrive and learn in the clinic.
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Affiliation(s)
- Eivind Alexander Valestrand
- Center for Medical Education, Faculty of Medicine, University of Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
| | - Beth Whelan
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
- Student Health and Wellness Center, Memorial University, St. John's, NL, Canada
| | | | - Edvin Schei
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
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Alwatban L, Alageel MS, Alshehri LA, Alfehaid NS, Albahlal RA, Almazrou NH, Almubarak R. The Stigma of Burnout Impeding Formal Help: A Qualitative Study Exploring Residents' Experiences During Training. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:333-342. [PMID: 38646001 PMCID: PMC11032676 DOI: 10.2147/amep.s453564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/02/2024] [Indexed: 04/23/2024]
Abstract
Purpose Burnout is an occupational stress syndrome that gives rise to emotional exhaustion (EE) depersonalization (DP) and reduced personal accomplishment (PA). Increasing rates of burnout among health care professionals has been reported globally. Saudi Arabia appears to be among the highest in prevalence with reports of higher than 70%. Medical residents in training are the highest group at risk. The literature has repeatedly linked burnout among residents with poor academic performance on training exams, impaired quality of life, career choice regret and intentions to abandon medicine. In this study, we explore the factors that contribute to resident burnout, their experiences with burnout and how they choose to mitigate it. Methods A qualitative design was used to conduct this study in the city of Riyadh, Saudi Arabia. A total of 14 residents from surgical and non-surgical programs were interviewed through in-depth interviews. Interpretive thematic analysis was used in coding and generated coding templates. Categories were repetitively reviewed and revised, expanding to include new data as it emerged and collapsing to remove redundant codes. Categories were organized into the final themes and sub-themes. Results All participants demonstrated a shared thread of shame in reaching the level of burnout. Three main interlinked themes were identified: Burnout stigma cycle, amalgamated causes of burnout and self-coping with burnout. One of the concerning findings in our study is the participants' pursuit of self-coping strategies and the avoidance of formal help, creating a cycle of suffering in silence. Conclusion The literature has repeatedly reported high levels of burnout among residents in training. This study has added another dimension to those findings through the exploration of residents actual accounts and appears to link burnout with suboptimal training and working conditions. We have highlighted the pivotal role stigma and shame play in completely preventing residents from seeking professional help.
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Affiliation(s)
- Lemmese Alwatban
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- University Family Medicine Center, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mai S Alageel
- Department of Family Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Lina A Alshehri
- Department of Neurosurgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Carrard V, Berney S, Bourquin C, Ranjbar S, Castelao E, Schlegel K, Gaume J, Bart PA, Schmid Mast M, Preisig M, Berney A. Mental health and burnout during medical school: Longitudinal evolution and covariates. PLoS One 2024; 19:e0295100. [PMID: 38626104 PMCID: PMC11020803 DOI: 10.1371/journal.pone.0295100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/28/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Medical students' rate of depression, suicidal ideation, anxiety, and burnout have been shown to be higher than those of the same-age general population. However, longitudinal studies spanning the whole course of medical school are scarce and present contradictory findings. This study aims to analyze the longitudinal evolution of mental health and burnout from the first to the last year of medical school using a wide range of indicators. Moreover, biopsychosocial covariates that can influence this evolution are explored. METHOD In an open cohort study design, 3066 annual questionnaires were filled in by 1595 different students from the first to the sixth year of the Lausanne Medical School (Switzerland). Depression symptoms, suicidal ideation, anxiety symptoms, stress, and burnout were measured along with biopsychosocial covariates. The longitudinal evolution of mental health and burnout and the impact of covariates were modelled with linear mixed models. RESULTS Comparison to a same-aged general population sample shows that medical students reported significantly more depression symptoms and anxiety symptoms. Medical students' mental health improved during the course of the studies in terms of depression symptoms, suicidal ideation, and stress, although suicidal ideation increased again in the last year and anxiety symptoms remained stable. Conversely, the results regarding burnout globally showed a significant worsening from beginning to end of medical school. The covariates most strongly related to better mental health and less burnout were less emotion-focused coping, more social support, and more satisfaction with health. CONCLUSION Both improvement of mental health and worsening of burnout were observed during the course of medical school. This underlines that the beginning and the end of medical school bring specific challenges with the first years' stressors negatively impacting mental health and the last year's difficulties negatively impacting burnout.
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Affiliation(s)
- Valerie Carrard
- Department of Psychiatry, Psychiatric Liaison Service, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Sylvie Berney
- Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Céline Bourquin
- Department of Psychiatry, Psychiatric Liaison Service, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Setareh Ranjbar
- Department of Psychiatry, Psychiatric Epidemiology and Psychopathology Research Centre, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Psychiatric Epidemiology and Psychopathology Research Centre, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Katja Schlegel
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - Jacques Gaume
- Department of Psychiatry, Addiction Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Pierre-Alexandre Bart
- Department of Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Marianne Schmid Mast
- Faculty of Business and Economics (HEC Lausanne), Department of Organizational Behavior, University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Psychiatric Epidemiology and Psychopathology Research Centre, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Alexandre Berney
- Department of Psychiatry, Psychiatric Liaison Service, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
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Zapata J, Zavala-Idar A, Recto P, Lesser J. The mental health consequences of COVID-19 on a sample of health professions students: a mixed methods study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-10. [PMID: 38603780 DOI: 10.1080/07448481.2024.2338425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/22/2024] [Indexed: 04/13/2024]
Abstract
Objective: To assess and examine how the COVID-19 pandemic may have impacted the mental health of a sample of health professions students (HPS) using an explanatory sequential mixed-methods design. Participants: Participants included 41 HPS enrolled in a co-curricular interprofessional education (IPE) program. Measurements: Measures included the CES-D scale, PSS scale, and the GAD scale. Qualitative description was used to explore the experiences of these HPS. Results: The HPS explained that fear of acquiring COVID-19, transmitting the virus to loved ones, and dying as a result of the disease negatively influenced their mental health. The HPS revealed that there were some beneficial outcomes resulting from the pandemic, including the strengthening of family bonds and the cultivation of resiliency. Conclusions: The pandemic has had a negative impact on the mental health of these HPS. It is essential that these students receive support for their mental health in order to provide optimal care to the population they serve.
