Empathy, burnout, life satisfaction, correlations and associated socio-demographic factors among Chinese undergraduate medical students: an exploratory cross-sectional study

Mobile Phone Addiction and Psychological Capital Mediates the Relationship Between Life Satisfaction and Learning Burnout in Chinese Medical Postgraduate Students: A Structural Equation Model Analysis

Purpose

To analyze the relationship between life satisfaction and learning burnout, and explore the mediating effect of mobile phone addiction and psychological capital, and to provide a theoretical basis for the study of measures for medical postgraduate students to maintain a positive psychological state and keep interest and enthusiasm in academic life.

Methods

Convenience cluster sampling was used to recruit 628 medical postgraduate students in Chongqing, China. The Learning Burnout Questionnaire (LBQ), life satisfaction self-rated item, Mobile Phone Addiction Tendency Scale (MPATS), and the Psychological Capital Questionnaire (PCQ) were used to examine participants. Hierarchical regression was used to analyze the effect of life satisfaction, mobile phone addiction, and psychological capital on learning burnout. A structural equation model (SEM) with maximum likelihood was used to evaluate the mediating effect of mobile phone addiction and psychological capital on the relationship between life satisfaction and learning burnout. The bootstrap method was used to confirm the significance of the mediating effect.

Results

The average learning burnout score was (55.81±10.55). Results of hierarchical regression revealed that life satisfaction and psychological capital had a significant negative predictive effect on learning burnout, and mobile phone addiction had a positive predictive effect on learning burnout (p<0.05). The SEM revealed that the total and direct effects of life satisfaction on learning burnout were significant, and the mediating effects of mobile phone addiction and psychological capital between life satisfaction and learning burnout were significant (p<0.05).

Conclusion

Life satisfaction is a direct predictor of learning burnout among Chinese medical postgraduate students, and this relationship is mediated by mobile phone addiction and psychological capital.

Academic burnout syndrome among medical students in Serbia: prevalence of high risk and determinants

BACKGROUND

Although burnout syndrome has been described in numerous research studies, the data on burnout syndrome among medical students in developing countries is scanty. This study aimed to determine the prevalence of high-risk for burnout syndrome and its associated factors among university undergraduate medical students in Serbia.

METHODS

An observational, analytical, cross-sectional study was conducted using the Maslach Burnout Inventory-Student Survey and a survey on associated factors. The research was carried out from February to March 2014. Multivariate logistic regression was used to determine the adjusted odds ratio (Odds Ratio, OR) with 95% Confidence Interval (95%CI) in order to identify independent correlates of high risk of burnout syndrome.

RESULTS

A high risk for burnout syndrome was noted in 15.0% of respondents; that is, 114/760 medical students suffered from high emotional exhaustion, high cynicism, and low academic efficiency. According to the results of multivariate logistic regression, the main significant independent correlates of high risk for burnout syndrome in medical students were: age of students (for aged 22-24: adjusted OR = 5.64, 95%CI = 2.58-12.34, p < 0.001 for aged ≥ 25: adjusted OR = 5.65, 95%CI = 2.08-15.39, p = 0.001) with p for trend < 0.001, higher frequency of alcohol consumption (for habit 1-2 times a week: adjusted OR = 2.01, 95%CI = 1.01-4.03, p = 0.048) with p for trend = 0.025, and use of sedatives (adjusted OR = 3.44, 95%CI = 1.31-9.04; p = 0.012).

CONCLUSION

The present study identified several factors associated with burnout syndrome in Serbian medical students. Some factors associated with the high risk of burnout syndrome in medical students are modifiable. It is important to carry out similar research on burnout syndrome in the future, especially using longitudinal studies, in order to evaluate the associations found in this cross-sectional study.

Cognitive empathy variations during internship: a study from Iran

OBJECTIVE

Despite the critical role of empathy in medical students, various studies have provided conflicting evidence regarding changes in empathy during medical study. The present study was designed to investigate changes in cognitive empathy during the internship.

METHOD

A study was conducted at the Afzalipour School of Medicine, Kerman University of Medical Sciences. All medical students at the beginning of their internship were entered the study as a cohort and asked to complete a two-part questionnaire including demographic characteristics and the Persian version of the Jefferson Scale of Empathy-Student Version (JSE-S). The questionnaire was completed again at the end of the internship. Data were analyzed using SPSS software using paired t- test and one-way repeated measures.

RESULTS

A total of 108 interns participated with a mean age of 23.85 ± 1.47 years, and a female majority (61.1%). The mean score of standing in the patient's shoe increased significantly (P < 0.001) during the internship, whereas the mean score of compassionate care decreased (P < 0.001). The overall score of empathy decreased during the internship, but the difference was not statistically significant. (P = 0.105). No statistically significant difference was found in the mean score of empathy and its subscales based on demographic characteristics in the two phases of the study.

CONCLUSION

our results revealed that the level of cognitive empathy in the current study was higher than that in previous studies. The changes were consistent with some studies and contradictory to others. Considering that similar changes were observed in the subgroup analysis, it is necessary to focus more on the factors that cause this feeling to fade during the internship through appropriate assessment and timely intervention.

Engaging nursing students with a behaviour change intervention designed to improve their lifestyle

BACKGROUND

In common with the general population, nursing students struggle to live a healthy lifestyle.

AIMS

To recruit students in a behaviour change intervention, using the COM-B model of behaviour change to understand engagement.

METHODS

Nursing students were invited to complete an online survey assessing height, weight, BMI, physical activity, lifestyle satisfaction, motivation for leading a healthy life, and quality of life. Those identified as overweight or not physically active were offered a webinar and social media site to support setting personal goals and boosting motivation to achieve a healthy lifestyle.

FINDINGS

25% of invited students engaged with the interventions, 19% attending a webinar and 19% joining the social media site. No statistically reliable differences between those who engaged and those who did not were identified.

CONCLUSION

Current models of behaviour change do not predict engagement. Interventions may need to be integrated into the curriculum to elicit change.