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Affiliation(s)
- Jose Zapata
- South Texas AHEC, The University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Annette Zavala-Idar
- South Texas AHEC, The University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Pamela Recto
- South Texas AHEC, The University of Texas Health at San Antonio, San Antonio, Texas, USA
| | - Janna Lesser
- South Texas AHEC, The University of Texas Health at San Antonio, San Antonio, Texas, USA
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Jorissen A, van de Kant K, Ikiz H, van den Eertwegh V, van Mook W, de Rijk A. The importance of creating the right conditions for group intervision sessions among medical residents- a qualitative study. BMC MEDICAL EDUCATION 2024; 24:375. [PMID: 38580954 PMCID: PMC10996180 DOI: 10.1186/s12909-024-05342-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/22/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND The burnout rates among residents urge for adequate interventions to improve resilience and prevent burnout. Peer reflection, also called group intervision sessions, is a potentially successful intervention to increase the resilience of young doctors. We aimed to gain insight into the perceived added value of intervision sessions and the prerequisite conditions to achieve this, according to residents and intervisors. Our insights might be of help to those who think of implementing intervision sessions in their institution. METHODS An explorative, qualitative study was performed using focus groups and semi-structured interviews with both residents (n = 8) and intervisors (n = 6) who participated in intervision sessions in a university medical center in the Netherlands. The topic list included the perceived added value of intervision sessions and factors contributing to that. The interviews were transcribed verbatim and coded using NVivo. Thematic analysis was subsequently performed. RESULTS According to residents and intervisors, intervision sessions contributed to personal and professional identity development; improving collegiality; and preventing burn-out. Whether these added values were experienced, depended on: (1) choices made during preparation (intervisor choice, organizational prerequisites, group composition, workload); (2) conditions of the intervision sessions (safety, depth, role of intervisor, group dynamics, pre-existent development); and (3) the hospital climate. CONCLUSIONS Intervision sessions are perceived to be of added value to the identity development of medical residents and to prevent becoming burned out. This article gives insight in conditions necessary to reach the added value of intervision sessions. Optimizing preparation, meeting prerequisite conditions, and establishing a stimulating hospital climate are regarded as key to achieve this.
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Affiliation(s)
- Anouk Jorissen
- Department of Social Medicine, Care and Public Health, Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
| | - Kim van de Kant
- Academy for Postgraduate Medical Training, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202 AZ, the Netherlands.
- Department of Family Medicine, Care and Public Health, Research Institute (CAPHRI), Maastricht University, PO Box 5800, Maastricht, 6202 AZ, the Netherlands.
| | - Habibe Ikiz
- Department of Gynecology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Valerie van den Eertwegh
- Skillslab, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Walther van Mook
- Academy for Postgraduate Medical Training, Maastricht University Medical Center, PO Box 5800, Maastricht, 6202 AZ, the Netherlands
- Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- School of Health Professions Education (SHE), Maastricht University, Maastricht, the Netherlands
| | - Angelique de Rijk
- Department of Social Medicine, Care and Public Health, Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands
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Lie JJ, Huynh C, Li J, Mak N, Wiseman SM. Psychological Impact of the COVID-19 Pandemic on Canadian Surgical Residents: A Province-Wide Study. JOURNAL OF SURGICAL EDUCATION 2024; 81:486-494. [PMID: 38388311 DOI: 10.1016/j.jsurg.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/22/2023] [Accepted: 12/22/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVES The objective of this study was to evaluate the psychological impact of the COVID-19 pandemic on surgical residents. DESIGN An online survey was distributed evaluating multiple domains: demographics, health and socioeconomic factors, clinical experience, educational experience, and psychological outcomes. The Mayo Clinic Resident Well-Being Index (RWBI) was used as a validated measure of resident mental health. SETTING AND PARTICIPANTS Surgical residents from University of British Columbia's surgical residency programs. RESULTS A total of 31/86 surgical residents responded to the survey. Of which, 57% and 46% reported feeling burned out or depressed, respectively. Residents who were concerned about personal protective equipment supply and who lived with family members with comorbidities had a higher risk of depression (p = 0.03, p = 0.04). The median Mayo Clinic Resident Well-Being Index was 2.5, higher than the median of 2 observed in the United States national survey of residents. CONCLUSIONS The pandemic had a considerable negative impact on the psychological well-being of surgical residents.
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Affiliation(s)
- Jessica J Lie
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Caroline Huynh
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer Li
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicole Mak
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada.
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Varpio L, Parker R, MacLeod A. Understanding the Differences That Differentiate: A Model for Deciding Which Literature Review to Conduct. J Grad Med Educ 2024; 16:146-150. [PMID: 38993309 PMCID: PMC11234308 DOI: 10.4300/jgme-d-24-00151.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Affiliation(s)
- Lara Varpio
- Lara Varpio, PhD, is Professor, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, and Co-Director, Research in Medical Education, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Robin Parker
- Robin Parker, MLIS, is Evidence Synthesis Librarian, W.K. Kellogg Health Sciences Library and Department of Community Health & Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; and
| | - Anna MacLeod
- Anna MacLeod, PhD, is Professor and Director, Education Research, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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Savage NM, Santen SA, Rawls M, Marzano DA, Wong JH, Burrows HL, Hicks RA, Aboff BM, Hemphill RR. Understanding resident wellness: A path analysis of the clinical learning environment at three institutions. MEDICAL TEACHER 2024:1-7. [PMID: 38557254 DOI: 10.1080/0142159x.2024.2331038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE The clinical learning environment (CLE) affects resident physician well-being. This study assessed how aspects of the learning environment affected the level of resident job stress and burnout. MATERIALS AND METHODS Three institutions surveyed residents assessing aspects of the CLE and well-being via anonymous survey in fall of 2020 during COVID. Psychological safety (PS) and perceived organizational support (POS) were used to capture the CLE, and the Mini-Z Scale was used to assess resident job stress and burnout. A total of 2,196 residents received a survey link; 889 responded (40% response rate). Path analysis explored both direct and indirect relationships between PS, POS, resident stress, and resident burnout. RESULTS Both POS and PS had significant negative relationships with experiencing a great deal of job stress; the relationship between PS and stress was noticeably stronger than POS and stress (POS: B= -0.12, p=.025; PS: B= -0.37, p<.001). The relationship between stress and residents' level of burnout was also significant (B = 0.38, p<.001). The overall model explained 25% of the variance in resident burnout. CONCLUSIONS Organizational support and psychological safety of the learning environment is associated with resident burnout. It is important for educational leaders to recognize and mitigate these factors.
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Affiliation(s)
- Nastassia M Savage
- FMP Consulting, Arlington, VA, USA
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Sally A Santen
- Dean's Office, Virginia Commonwealth University, Richmond, VA, USA
- Emergency Medicine and Medical Education, University of Cincinnati, Cincinnati, OH, USA
| | - Meagan Rawls
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Bon Secours Mercy Health, Richmond, VA, USA
| | - David A Marzano
- Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Jean H Wong
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Heather L Burrows
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Ralph A Hicks
- Department of Pediatrics, Indiana University, Indianapolis, IN, USA
| | - Brian M Aboff
- Graduate Medical Education, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Robin R Hemphill
- Cincinnati Veterans Association Medical Center, Cincinnati, OH, USA
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West HM, Flain L, Davies RM, Shelley B, Edginton OT. Medical student wellbeing during COVID-19: a qualitative study of challenges, coping strategies, and sources of support. BMC Psychol 2024; 12:179. [PMID: 38549145 PMCID: PMC10979564 DOI: 10.1186/s40359-024-01618-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/22/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Medical students face challenges to their mental wellbeing and have a high prevalence of mental health problems. During training, they are expected to develop strategies for dealing with stress. This study investigated factors medical students perceived as draining and replenishing during COVID-19, using the 'coping reservoir' model of wellbeing. METHODS In synchronous interactive pre-recorded webinars, 78 fourth-year medical students in the UK responded to reflective prompts. Participants wrote open-text comments on a Padlet site. Responses were analysed using reflexive thematic analysis. RESULTS Analysis identified five themes. COVID-19 exacerbated academic pressures, while reducing the strategies available to cope with stress. Relational connections with family and friends were affected by the pandemic, leading to isolation and reliance on housemates for informal support. Relationships with patients were adversely affected by masks and telephone consultations, however attending placement was protective for some students' wellbeing. Experiences of formal support were generally positive, but some students experienced attitudinal and practical barriers. CONCLUSIONS This study used a novel methodology to elicit medical students' reflections on their mental wellbeing during COVID-19. Our findings reinforce and extend the 'coping reservoir' model, increasing our understanding of factors that contribute to resilience or burnout. Many stressors that medical students typically face were exacerbated during COVID-19, and their access to coping strategies and support were restricted. The changes to relationships with family, friends, patients, and staff resulted in reduced support and isolation. Recognising the importance of relational connections upon medical students' mental wellbeing can inform future support.
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Affiliation(s)
- Helen M West
- Department of Psychology, University of Liverpool, Eleanor Rathbone Building, Bedford Street South, Liverpool, L69 7ZA, UK.
| | - Luke Flain
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Rowan M Davies
- School of Medicine, University of Liverpool, Liverpool, UK
- Salford Royal NHS Foundation Trust, Manchester, UK
| | - Benjamin Shelley
- School of Medicine, University of Liverpool, Liverpool, UK
- Calderdale and Huddersfield NHS Foundation Trust, West Yorkshire, UK
| | - Oscar T Edginton
- School of Medicine, University of Liverpool, Liverpool, UK
- Leeds Teaching Hospitals NHS Foundation Trust, Leeds, UK
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Torales J, González RE, Ríos-González C, Real-Delor R, O'Higgins M, Paredes-González X, Almirón-Santacruz J, Díaz NR, Castaldelli-Maia JM, Ventriglio A, Barrios I. Spanish validation of the Stigma of Occupational Stress Scale for Doctors (SOSS-D) and factors associated with physician burnout. Ir J Psychol Med 2024; 41:86-93. [PMID: 36189611 DOI: 10.1017/ipm.2022.41] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the psychometric properties of the Spanish version of the Stigma of Occupational Stress Scale for Doctors (SOSS-D) and the factors associated with Physician Burnout in Paraguay. METHODS Participants included 747 Paraguayan healthcare workers, aged 24-77 years old, of both sexes. SOSS-D was translated into Spanish and validated through an exploratory and confirmatory factor analysis. Participants were also scored with the Oldenburg Burnout Inventory (OLBI), the CAGE questionnaire, and the stigma subscale of the Perceived Barriers to Psychological Treatment (PBPT) measure. RESULTS Three factors had a raw eigenvalue greater than 1, and explained 61.7% of total variance. The confirmatory analysis confirmed that the scale is three-dimensional. The model adjustment was good, according to all fit indices. OLBI results indicate clinically significant disengagement in 85.9% and clinically significant exhaustion in 91.6% of participants. Of the 747 participants, 57.6% reported alcoholic beverage consumption and among those, 19.3% had problematic alcohol consumption according to the CAGE questionnaire. The correlation between SOSS-D and the stigma subscale of the PBPT was statistically significant (r = 0.245, p < 0.001). CONCLUSIONS The Spanish version of the SOSS-D was found to have good psychometric properties and adequately reproduces the three-dimensional model of the original English version.