Empathy in undergraduate medical students: a multi-center cross-sectional study in China

BACKGROUND

Fostering empathy has been continuously emphasized in the global medical education. Empathy is crucial to enhance patient-physician relationships, and is associated with medical students' academic and clinical performance. However, empathy level of medical students in China and related influencing factors are not clear.

METHODS

This was a cross-sectional study among medical students in 11 universities. We used the Jefferson Scale of Empathy Student-version of Chinese version to measure empathy level of medical students. Factors associated with empathy were identified by the univariate and multivariate logistic regression analyses. Based on the variables identified above, the nomogram was established to predict high empathy probability of medical students. Receiver operating characteristic curve, calibration plot and decision curve analysis were used to evaluate the discrimination, calibration and educational utility of the model.

RESULTS

We received 10,901 samples, but a total of 10,576 samples could be used for further analysis (effective response rate of 97.02%). The mean empathy score of undergraduate medical students was 67.38 (standard deviation = 9.39). Six variables including gender, university category, only child or not, self-perception doctor-patient relationship in hospitals, interest of medicine, Kolb learning style showed statistical significance with empathy of medical students (P < 0.05). Then, the nomogram was established based on six variables. The validation suggested the nomogram model was well calibrated and had good utility in education, as well as area under the curve of model prediction was 0.65.

CONCLUSIONS

We identify factors influencing empathy of undergraduate medical students. Moreover, increasing manifest and hidden curriculums on cultivating empathy of medical students may be needed among medical universities or schools in China.

The impact of empathy on medical students: an integrative review

INTRODUCTION

Empathy is considered the ability to understand or feel others emotions or experiences. As an important part of medical education, empathy can affect medical students in many ways. It is still lacking a comprehensive evaluation of the existing articles on empathy's impact on medical students, despite the existence of many articles on the topic.

OBJECTIVES

To summarize the impact of empathy on medical students during medical education from four perspectives: mental health, academic performance, clinical competence, and specialty preference.

METHODS

The search terms used for retrieval were "empathy", "medical student", "mental health", "depression", "anxiety", "burnout", "examinations", "academic performance", "clinical competence", "specialty preference" on PubMed, EBSCO, and Web of Science before January 2024. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed based on inclusion/exclusion criteria. A consensus was drawn on which articles were included.

RESULTS

Our results indicated that high empathy was a positive factor for mental health, However, students with high affective empathy were more likely to suffer from depression, anxiety, and burnout. Empathy was found to be unrelated to academic performance, but positively correlated with clinical competence, particularly in terms of communication skills. Medical students with high levels of empathy tended to prefer people-oriented majors.

CONCLUSIONS

Medical students who score higher on the self-reported empathy scales often have better mental health, better communication skills, and tend to choose people-oriented specialties. But empathy is not related to academic performance. Additionally, the different dimensions of empathy have different impacts on medical students. It is necessary to design targeted courses and training for medical students to enhance their empathy.

Association between burnout and empathy in medical residents

BACKGROUND

Burnout is a work-related syndrome that can affect physicians' performance. Empathy is one of the clinical competencies in whose formation many factors play a role. Empathy and burnout are important topics of research in medical sciences, and both are related to the communication between the patient and the physician. This study investigated the relationship between occupational burnout and empathy among medical residents.

METHOD

This cross-sectional study was conducted on 297 medical residents in Ahvaz Jundishapur University of Medical Sciences from January to March 2021. The data collection tools were the Jefferson Scale of Empathy (JSE) and the Maslach Burnout Inventory (MBI). The reliability of the instruments was measured by calculating Cronbach's alpha. Data were analyzed by SPSS-18, using the Pearson correlation test and linear regression models.

RESULTS

The average age of the study population was 33.06 ±4.7 years, with more than half being females (57.6%) and married (51.9%). The residents' mean scores of empathy and overall burnout were 102.87 out of 140 and 55.90 out of 132, respectively. The burnout scores showed an inverse correlation with the overall empathy scores (r = -0.123, P = 0.035), and the score of standing in the patient's shoes (r = -0.165, P = 0.004). Linear regression test was used to detect which dimension of empathy was a better predictor for the reduction of burnout scores. Results showed that the best predictor was standing in the patient's shoes (P = 0.014).

CONCLUSION

The findings showed a negative association between empathy and burnout among medical residents, which suggests the need for adjustment of the existing burnout management at the institutional level. Therefore, residents should be supported by managers to reduce burnout and improve their empathic behavior.

A Network Analysis Study on the Structure and Gender Invariance of the Satisfaction with Life Scale among Spanish University Students

INTRODUCTION

The psychometric properties of the Satisfaction With Life Scale (SWLS) have been evaluated across numerous languages and population groups, primarily from a factor analysis perspective. In some studies, inconsistencies in structural invariance have been identified.

OBJECTIVE

This study aims to analyze the properties and gender invariance of the SWLS from a network analysis perspective.

METHOD

A total of 857 Spanish university students were obtained through a stratified random cluster sampling method in a cross-sectional survey design study. Descriptive analysis of the items, partial-correlation network, Bayesian network model estimation, and invariance analysis by gender were conducted.

RESULTS

The instrument did not exhibit any floor or ceiling effects. Each item can be considered univariately normally distributed, and all items clustered in a single and stable community. The partial-correlation network model and centrality measures were stable in the full sample and invariant across genders. Item 3 emerged as the most central node in the network with the highest predictability. The Bayesian network indicated that items 2 and 4 initiate the process, while item 5 acts as the sink, and items 1 and 3 act as mediators.

CONCLUSIONS

The SWLS can be used as a unidimensional measure, and the total score and relationships among items are stable and reliable. Any potential differences among genders cannot be associated with the functioning of the instrument. The predictability of every item was high, and the Bayesian network clearly identified different roles among the items.

Prejudice and determinants regarding tuberculosis patients among medical students in Dalian, Northeast China: a cross-sectional study

Background

Health workers play a central role in global tuberculosis (TB) elimination efforts. If medical students have prejudiced attitudes toward TB patients, this may make it difficult for them to provide effective health care to TB patients in their future roles as health workers. There is currently no research on prejudice toward TB patients among medical students in China. This study aimed to explore the current status of medical students' prejudice against patients with TB and its associated predictors.