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Affiliation(s)
- J Torales
- Department of Medical Psychology, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - R E González
- San Pablo General Maternity and Children's Hospital, Ministry of Public Health and Social Welfare, Asunción, Paraguay
| | - C Ríos-González
- Research Department, School of Medical Sciences, National University of Caaguazú, Coronel Oviedo, Paraguay
| | - R Real-Delor
- Postgraduate Program in Internal Medicine, National University of Itapúa, Encarnación, Paraguay
| | - M O'Higgins
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - X Paredes-González
- School of Medical Sciences, University of the Pacific, Asunción, Paraguay
| | - J Almirón-Santacruz
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - N R Díaz
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - J M Castaldelli-Maia
- Department of Neuroscience, Fundação do ABC, Santo André, SP, Brazil
- Department of Psychiatry, University of São Paulo, São Paulo, SP, Brazil
| | - A Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - I Barrios
- Department of Statistics (Santa Rosa Campus), School of Medical Sciences, National University of Asunción, Santa Rosa del Aguaray, Paraguay
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Madrazo L, Choo-Foo J, Domecq MC, LaDonna KA, Humphrey-Murto S. Illness presenteeism among physicians and trainees: Study protocol of a scoping review. PLoS One 2024; 19:e0297447. [PMID: 38421967 PMCID: PMC10903841 DOI: 10.1371/journal.pone.0297447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 01/04/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Illness presenteeism (IP) is the phenomenon where individuals continue to work despite illness. While it has been a prevalent and longstanding issue in medicine, the recent onset of the COVID-19 pandemic and the growing movement to improve physician wellness brings renewed interest in this topic. However, there have been no comprehensive reviews on the state of literature of this topic. PURPOSE The main aim of this scoping review is to explore what is known about presenteeism in physicians, residents, and medical students in order to map and summarize the literature, identify research gaps and inform future research. More specifically: How has illness presenteeism been defined, problematized or perceived? What methods and approaches have been used to study the phenomenon? Has the literature changed since the pandemic? METHOD Using the Arksey and O'Malley framework several databases will be searched by an experienced librarian. Through an iterative process, inclusion and exclusion criteria will be developed and a data extraction form refined. Data will be analyzed using quantitative and qualitative content analyses. POTENTIAL IMPLICATIONS OF RESULTS By summarizing the literature on IP, this study will provide a better understanding of the IP phenomena to inform future research and potentially have implications for physician wellness and public health.
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Affiliation(s)
- Lorenzo Madrazo
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jade Choo-Foo
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Kori A. LaDonna
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Innovation and Medical Education, University of Ottawa, Ottawa, Ontario, Canada
| | - Susan Humphrey-Murto
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Department of Innovation and Medical Education, University of Ottawa, Ottawa, Ontario, Canada
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Valestrand EA, Kvernenes M, Kinsella EA, Hunskaar S, Schei E. Transforming self-experienced vulnerability into professional strength: a dialogical narrative analysis of medical students' reflective writing. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10317-3. [PMID: 38401015 DOI: 10.1007/s10459-024-10317-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/04/2024] [Indexed: 02/26/2024]
Abstract
Medical students' efforts to learn person-centered thinking and behavior can fall short due to the dissonance between person-centered clinical ideals and the prevailing epistemological stereotypes of medicine, where physicians' life events, relations, and emotions seem irrelevant to their professional competence. This paper explores how reflecting on personal life experiences and considering the relevance for one's future professional practice can inform first-year medical students' initial explorations of professional identities. In this narrative inquiry, we undertook a dialogical narrative analysis of 68 essays in which first-year medical students reflected on how personal experiences from before medical school may influence them as future doctors. Students wrote the texts at the end of a 6-month course involving 20 patient encounters, introduction to person-centered theory, peer group discussions, and reflective writing. The analysis targeted medical students' processes of interweaving and delineating personal and professional identities. The analysis yielded four categories. (1) How medical students told their stories of illness, suffering, and relational struggles in an interplay with context that provided them with new perspectives on their own experiences. Students formed identities with a person-centered orientation to medical work by: (2) recognizing and identifying with patients' vulnerability, (3) experiencing the healing function of sharing stories, and (4) transforming personal experiences into professional strength. Innovative approaches to medical education that encourage and support medical students to revisit, reflect on, and reinterpret their emotionally charged life experiences have the potential to shape professional identities in ways that support person-centered orientations to medical work.
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Affiliation(s)
- Eivind Alexander Valestrand
- Center for Medical Education, Faculty of Medicine, University of Bergen, Bergen, Norway.
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - Monika Kvernenes
- Center for Medical Education, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Elizabeth Anne Kinsella
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Steinar Hunskaar
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Edvin Schei
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Gupta A. Commentary on "Hidden". ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:161. [PMID: 38294424 DOI: 10.1097/01.acm.0001006612.70402.96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Anjali Gupta
- A. Gupta is adjunct assistant professor, Department of Psychiatry, Georgetown University School of Medicine, Washington, DC; ; Twitter: @AnjaliMGupta14
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38
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Bedross A, Siraw BB, Alkhidir A, Zaher EA, Patel P, Kumar A, Bostoros P, Sqour H, Kumar P, Eshan SH. The Impact of an Intern's Clinical Guidebook on Easing the Transition of New Interns Into the United States Healthcare System. Cureus 2024; 16:e54874. [PMID: 38533177 PMCID: PMC10964215 DOI: 10.7759/cureus.54874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 03/28/2024] Open
Abstract
This study explores the efficacy of an intern's clinical guidebook in facilitating the transition of categorical internal medicine interns into the United States healthcare system. New interns, particularly foreign medical graduates, face multifaceted challenges during their initial year of residency. The research, conducted at Ascension Saint Joseph Hospital in Chicago, employed a quasi-experimental pre-post design involving 20 interns. Participants were provided with an intern's clinical guidebook, and their knowledge was assessed through pre and post exams. Results demonstrated a statistically significant improvement in overall knowledge, with mean scores increasing from 65% to 77.37%. Subgroup analysis revealed similar improvements among both male and female interns. Data confidentiality and ethical considerations were prioritized, with participant data anonymized and stored securely. Despite limitations, this study highlights the guidebook's potential to enhance intern education and improve the quality of care provided during the crucial transition period. Further research is recommended to validate and extend these findings.
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Affiliation(s)
- Andranik Bedross
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
| | - Bekure B Siraw
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
| | - Ayah Alkhidir
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
| | - Eli A Zaher
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
| | - Parth Patel
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
| | - Ashok Kumar
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
| | - Peter Bostoros
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
| | - Hasan Sqour
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
| | - Pardeep Kumar
- Internal Medicine, Ascension Saint Joseph Hospital, Chicago, USA
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Schwatka NV, Burden M, Dyrbye LN. An Organizational Leadership Development Approach to Support Health Worker Mental Health. Am J Public Health 2024; 114:142-147. [PMID: 38354347 PMCID: PMC10916722 DOI: 10.2105/ajph.2023.307407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 02/16/2024]
Affiliation(s)
- Natalie V Schwatka
- Natalie V. Schwatka is with the Center for Health, Work & Environment, Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora. Marisha Burden is with the Division of Hospital Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora. Liselotte N. Dyrbye is the senior associate dean of faculty and chief well-being officer, professor of medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Marisha Burden
- Natalie V. Schwatka is with the Center for Health, Work & Environment, Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora. Marisha Burden is with the Division of Hospital Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora. Liselotte N. Dyrbye is the senior associate dean of faculty and chief well-being officer, professor of medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | - Liselotte N Dyrbye
- Natalie V. Schwatka is with the Center for Health, Work & Environment, Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora. Marisha Burden is with the Division of Hospital Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora. Liselotte N. Dyrbye is the senior associate dean of faculty and chief well-being officer, professor of medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
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Anurat K, Thamyongkit S, Pakakasama S, Sumrithe S. Assessing the role of mentors in mitigating burnout and enhancing professional development in medical education. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2024; 15:1-7. [PMID: 38284420 PMCID: PMC11288619 DOI: 10.5116/ijme.659b.d08c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
Objectives To assess the correlation between mentor behaviours and medical student burnout and their professional development within medical education. Methods A cross-sectional study using convenience sampling was conducted among third-, fifth-, and sixth-year medical students (N=307). Participants voluntarily completed anonymous online questionnaires measuring the Mentor Behavior Scale, the Maslach Burnout Inventory-Student Survey, and the Professional Self-Identity Questionnaire. Multivariate regression analysis was performed to analyse relationships between student burnout, mentor behaviours and their impact on professional development. Results Among participants, 26% (N=80) experienced burnout, which was significantly associated with lower competency support (OR = 2.0, 95% CI: 1.1-3.5, p = 0.016), medication use (OR = 2.1, 95% CI: 1.1-4.0, p = 0.029), and a lower Grade Point Average (OR = 3.3, 95% CI: 1.6-6.9, p = 0.001) compared to non-burnout students. In the development of professional identity, a high level of mentor relationship structure had statistically significant associations with higher scores in key domains of the Professional Self-Identity Questionnaire, including teamwork (OR = 3.9, 95% CI: 1.5-9.9, p < 0.01), communication (OR = 3.4, 95% CI: 1.5-7.7, p < 0.01), ethical awareness (OR = 3.3, 95% CI: 1.4-8.0, p < 0.01), and record use (OR = 2.8, 95% CI: 1.2-6.5, p < 0.05). Conclusions The impact of mentor behaviours on medical students is evident. Enhancing mentorship by addressing specific mentor behaviours can improve programme quality. Future research should explore the long-term effects and strategies for effectively implementing targeted enhancements in mentor behaviours.
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Affiliation(s)
- Kingthong Anurat
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Sorawut Thamyongkit
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Samart Pakakasama
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Sutida Sumrithe
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
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Agarwal AK, Gonzales R, Munden C, Albright D, Tsao S. Medical Students' Perceptions on Identifying and Addressing Emotional Responses in Emergency Medicine: Pilot Investigation. JMIR Form Res 2024; 8:e50827. [PMID: 38198202 PMCID: PMC10809065 DOI: 10.2196/50827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Training in acute care, such as emergency medicine (EM), where exposure to critically ill and injured patients is high, impacts the well-being of trainees and contributes to burnout. Investigating how, and if, trainees prepare for these situations is necessary to ensure they are supported. OBJECTIVE This study aimed to evaluate medical students' perspectives and emotional preparedness for handling acute care and trauma. METHODS We conducted a pilot investigation using a remote digital survey of medical students during their EM clerkship at a large, urban academic institution. The primary outcome of interest was student-reported preparedness and comfort in handling trauma and critical care patient encounters. Secondary outcomes included awareness of well-being resources and comfort in accessing digital well-being resources. RESULTS A total of 57 medical students completed the voluntary digital survey, and half of the students (n=28, 49%) reported having witnessed the care of a critically ill or a penetrating trauma patient (eg, a victim of gun violence). A majority (n=40, 70%) had thought about how these events may impact them, and over half felt unprepared to identify the emotional impact these cases may have on them (n=31, 54%) or address the emotional or mental health impact (n=36, 63%). Less than a quarter (n=14, 25%) were aware of digital mental health resources, and 58% (n=33) did not feel fully comfortable connecting with resources if needed. Students who had previously witnessed critical care were significantly more likely to report feeling well prepared in identifying the emotional impact and addressing this impact. CONCLUSIONS In this cross-sectional survey, students did not feel fully prepared to identify or address the emotional impact of working in EM. Additionally, they lacked awareness of or comfort with accessing digital institutional resources meant to support their well-being, such as a large web-based platform. These findings can help inform and guide interventions by educational and academic leaders. The aim would be to create and promote environments that empower students with tools to identify their own emotions and connect to well-being resources.