Methods

We conducted a cross-sectional questionnaire survey among medical students at a medical university in Dalian, Liaoning Province, Northeast China. Multiple logistic regression analysis was employed to determine the predictive factors of medical students' prejudice against patients with TB.

Results

More than half (57.23%) of the medical students held prejudices against individuals with TB. Multivariate logistic regression analysis revealed that not receiving TB health education (OR: 2.12, 95% CI: 1.35-3.32), not knowing a person with TB (OR: 2.52, 95% CI: 1.39-4.56), and fear of TB/TB patients (OR: 6.79, 95% CI: 4.36-10.56) were identified as risk factors for medical students' prejudice against TB patients. Conversely, residing in rural areas (OR: 0.60, 95% CI: 0.38-0.95), agreeableness (OR: 0.82, 95% CI: 0.73-0.92) and emotional stability (OR: 0.90, 95% CI: 0.81-1.00) in the Big Five personality traits, and a better understanding of TB knowledge (OR: 0.58, 95% CI: 0.38-0.89) were identified as protective factors.

Conclusion

In China, a considerable number of medical students still exhibit prejudice against patients with TB. Targeted interventions, such as incorporating TB health education into the core curriculum of medical students, and enhance their agreeableness and emotional stability, are still needed. Furthermore, greater focus should be placed on medical students from urban backgrounds or those who harbor fear or do not know a person with TB.

A scoping review on the relationship between mental wellbeing and medical professionalism

BACKGROUND

Mental wellbeing issues among medical students are common, and their relationship to medical professionalism is debated. Few studies have attempted to link such issues with undergraduate medical education. This review aimed to advance the knowledge on this matter by exploring the relationship between mental wellbeing and medical professionalism in undergraduate medical education.

METHODS

We collected the literature about mental wellbeing and medical professionalism (published from 1 January 1986 to 31 March 2021) from the Web of Science, PubMed, Scopus and ScienceDirect databases using the search terms 'mental wellbeing' and 'medical professionalism'.We included all peer-reviewed articles in which mental wellbeing and medical professionalism in the undergraduate medical education context were the central topics regardless of the age range, nationality, race and gender of the participants.

RESULTS

From the 13,076 Iinitially found articles, 16 were included. These 16 articles were from nine countries in four different continents, which all together helped us find answer to our research question using extracted points relating to the main study themes (mental wellbeing and medical professionalism). Under theme 1 (mental wellbeing), six subthemes emerged: burnout, stress, depression, disappointment, depersonalisation and conscientiousness. Theme 2 (medical professionalism), on the other hand, had five subthemes: empathy, academic performance, compassion, unprofessional behaviour and professionalism. A significant inverse association was found between empathy and burnout. Academic performance was also related to burnout. At the same time, empathy was found to have a varied association with stress. Moreover, compassion was found to alleviate burnout and nurture professional gratification.

CONCLUSION

The medical professionalism attributes were found to deteriorate as the mental wellbeing issues grow. This can harm medical students' overall health, current learning abilities and future attitudes towards their patients. Explicit primary research is thus required to examine and intervene in the cause-effect relationship between medical professionalism and mental wellbeing.

Academic Motivation and Social Support: Mediating and Moderating the Life Satisfaction and Learning Burnout Link

Background

The phenomenon of university students' learning burnout has attracted the research of many scholars because of its typicality. This study aims to explore the relationship between life satisfaction, academic motivation, social support and learning burnout among university students and its underlying mechanisms.

Methods

A total of 1917 university students participated in this cross-sectional study. Research instruments included the Adolescent Student Life Satisfaction Scale, University Students' Academic Motivation Questionnaire, Adolescent Learning Burnout Scale and Adolescent Social Support Scale. The data analysis comprised descriptive statistics, correlation analyses, and assessment of multicollinearity through Variance Inflation Factor (VIF). Advanced analyses were conducted using Model 4 for mediation and Model 1 for moderation from the PROCESS macro.

Results

(1) life satisfaction significantly and positively predicts academic motivation; (2) academic motivation significantly and negatively predicts learning burnout; and (3) life satisfaction significantly and negatively predicts learning burnout; (4) academic motivation partially mediates the effect of life satisfaction on learning burnout; and (5) social support plays a moderating role in the effect of academic motivation on learning burnout.

Discussions

These results illuminate the complex web of relationships among life satisfaction, academic motivation, social support, and learning burnout. The partial mediating role of academic motivation underscores its significance in the link between life satisfaction and learning burnout. Additionally, the moderating impact of social support emphasizes its role in ameliorating or exacerbating the effects of academic motivation on learning burnout.

Conclusion

These findings can help researchers and educators better understand the underlying mechanisms between life satisfaction and learning burnout. Meanwhile, the results of the study can provide practical and effective operational suggestions for preventing and intervening in university students' learning burnout and improving their academic motivation.

Empathy levels among undergraduate medical students in Karachi, Pakistan: a cross-sectional study

Empathy is a concept native to the field of medicine. However, over the course of medical school, empathy levels are expected to decline. The aim of this study was to assess the empathy levels among medical students in relation to their year of study and specialties of choice in the future.

MATERIALS AND METHODS

A cross-sectional study was conducted to assess empathy levels among students from medical colleges in Karachi, Pakistan, using an online survey. The total duration of the study was 2 months. The authors analyzed the data using SPSS version 20.

RESULTS

A total of 463 undergraduate medical students participated in this survey. The overall mean empathy score was 101.9±16.3 with 104.6±14.1 for females, which was significantly higher than the male participants. The highest empathy levels were demonstrated in fourth-year medical students with a mean empathy score of 104.1±16.3, whereas, the lowest empathy levels were found in second-year medical students with a mean empathy score of 99.8±9.4. Study participants considering emergency medicine, neurology, obstetrics/gynecology, and oncology as their specialty of choice demonstrated the highest empathy levels followed by pediatrics and internal medicine.