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Affiliation(s)
- Anish Kumar Agarwal
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Health Care Transformation and Innovation, Penn Medicine, Philadelphia, PA, United States
| | - Rachel Gonzales
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Center for Health Care Transformation and Innovation, Penn Medicine, Philadelphia, PA, United States
| | - Cory Munden
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - DaCarla Albright
- Department of Obstetrics and Gynecology, University of Pennyslvania, Philadelphia, PA, United States
| | - Suzana Tsao
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Till B, Hofhansl A, Niederkrotenthaler T. Effects of the mental health promotion seminar 'Coping with stress' in the undergraduate medical curriculum of the Medical University of Vienna. BMC MEDICAL EDUCATION 2024; 24:41. [PMID: 38191363 PMCID: PMC10773058 DOI: 10.1186/s12909-023-05019-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/29/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND High prevalence rates of distress and burnout in medical students are well-documented in mental health literature. Different types of interventions have been developed in the past in order to reduce stress in medical undergraduate students and promote better coping skills. There is, however, a paucity of studies that have tested the effectiveness of these interventions. This study aimed to examine the effect of different versions of the seminar 'Coping with stress', which was implemented in the first year of the undergraduate curriculum of the Medical University of Vienna in the summer semester of 2018, on students' mental health. METHODS Invitations to participate in the study were sent via email to six cohorts of students from the Medical University of Vienna. Two cohorts participated in the onsite version of the seminar 'Coping with stress', whereas two cohorts participated in the online version of the seminar, and two cohorts received no intervention (control group). Data on burnout risk, life satisfaction, stress, and knowledge about available help resources were collected via online questionnaires from n = 137 students before and after the curriculum module that contained the seminar. RESULTS Medical students who participated in the onsite seminar reported a reduction of some aspects of burnout, a decrease in stress, and an increase in knowledge about available help resources. No such effect was seen in the control group. Participants of the online seminar experienced a similar increase in knowledge about available help resources, but no changes in other outcomes. CONCLUSIONS The findings support the notion that the onsite seminar of 'Coping with stress' had a positive impact on medical students' mental health and is a useful addition to the medical curriculum by promoting mental health literacy. TRIAL REGISTRATION This research has been registered in the German Clinical Trial Registry with the registration number DRKS00018981 and the registration date 14/11/2019.
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Affiliation(s)
- Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, A-1090, Austria.
| | - Angelika Hofhansl
- Medical Didactics, Teaching Center, Medical University of Vienna, Vienna, Austria
| | - Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, A-1090, Austria
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Esparza-Reig J, Julián M. Association between suicidal ideation and burnout: A meta-analysis. DEATH STUDIES 2024:1-12. [PMID: 38180020 DOI: 10.1080/07481187.2023.2300064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Approximately 700,000 people die by suicide annually worldwide. Researchers have explored a spectrum of experiences that involve stress in academic or work environments and potentially intensify suicidal thoughts or behaviors. However, no meta-analysis has examined the relationship between suicidal ideation (SI) and burnout. This study consisted of a meta-analysis to examine the association between SI and burnout syndrome, utilizing the WoS Core Collection, Scopus, PubMed, PsycINFO, DIALNET, and Google Scholar databases. Twenty-one samples met the study's eligibility criteria for inclusion in the analysis. The results revealed a significant relationship between SI and burnout, with the type of burnout (occupational, academic, and parental) emerging as the most significant moderating variable. Occupational burnout exhibited the lowest correlation, followed by academic and parental burnout. These findings suggest the importance of developing tools to assess SI within the context of the work environment, parenting and academics, and psychoeducational programs for managing stress.
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Affiliation(s)
| | - Martín Julián
- Department of Psychology, Universidad Europea de Valencia, Valencia, Spain
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Prendergast M, Cardoso Pinto AM, Harvey CJ, Muir E. Burnout in early year medical students: experiences, drivers and the perceived value of a reflection-based intervention. BMC MEDICAL EDUCATION 2024; 24:7. [PMID: 38172864 PMCID: PMC10765935 DOI: 10.1186/s12909-023-04948-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 12/07/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION According to the 11th Revision of the International Classification of Diseases, burnout is defined as a syndrome resulting from chronic work-related stress that has not been successfully managed. Burnout is increasingly prevalent amongst medical students and has been shown to lead to worsened academic engagement, feelings of inadequacy, poor mental health and increased risk of withdrawal from the course. The aim of this study was to explore the experience of burnout amongst early year medical students and evaluate the perceived impact of a reflection-based intervention on their awareness and experience of burnout. METHODS The reflection-based intervention comprised two tutorials covering the presentation, drivers, impact and management strategies for burnout syndrome. These were introduced into the second-year medical curriculum at Imperial College London. As part of the reflection-based intervention, students were invited to complete an anonymous Qualtrics form three times during the academic year. This included the Shirom-Melamed Burnout Measure (SMBM) and a free-text question prompting the student to consider their stressors at the time of completing the intervention. The former is composed of 14-questions measuring the extent of feelings or behaviours suggestive of burnout, divided into three categories: physical fatigue, cognitive weariness and emotional exhaustion. At the end of the academic year, students were invited to participate in an online focus group to further explore their experience of burnout and their perceived value of the reflection-based intervention. Results of the SMBM were explored descriptively; free-text questions and the focus group transcript were analysed using inductive thematic analysis. RESULTS A total of 59 submissions for the reflection-based intervention were analysed: 26 students participated and consented in the first round, 8 in the second and 25 in the third round. Overall median burnout scores were 4 (IQR 3-5), 2 (IQR 1-4) and 3 (IQR 2-5) in each round of the SMBM, respectively. A total of 8 (30.8%) met the threshold for severe burnout (≥ 4.4) in round 1 of the questionnaire, zero in the second round and 4 (16%) in the third round. Physical and cognitive fatigue showed higher median scores than emotional exhaustion in every round. Four students participated in the focus group, which had two sections. The first was reflecting on burnout in medical school and the intervention, which revealed four themes: (1) indicators of burnout (often insidious, but may involve lack of energy and motivation, or changes in perceived personality); (2) perceived drivers of burnout (perceived expectation that medical school is supposed to be challenging and consistent prioritisation of work over wellbeing); (3) working habits of medical students (unachievable self-expectations and feelings of guilt when not working); (4) value of the intervention (the teaching and reflection-based intervention prompted students to identify signs of burnout in themselves and consider management strategies). The second section included considerations for implementing burnout interventions into the medical school curriculum, which revealed three themes: (1) desire to learn about burnout (students hoped to gain insight into burnout and methods of prevention as part of their curriculum); (2) importance of community (group interventions and the involvement of Faculty helped students feel less isolated in their experiences); (3) feasibility of interventions (sustainable interventions are likely to be those that are efficient, such as using multiple-choice questions, and with allocated periods in their timetable). CONCLUSION Second-year medical students demonstrated symptoms and signs of burnout, including exhaustion, lack of motivation and changes in personality. They also expressed a desire to gain greater awareness of burnout and insight into preventative strategies within the medical curriculum. Whilst certain drivers of burnout can be prevented by students themselves through adequate prevention strategies, many remain systemic issues which require curriculum-level change to be effectively addressed. The students found that the reflection-based intervention was effective at improving their perception of burnout and a convenient tool to use, which could be implemented more widely and continued longer-term throughout medical school.