CONCLUSION

On average, there was a female preponderance in empathy levels among undergraduate medical students. Empathy levels among fourth-year students involved in clinical practice were greater as compared to students in their initial years of study. Further investigations are required to validate the findings of this study.

The relationship between the burnout syndrome and academic success of medical students: a cross-sectional study

The burnout syndrome may affect academic achievement, but research on burnout and academic success of medical students is sparse. This research aimed to estimate the prevalence of high risk of burnout in students of medicine and to investigate its association with academic performance. It included 760 full-time medical students who completed the survey (response rate = 90.9 %). A significant independent predictor for high burnout risk in students with lower grade point average (GPA) was male gender (adjusted OR=2.44; 95 % CI=1.14-5.23; P=0.022). Among students with higher GPA, high burnout risk was associated with the use of sedatives (adjusted OR=6.44; 95 % CI=1.80-22.99; P=0.004).

The effect of maternal empathy on infants' attachment security: Moderation by maternal emotion regulation and infant temperament

This study examined the relationship between maternal empathy and infants' attachment security and tested the moderating effects of maternal emotion regulation and infant negative emotional temperament. Participants were sampled from 215 families whose infants were 6 months old (T1) and from 170 families of the same cohort whose infants were 14 months old (T2). At T1, mothers were measured for their empathy (empathic concern and perspective taking), emotion regulation (reappraisal and suppression), and infant negative emotional temperament (sadness, falling reactivity, fear, and distress to limitations). At T2, mothers were again measured for their emotion regulation, and infant attachment was measured using the Strange Situation Procedure. Maternal empathic concern (EC) and perspective taking (PT) were found to be positively related to infant attachment security, while maternal reappraisal and infant temperamental sadness moderated the relationship between maternal PT and infant attachment security. No significant moderation effects were found between maternal EC and infant attachment security. Simple slope results showed that for infants with higher maternal reappraisal or infant sadness, maternal PT could positively predict infant attachment security. These findings highlight the importance of how the individual characteristics of mothers and infants may interact with maternal empathy during the critical period of infant attachment formation.

Translation and validation of the Chinese version of the Friedman life balance scale among nursing students: A psychometric analysis

AIM

To conduct a Chinese translation and validation of the Friedman Life Balance Scale (FLBS).

BACKGROUND

Prevalence of mental disorders is high among nursing students. Life balance is important for nursing students, which may help them increase efficiency in their studies and develop physical and psychological health. Yet, little is known about life balance in nursing students. Therefore, it is crucial to evaluate the status of life balance of the students to lay the foundation for exploring its associated factors.

DESIGN

A multi-centre cross-sectional design.

METHOD

The study was comprised of 420 nursing students from 15 hospitals and two educational institutes in East, North and Northeast China from July 2021 to January 2022. The Chinese version of the FLBS was translated and adapted based on published, standardized, international guidelines. Psychometric evaluation included floor and ceiling effects, factorial validity, convergent validity, discriminant validity, internal consistency, test-retest reliability, diagnosis accuracy and calibration. The tests used for validity included floor and ceiling effects, confirmatory factor analysis, average extracted variance (AVE) value, composite reliability, correlations with life satisfaction and subjective well-being. The tests used for reliability incudes Cronbach's alpha and intraclass correlation coefficients. Diagnosis accuracy was tested by the area under the curve and calibration was tested by Hosmer-Lemeshow goodness-of-fit test.

RESULTS

The Chinese version of the Friedman life balance scale did not demonstrate floor or ceiling effect, showing content validity is not limited. Confirmatory factor analysis showed acceptable model fit after it was modified. Convergent validity and discriminant validity of the Friedman life balance scale were supported, except subscales two and three were not discriminated well by AVE technique. The internal consistency was acceptable and the test-retest reliability was good with 0.858. The area under the curve was 0.762 and the optimal cut-off point for depressive symptoms was 44. Hosmer-Lemeshow goodness-of-fit test showed the calibration to be acceptable. Life balance is moderate among Chinese nursing students. The subscale "self-forgive, compassion, love" had the highest correlations with well-being and life satisfaction.

CONCLUSIONS

The Chinese version of the Friedman life balance scale is a suitable instrument for assessing life balance in Chinese-speaking contexts. It also may have potential utility in identifying nursing students with or without depressive symptoms that may need further examination. Future work should examine additional samples of Chinese nursing students, as well as, perhaps other student populations to determine the extent to which the psychometric properties of the FLBS generalize to other students and contexts.

Reflection, Sense of Belonging, and Empathy in Medical Education-Introducing a "Novel" Model of Empathetic Development by Literature

Empathy, self-reflection, and inclusion of the medical humanities in medical education are increasingly gaining attention. This seems prudent, as studies indicate that high physician empathy is associated with better patient outcomes and could protect against physician burnout. In addition, utilizing self-reflection has been reported to surge diagnostic accuracy and increase the ability of clinical health care providers. Therefore, in medical education, there is a need to address these, however intricate, most important skills. Not oblivious to this, for decades many medical schools have reaped experience from the humanities, sprouting the field of the medical humanities. However, significant barriers encountered when teaching the medical humanities to medical students are of concern. Consequently, a theory-based, inclusive, representative, and intuitive approach to the teachings is coveted. The aim of this article is to describe and present such an approach. To this end, I introduce a novel Model of Empathetic Development by Literature, schematizing the path from reading a text to displaying an act of empathy. Ever mindful of the relevance and feasibility to medical students, this article reflects on thoughts and evidence behind the hypothesis; that sense of belonging, self-reflection, and empathy could be gained by reading and discussing literary fiction. Referring to both original research articles, books of popular science, and philosophical considerations, a clear line of reasoning for the inclusion of literary fiction in medical education is made. Thereafter, it is outlined, how-in a medical humanities course at Copenhagen University-specific literary excerpts are utilized to bring forth reflection on different aspects, circumstances, and conditions of being a physician, thereby kindling the medical students' sense of belonging to their profession. As such, this perspective piece demonstrates a concrete approach to how a literary educative technique could manifest.

Physical activity, sleep quality and life satisfaction in adolescents: A cross-sectional survey study

Background

Physical activity, sleep is an important component of adolescents' 24-h movement behavior, and life satisfaction predicts adolescent physical and mental health. However, few studies have explored the relationship between the two variables among Chinese high school students. Consequently, this study aimed to explore the relationship between sleep quality and life satisfaction among Chinese high school students.

Methods

This cross-sectional study was conducted in October 2020 in five high schools in Xuchang City, China. High school students from senior 1 to senior 3 were asked to fill up a questionnaire of demographic characteristics and validated screen instructions for sleep quality (Pittsburgh Sleep Quality Index) and life satisfaction (Satisfaction with Life Scale). The multivariate regression model was applied to explore the association between sleep quality and life satisfaction.

Results

A total of 1127 individuals (51.1% males) participated in this survey, and the prevalence of poor sleep quality was 42.3%. The mean score on the Satisfaction with Life Scale was 16.72 ± 5.67, according to the corresponding scoring criteria, with 15-19 being generally dissatisfied. After controlling for demographic variables, the contribution of subjective sleep quality (β = - 0.181, p < 0.01), sleep duration (β = - 0.080, p < 0.01) and daytime dysfunction (β = - 0.311, p < 0.01) to life satisfaction of high school students increased to 23.2%, indicating that subjective sleep quality, sleep duration, and daytime dysfunction were 22.9% predictive of life satisfaction among high school students. And also, physical activity on schooldays and weekend days were associated with better sleep quality and higher life satisfaction (p < 0.05).

Conclusions

Among Chinese high school students, the prevalence of sleep problems was high, and the majority of students held moderate life satisfaction. Sleep quality was positively correlated with life satisfaction among Chinese high school students, with better sleep quality resulting in higher life satisfaction among students.

Effectiveness of mindfulness-based interventions on empathy: A meta-analysis

Empathy is essential for human survival and social interaction. Although mindfulness-based interventions (MBIs) have been used to improve empathy in healthy populations, its therapeutic efficacy remains unknown. This study aims to investigate the therapeutic effects of MBIs on empathy in a healthy population and the potential factors affecting the efficacy of MBIs. The literature search focused on PubMed, Embase, Web of Science, Cochrane Library, and CNKI from inception to September 2022. Randomized controlled trials and quasi-experimental studies reporting the effects of using MBIs on empathy in healthy populations were included. A total of 13 studies were included in this review. Results of the meta-analysis showed that MBIs improved empathy (SMD, 0.372, 95% CI, 0.164-0.579, p = 0.001) in the healthy population compared with that in the control group. Moreover, results of the subgroup analysis showed that intervention dose (over 24 h vs. under 24 h), format (online vs. offline), and types (different types) were important factors affecting treatment outcomes. This comprehensive review suggests that MBIs are effective treatment for empathy in healthy population. Future research should markedly focus on large-sample, rigorously designed experiments to explore the long-term effects of MBIs on empathy and to elucidate the underlying mechanisms of MBIs. This study provides a reference for the daily application of MBIs.

First-year nursing students' initial contact with the clinical learning environment: impacts on their empathy levels and perceptions of professional identity

Background

Research shows that the clinical learning environment can affect medical learners’ levels of empathy and formation of professional identity. However, few studies examined the impacts of early exposure to the clinical learning environment on first-year nursing students’ empathy levels and professional identity perceptions.

Aim

This study aimed to explore effects of initial contact with the clinical learning environment on first-year nursing students’ empathy levels and perceptions of professional identity.

Methods

This is a mixed-methods study conducted in a medical university and its affiliated hospital in Northeast China. For quantitative analysis, 220 first-year nursing students finished Interpersonal Reactivity Index (IRI) twice before and after their five-day clinical placement in the hospital in June, 2021. Paired samples t tests were used to explore the changes in first-year nursing students’ cognitive empathy, affective empathy and total empathy levels as measured by IRI before and after the clinical placement. For qualitative analysis, 15 first-year nursing students’ diary recording their clinical learning experiences were analyzed. An inductive thematic analysis approach was adopted to extract themes from the content on professional identity in nursing students’ diary.

Results

After the five-day clinical placement, first-year nursing students’ cognitive empathy, affective empathy and total empathy levels all increased. Five themes emerged regarding nursing students’ perceptions of professional identity: (1) Love for the nursing profession; (2) Multiple roles nurses play; (3) Personal characteristics a good nurse needs to have; (4) Deeper understanding of the nursing profession; (5) New understanding of the relationships between patients and nurses, between patients and doctors, and between doctors and nurses.

Conclusions

First-year nursing students’ initial contact with the clinical learning environment helped them enhance empathy levels and shape professional identity. Nursing educators may consider providing nursing students with opportunities of early exposure to the clinical learning setting to cultivate their empathy and develop their professional identity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-022-01016-8.

Mental health conditions and academic burnout among medical and non-medical undergraduates during the mitigation of COVID-19 pandemic in China

The outbreak of the novel coronavirus disease 2019 (COVID-19) has posed a great impact on people's mental health, especially for undergraduate students. This study aimed to compare the mental health conditions and academic burnout between medical and non-medical undergraduates in China when the COVID-19 pandemic is mitigating. A cross-sectional online survey was conducted among 4,972 undergraduates between October 2020 and April 2021, when the pandemic was basically under control. The survey included basic demographics information and standardized scales to evaluate depression, anxiety, perceived stress, daytime sleepiness, alcohol abuse/dependence, quality of life, fatigue, and academic burnout. Compared with medical undergraduates, non-medical undergraduates had higher rates of moderate to severe depression symptoms (29.1% vs. 17.9%, P < 0.001), moderate to severe anxiety symptoms (19.7% vs. 8.9%, P < 0.001), alcohol abuse/dependence (16.3% vs.10.3%, P < 0.001), excessive daytime sleepiness (47.4% vs. 43.4%, P = 0.018), high perceived stress (34.7% vs. 22.2%, P < 0.001), high level of fatigue (51.8% vs. 42.2%, P < 0.001), low QOL (35.8% vs. 21.4%, P < 0.001), and higher academic burnout score (59.4 vs. 57.5, P < 0.001). Being non-medical undergraduates, depression, alcohol abuse/dependence, excessive daytime sleepiness, and high perceived stress were positively associated with academic burnout, while high QOL was negatively associated with the burnout (all P < 0.001). Excessive daytime sleepiness was the strongest predictor for academic burnout.