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Affiliation(s)
| | | | | | - Elizabeth Muir
- Department of Primary Care and Public Health, Imperial College, London, UK
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Johnson JI, Beasley H, Southwick D, Lords AM, Kessler R, Vrablik ME, Baker RT. Development of a hybrid point-of-care ultrasound curriculum for first year medical students in a rural medical education program: a pilot study. BMC MEDICAL EDUCATION 2024; 24:16. [PMID: 38172848 PMCID: PMC10765644 DOI: 10.1186/s12909-023-05005-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The field of point-of-care ultrasound (POCUS) has advanced in recent decades due to the benefits it holds for medical providers. However, aspiring POCUS practitioners require adequate training. Unfortunately, there remains a paucity of resources to deliver this training, particularly in rural and underserved areas. Despite these barriers, calls for POCUS training in undergraduate medical education are growing, and many medical schools now deliver some form of POCUS education. Our program lacked POCUS training; therefore, we developed and implemented a POCUS curriculum for our first-year medical students. METHODS We developed a POCUS curriculum for first year medical students in a rural medically underserved region of the United States. To evaluate our course, we measured learning outcomes, self-reported confidence in a variety of POCUS domains, and gathered feedback on the course with a multi-modal approach: an original written pre- and post-test, survey tool, and semi-structured interview protocol, respectively. RESULTS Student (n=24) knowledge of POCUS significantly increased (pre-test average score = 55%, post-test average score = 79%, P<0.0001), and the course was well received based on student survey and interview feedback. In addition, students reported increased confidence toward a variety of knowledge and proficiency domains in POCUS use and their future clinical education and practice. CONCLUSIONS Despite a lack of consensus in POCUS education, existing literature describes many curricular designs across institutions. We leveraged a combination of student initiatives, online resources, remote collaborations, local volunteers, and faculty development to bring POCUS to our institution in a rural and medically underserved region. Moreover, we demonstrate positive learning and experiential outcomes that may translate to improved outcomes in students' clinical education and practice. Further research is needed to evaluate the psychomotor skills, broader learning outcomes, and clinical performance of students who take part in our POCUS course.
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Affiliation(s)
- Joshua I Johnson
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA.
- University of Washington School of Medicine, Seattle, Washington, USA.
| | - Heather Beasley
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Derek Southwick
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Allie M Lords
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Ross Kessler
- University of Washington School of Medicine, Seattle, Washington, USA
- Department of Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Michael E Vrablik
- University of Washington School of Medicine, Seattle, Washington, USA
- Department of Emergency Medicine, University of Washington, Seattle, Washington, USA
| | - Russell T Baker
- WWAMI Medical Education Program, University of Idaho, Moscow, Idaho, USA
- University of Washington School of Medicine, Seattle, Washington, USA
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Li H, Upreti T, Do V, Dance E, Lewis M, Jacobson R, Goldberg A. Measuring wellbeing: A scoping review of metrics and studies measuring medical student wellbeing across multiple timepoints. MEDICAL TEACHER 2024; 46:82-101. [PMID: 37405740 DOI: 10.1080/0142159x.2023.2231625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
PURPOSE Studies have demonstrated poor mental health in medical students. However, there is wide variation in study design and metric use, impairing comparability. The authors aimed to examine the metrics and methods used to measure medical student wellbeing across multiple timepoints and identify where guidance is necessary. METHODS Five databases were searched between May and June 2021 for studies using survey-based metrics among medical students at multiple timepoints. Screening and data extraction were done independently by two reviewers. Data regarding the manuscript, methodology, and metrics were analyzed. RESULTS 221 studies were included, with 109 observational and 112 interventional studies. There were limited studies (15.4%) focused on clinical students. Stress management interventions were the most common (40.2%). Few (3.57%) interventional studies followed participants longer than 12 months, and 38.4% had no control group. There were 140 unique metrics measuring 13 constructs. 52.1% of metrics were used only once. CONCLUSIONS Unique guidance is needed to address gaps in study design as well as unique challenges surrounding medical student wellbeing surveys. Metric use is highly variable and future research is necessary to identify metrics specifically validated in medical student samples that reflect the diversity of today's students.