Different scoring methods of the VARK questionnaire to evaluate dentistry Students' learning styles

INTRODUCTION

The way students process and organise information to facilitate learning is known as learning style. Knowing one's learning style can improve learning and help teachers choose their teaching methods more effectively. This study was conducted to investigate different scoring methods of the VARK questionnaire and compare different learning styles in different stages of dental school.

MATERIALS AND METHODS

Students in three stages of the dental school participated in this study: basic sciences, preclinical and clinical. The validated reliable Persian VARK questionnaire was utilised. Collected data were computed and analysed in three ways: raw, normalised and weighted scoring by ANOVA and chi-squared tests (α = .05).

RESULT

The most favoured learning style was auditory; however, the prevalence of other learning styles varied through stages. On analyses of visual and auditory learning styles by all methods of scoring, no significant difference was seen in different stages (study time). The kinetic learning style, using normalised scoring method, was used more significantly when the grade increased (p-value = .028). However, in the weighted method, this effect was not significant. The read-write learning style using all three scoring methods showed an inverse relationship with the level of education (p-value <.05), which means the tendency to use this style of learning decreased when the level of education increased.

CONCLUSION

As the educational level increases, students are more inclined to use kinetic and less likely to employ read-write learning style. There was not a significant difference in the use of visual and aural learning styles in any stages of dental school.

Associations between academic burnout, resilience and life satisfaction among medical students: a three-wave longitudinal study

BACKGROUND

Research shows that there are connections among academic burnout, resilience, and life satisfaction in medical students. However, no study has yet examined the temporal relationships between academic burnout, resilience, and life satisfaction among medical students. This longitudinal study aimed to examine the temporal associations between academic burnout, resilience, and life satisfaction and to explore the possible mediating role of resilience in the relationship between academic burnout and life satisfaction among medical students.

METHODS

This is a three-wave longitudinal study covering the preclinical education period of 20 months. From October 2018 to June 2020, a total of 190 students majoring in clinical medicine filled out the Chinese College Student Academic Burnout Inventory (CCSABI), the Connor-Davidson Resilience Scale (CD-RISC) and the Satisfaction With Life Scale (SWLS) three times. Cross-lagged models were constructed to examine the temporal relationships between academic burnout, resilience, and life satisfaction and longitudinal mediation models were constructed to explore the possible mediating role of resilience in the association of academic burnout with life satisfaction.

RESULTS

Among medical students, resilience uni-directionally and positively predicted life satisfaction, while academic burnout uni-directionally and negatively predicted life satisfaction. However, the temporal association between resilience and academic burnout was negative and somewhat bidirectional. Resilience had a significant mediating effect on the relationship between academic burnout and life satisfaction in medical students.

CONCLUSIONS

Medical educators need to identify and take effective measures to combat academic burnout problems which can lead to reduced life satisfaction among medical students. Resilience-based interventions may be promising in buffering the negative impacts of academic burnout and improving life satisfaction. It is recommended that effective resilience-promotion interventions be developed and implemented in medical education to help enhance medical students' psychological well-being.

Family function and life satisfaction of postgraduate medical students during the COVID-19 pandemic: the mediating role of meaning in life and depression

Recent studies have documented life satisfaction of people have changed during the COVID-19 pandemic. However, it is unknown about the influential factors and mechanisms of life satisfaction of postgraduate medical students during the COVID-19 pandemic. There is a strong link among life satisfaction and individual quality of life and achievement, so it is important to explore the influence mechanism of life satisfaction of postgraduate medical students and explore ways to improve life satisfaction for the development of postgraduate medical students. The current study was based on the Circumplex Model of Marital and Family System, The Theory of Family Functioning, The Meaning Maintenance Model, The Theory of Personal Meaning and Existential Theory to construct theoretical framework and examine whether meaning in life and depression would mediate the link between family function and postgraduate medical students' life satisfaction. By convenient sampling method, a total of 900 postgraduate medical students (Mage = 27.01 years, SD = 3.33) completed questionnaires including Family APGAR Scale, Chinese Version of Meaning In Life Questionnaire, Patient Health Questionnaire, and Satisfaction With Life Scale. In this study, SPSS 25.0 was used for correlation analysis, regression analysis and common method bias test, and AMOS 23.0 was used for structural equation modeling analysis. The results showed that (a) family function could predict life satisfaction of postgraduate medical students significantly; (b) both meaning in life and depression mediated the association between family function and life satisfaction in a parallel manner; (c) meaning in life and depression sequentially mediated the link between family function and life satisfaction of postgraduate medical students. The study illuminates the role of meaning in life and depression in improving life satisfaction and implies that it is necessary to focus on the changes of life satisfaction of postgraduate medical students during the COVID-19 pandemic, and medical educator can improve the sense of meaning in life of postgraduate medical students through improving their family function, further decreasing the risk of depression, finally improving their life satisfaction.

Development of student empathy during medical education: changes and the influence of context and training

PURPOSE

Empathy levels have been observed to often decrease when medical undergraduates move to the clinical years, particularly in the Western countries. However, empathy either remains similar or increases in many Asian medical schools. This study investigated the longitudinal empathy profile of medical students in Singapore.

METHODS

Two cohorts of medical students who enrolled in 2013 and 2014 to the National University of Singapore were tracked for 5 years. The Jefferson Scale of Empathy-student version was used. Analyses on the mean of the empathy level and individual factors, year-wise and gender comparison were conducted.

RESULTS

Average response rates for cohort 1 and 2 were 68.1% (n=181-263) and 55.4% (n=81-265), respectively. For both cohorts, there was no significant change across year of study in the mean empathy score. Average scores for both cohorts were 113.94 and 115.66. Though not significant, we observed mean empathy to be lowest at the end of year 5 (112.74) and highest in year 2 (114.72) for cohort 1 while for cohort 2, the lowest level of empathy was observed in year 5 (114.20) and highest in year 4 (118.42). Analysis of subcomponents of empathy only showed a significant difference for cohort one factor 1 (perspective taking) and factor 3 (standing in patients' shoes) across the study years.