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Affiliation(s)
- Henry Li
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Tushar Upreti
- Max Rady College of Medicine, Faculty of Health Sciences, University of Manitoba Rady, Winnipeg, Canada
| | - Victor Do
- Department of Pediatrics, Faculty of Medicine, University of Toronto Temerty, Toronto, Canada
| | - Erica Dance
- Department of Emergency Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Melanie Lewis
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Ryan Jacobson
- Office of Advocacy and Wellbeing, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Aviva Goldberg
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba Rady, Winnipeg, Canada
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AlNahedh A, BinRusayyis A, Al-Tannir M, AlFayyad I. Prevalence of Depression and Burnout among Family Medicine Residents in Riyadh City, Saudi Arabia. Health Psychol Res 2023; 11:90620. [PMID: 38162541 PMCID: PMC10756857 DOI: 10.52965/001c.90620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/17/2023] [Indexed: 01/03/2024] Open
Abstract
Background The mental health of healthcare workers, particularly family medicine residents, is an area of growing concern, more so in the context of the COVID-19 pandemic. High levels of burnout and depression among these professionals can affect their well-being and patients' quality of care. Objectives The study aimed to determine the prevalence of depression and burnout among family medicine residents in Riyadh, Saudi Arabia. Materials and Methods A cross-sectional study was conducted among 213 family medicine residents, using a self-administered survey. The survey included the Maslach Burnout Inventory and the Patient Health Questionnaire (PHQ)-9 to assess burnout and depression. Descriptive statistics were used to summarize participants' characteristics, and regression model was developed to explore predictors of burnout and depression. Results The mean age of participants was 26.85±1.42 years, and 53.3% were males. The study found a high prevalence of emotional exhaustion (EE) and depersonalization (DP) among participants, with mean scores of 21.10±9.38 and 15.44±7.69, respectively, indicating moderate to high levels. Similarly, a high level of personal accomplishment (PA) was reported, with a mean score of 11.46±6.33. Around 10% of participants reported moderately severe and severe depression, with a mean PHQ-9 scale score of 6.03±5.10. Gender and depression severity were significantly associated with burnout (p=0.001 and p<0.001, respectively). Conclusion The study underscores a significant prevalence of burnout and depression among family medicine residents in Riyadh, with notable variations across different demographic and professional characteristics. This necessitates tailored mental health interventions for this population, especially in challenging times like the ongoing pandemic.
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Huber A, Rabl L, Höge-Raisig T, Höfer S. Well-Being, Mental Health, and Study Characteristics of Medical Students before and during the Pandemic. Behav Sci (Basel) 2023; 14:7. [PMID: 38275349 PMCID: PMC10812729 DOI: 10.3390/bs14010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024] Open
Abstract
Medical students report high demands, stressors, pressure to perform, and a lack of resources, and are therefore at a higher risk for mental strain and burnout. Due to the COVID-19 pandemic, study conditions have changed, and new challenges have emerged. Thus, this study aimed to examine medical students' well-being, mental health, and study characteristics before and during the pandemic. Data from 988 Austrian medical students were included into the cross-sectional comparisons, and 63 students were included into the longitudinal analyses (variance analyses/t-tests or appropriate non-parametric tests). Well-being before and during the pandemic did not differ significantly but the peri-pandemic cohort reported higher study satisfaction, more social support from lecturers, and less emotional exhaustion, cognitive demands, and stressors (information problems, organizational stressors, work overload). Longitudinally, work overload was also perceived to be higher before the pandemic; however, study satisfaction was lower. During the pandemic, approximately every seventh student exceeded the cut-off value for generalized anxiety disorder, and approximately every tenth student exceeded the cut-off value for major depression. These unexpected peri-pandemic results concerning constant high well-being, study satisfaction, and the perception of conditions may be based on response shift effects that require further exploration. The scores exceeding the reasonable cut-point for identifying probable cases of generalized anxiety disorder and depression may reflect medical students' needs, calling for an in-depth analysis if further health promotion is necessary.
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Affiliation(s)
- Alexandra Huber
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Luna Rabl
- Department of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (L.R.); (T.H.-R.)
| | - Thomas Höge-Raisig
- Department of Psychology, University of Innsbruck, 6020 Innsbruck, Austria; (L.R.); (T.H.-R.)
| | - Stefan Höfer
- Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University of Innsbruck, 6020 Innsbruck, Austria
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Kanjee Z, Beltran CP, Smith CC, Tibbles CD, Lewis JJ, Sullivan AM. "Two Years Later I'm Still Just as Angry": A Focus Group Study of Emergency and Internal Medicine Physicians on Disrespectful Communication. TEACHING AND LEARNING IN MEDICINE 2023:1-11. [PMID: 38041804 DOI: 10.1080/10401334.2023.2288706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/07/2023] [Indexed: 12/04/2023]
Abstract
Phenomenon: Disrespectful behavior between physicians across departments can contribute to burnout, poor learning environments, and adverse patient outcomes. Approach: In this focus group study, we aimed to describe the nature and context of perceived disrespectful communication between emergency and internal medicine physicians (residents and faculty) at patient handoff. We used a constructivist approach and framework method of content analysis to conduct and analyze focus group data from 24 residents and 11 faculty members from May to December 2019 at a large academic medical center. Findings: We organized focus group results into four overarching categories related to disrespectful communication: characteristics and context (including specific phrasing that members from each department interpreted as disrespectful, effects of listener engagement/disengagement, and the tendency for communication that is not in-person to result in misunderstanding and conflict); differences across training levels (with disrespectful communication more likely when participants were at different training levels); the individual correspondent's tendency toward perceived rudeness; and negative/long-term impacts of disrespectful communication on the individual and environment (including avoidance and effects on patient care). Insights: In the context of predominantly positive descriptions of interdepartmental communication, participants described episodes of perceived disrespectful behavior that often had long-lasting, negative impacts on the quality of the learning environment and clinical work. We created a conceptual model illustrating the process and outcomes of these interactions. We make several recommendations to reduce disrespectful communication that can be applied throughout the hospital to potentially improve patient care, interdepartmental collaboration, and trainee and faculty quality of life.
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Affiliation(s)
- Zahir Kanjee
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Christine P Beltran
- Program for Medical Education Innovations and Research, New York University Grossman School of Medicine, New York, New York, USA
| | - C Christopher Smith
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Carrie D Tibbles
- Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jason J Lewis
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Amy M Sullivan
- Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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Bhalodi RG. Sink or Swim. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:622-623. [PMID: 37964086 DOI: 10.1007/s40596-023-01898-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/02/2023] [Indexed: 11/16/2023]
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