CONCLUSION

No significant change in empathy score was observed during the transition from pre-clinical to clinical years, unlike many Western and Far-Eastern studies. This might be due to the curriculum and influence of the Asian values.

Factors Influencing Residents' Specialty Choices and Satisfaction: Impact of Gender, Career Motivation and Life Goals

OBJECTIVE

Resident physicians working in medical specialties play an essential role in the makeup of the healthcare workforce. However, there is little theoretical understanding of how different medical specialties are perceived or how residents' choices are made. Many factors can influence resident physicians' choice of specialty. Previous studies have looked at personality differences within specialties, but were unable to describe the heterogeneity of viewpoints that existed within each specialty. Our objective, was to gather information about factors related to resident's life goals and career motivation as a means of improving residency program design and enhancing the college's advisory capacity.

DESIGN

Our study used a self-report anonymous questionnaire to characterize the relationship between resident physicians' preferences and their choice of specialty.

SETTING

King Saud University & King Saud University Medical City.

PARTICIPANTS

353 residents.

RESULTS

The majority of respondents reported that their current specialty was one of their top three choices. Almost half were satisfied with their residency program, and 24.1% were very satisfied. Gender, specialty, and workload demonstrated significant associations with residency program satisfaction.

CONCLUSIONS

Our findings highlight the effects of career motivation and life goals for resident physicians in enhancing their career satisfaction. Ensuring that residents are able to find time for personal needs has important consequences for their perceptions of wellbeing and may be an effective strategy for promoting career satisfaction.

Associations Between Maladaptive Perfectionism and Life Satisfaction Among Chinese Undergraduate Medical Students: The Mediating Role of Academic Burnout and the Moderating Role of Self-Esteem

Empirical research has shown that maladaptive perfectionism may lead to lower life satisfaction. However, the relationship between maladaptive perfectionism and life satisfaction among medical students and the mechanism underlying this relationship still need to be further explored. The present study used a large sample of undergraduate medical students to examine the associations between maladaptive perfectionism and life satisfaction and to explore the mechanism underlying the associations. Specifically, the present study tried to probe the mediating role of academic burnout and the moderating role of self-esteem in the relationship between maladaptive perfectionism and life satisfaction in medical students. We invited 1628 undergraduate medical students from two medical universities in Northeastern China to participate in the survey. Among the students recruited, 1377 medical students (response rate: 84.6%) completed questionnaires including the Frost Multidimensional Perfectionism Scale (FMPS) maladaptive perfectionism subscales, the Chinese College Student Academic Burnout Inventory (CCSABI), the Satisfaction With Life Scale (SWLS), the Rosenberg Self-Esteem Scale (RSES) and demographic information. Results show that maladaptive perfectionism was significantly negatively related to life satisfaction among medical students and academic burnout played a significant mediating role (β = -0.10, BCa 95%CI: -0.12, -0.07) in this relationship. Moderated mediation analyses reveal that the mediating effect of maladaptive perfectionism on life satisfaction via academic burnout was moderated by self-esteem. Maladaptive perfectionism exerted a stronger effect on life satisfaction via the mediating role of academic burnout for medical students with high self-esteem [β = -0.026, SE = 0.009, 95%CI = (-0.047, -0.011)] than for medical students with low self-esteem [β = -0.019, SE = 0.009, 95%CI = (-0.038, -0.001)]. Medical institutions can implement effective interventions to decrease medical students' maladaptive perfectionism levels and academic burnout levels, and increase their self-esteem levels in order to enhance their life satisfaction.

Trajectories of Health Status during the Transition from School to University: Piloting the Method of Biographical Mapping in German Medical Students

Health status and health behavior change during the transition from school to university. However, it is still unclear whether these changes occur at specific points in time, and whether these changes are stable. Therefore, our aim was to conduct a pilot test on biographical mapping (BM) for the first time in this research area in order to map the trajectories of the health status of university students over time. This enabled us to also test the practicability of BM, and to assess the agreement of the findings of BM with those of a standardized questionnaire. We included 30 fourth-year university students. First, they filled in a standardized questionnaire on their sociodemographic information, current health status, and health status compared with that for their final year of school. Second, they filled in a BM grid that allows for drawing the changes in health status that have taken place over the transition period. The health status changed during the transition (e.g., slight decline in general subjective health), and was related to specific events before and after the transition (e.g., examinations), showing that all health variables were not stable over time. The findings of BM were also reflected in the standardized questionnaire. Using BM revealed the changes in health during a six-year-period, including the school-university transition. The identified changes in health during transition and at specific time points underline that not only assistance before the transition, but also psychological support during studies, seems to be important for the health promotion of students. Besides this, BM seems to be a useful, although time-consuming, instrument for which the results were similar to those in the questionnaire.

Improvement of the management of mental well-being and empathy in Chinese medical students: a randomized controlled study

BACKGROUND

Among Chinese medical students, there is a high prevalence of mental health-related issues and low empathy. Effective strategies to improve this situation are lacking. This study aims to investigate the efficacy of the intervention courses designed to enhance the mental health and empathy of senior Chinese medical students.

METHODS

A total of 146 3rd - and 4th -year medical students were randomized to an intervention group (n = 74) and a control group (n = 72). A pilot study including 5 pre-clinical students and 5 interns was first carried out to determine the themes and content of the intervention courses. The designed courses were delivered in the intervention group once a month three times, while the control group had no specific intervention. Five self-assessment questionnaires, including the General Self-Efficacy (GSE) scale, Medical Outcomes Study Short Form 8 (SF-8), Patient Health Questionnaire-9 (PHQ-9), Maslach Burnout Inventory (MBI), and Jefferson Scale of Empathy-Health Care Provider Student version (JSE-HPS), were completed by the students before and one month after the courses to evaluate their levels of self-efficacy (SE), quality of life (QoL), depression, burnout, and empathy, respectively. Qualitative data were collected via e-mail two years after the intervention.

RESULTS

Compared to the control group, the intervention group showed significantly higher scores for empathy (111.0 [IQR 102.0, 118.0] vs. 106.0 [IQR 93.0, 111.5]; P = .01) and QoL (32.0 [IQR 28.0, 35.0] vs. 29.5 [IQR 26.0, 34.0]; P = .04). The rate of depression was significantly lower in the intervention group than in the control group (13.5 % vs. 29.2 %; chi-square test, P = .02). However, no significant differences in self-efficacy (25.6 ± 4.8 vs. 24.3 ± 6.3; P = .16) or burnout (27.0 % vs. 34.7 %; Chi-square test, P = .31) were observed between the two groups.

CONCLUSIONS

The intervention courses had a positive impact on mental well-being and empathy in senior Chinese medical students, which might help provide novel information for their incorporation into the medical school curriculum.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02645643; Date of registration: 05/01/2016.

Heart and Head: Profiles and Predictors of Self-Assessed Cognitive and Affective Empathy in a Sample of Medical and Health Professional Students

For medical and health professions, students learning to respond to others' distress with well-regulated empathy is an important developmental skill linked to positive health outcomes and professionalism. Our study aimed to investigate the sociodemographic, psychological, and psychosocial differences between medical (MS) and health professional (HPS) students and their empathic abilities, since both populations share common stressors, namely, dealing with suffering people. Additionally, we were interested in assessing the psychological and psychosocial predictors of empathy of MS compared to HPS. One hundred thirty MS and 86 HPS were administered the Patient Health Questionnaire-9, Interpersonal Reactivity Index, Integrative Hope Scale, and UCLA Loneliness Scale. The two groups showed differences in their contextual characteristics, with the HPS group having larger families, lower parents' education levels, and lower family income compared to the MS group. In both groups, ~15% of students reported previous contact for psychological problems. A higher proportion of HPS (23.3%) reported depressive symptoms than MS (10%), and female HPS reported more intense feelings of loneliness than other subgroups of students. No differences were found between the two groups in self-assessed cognitive and affective empathy. In both groups, women showed greater affective scores than men and, at the same time, seemed to be particularly prone to personal distress. The cognitive empathic dimension of “perspective taking” was predicted by young age (OR, 612; 95% CI, 1.395–15.242) and the overall socioeconomic status (OR, 3.175; 95% CI, 1.154–8.734) of the HPS. Self-assessed affective competence was predicted by female gender (OR, 3.112; 95% CI, 1.328–7.288), depressive symptomatology (OR, 2.777; 95% CI, 1.004–7.681), higher mother's level of education (OR, 2.764; 95% CI, 1.147–6.659), and feeling of hope related to social relationships (OR, 1.367; 95% CI, 1.152–1.622). Risk factors for poor self-assessed affective emphatic skills were previous contact for psychological problems (OR, 3.263; 95% CI, 1.238–8.601) and feelings of loneliness (OR, 1.18; 95% CI, 1.09–1.276). Our findings emphasize the need to test psychosocial models to better understand empathic skills.

Empathy and COVID-19: Study in Professionals and Students of the Social Health Field in Ecuador

Empathy plays a fundamental role in health related occupations. In this study, we analysed empathy levels in professionals (117) and students (170) from various healthcare fields in Ecuador during the COVID-19 pandemic. The Interpersonal Reactivity Index was used in an online survey. The results show high levels of empathy in both groups, influenced by age and gender. The students presented higher levels of personal distress, and their age was negatively correlated to empathy. Additionally, professionals working in physical health scored higher levels of personal distress compared to those in the field of emotional health. COVID-19 has placed social health systems in great stress. Despite this, the personal capacities for empathy of both students and health professionals have not been diminished.

Implementation of the college student mental health education course (CSMHEC) in undergraduate medical curriculum: effects and insights

BACKGROUND

Extant literature reveals that medical students suffer from various mental health problems in the process of learning medicine. However, there are few studies evaluating the implementation of a mental health education course in medical curriculum. The current study aimed to test the effectiveness of an 8-week intensive mental health education course, the College Student Mental Health Education Course (CSMHEC), and to gain further insights on how the course could be improved from students' feedback.

METHODS

This is a quasi-experimental study with both quantitative and qualitative analyses. We recruited 374 first year medical students as our subjects with 188 (age = 17.97 ± 0.65 years, 37.2% male) for the experiment group and 186 (age = 18.02 ± 0.63 years, 40.3% male) for the control group. For quantitative analysis, Depression Anxiety Stress Scales-21 (DASS-21), Chinese College Student Academic Burnout Inventory (CCSABI) and Satisfaction With Life Scale (SWLS) were used and a 5-point Likert scale was used to indicate students' overall satisfaction with CSMHEC. For qualitative analysis, a thematic analysis method was adopted to gain insights from the feedback of medical students.

RESULTS

Medical students in the experiment group saw a significant decline in psychological distress (p < 0.001, d = 0.31) and academic burnout (p < 0.001, d = 1.46), while they experienced a significant increase in life satisfaction levels after the intervention (p < 0.001, d = 0.48). Compared with students in the control group, students in the experiment group had statistically significant lower levels of psychological distress (p < 0.05, d = 0.23) and academic burnout (p < 0.001, d = 0.70), but statistically significant higher levels of life satisfaction in the post-test (p < 0.01, d = 0.31). Most students in the experiment group were satisfied with CSMHEC and themes extracted in the thematic analysis shed light on how the course could be improved.

CONCLUSIONS

Implementing a mental health education course like CSMHEC in medical curriculum can be effective in helping medical students improve psychological health. More research needs to be conducted on further refinement and better design of such a course to implement in medical education.

Published Research on Burnout in Nursing in Spain in the Last Decade: Bibliometric Analysis

Scientific production in the last decades has evidenced an increase in burnout syndrome in healthcare professionals. The objective of this bibliometric study was to analyze scientific productions on burnout in nurses in 2009–2019. A search was made on the Web of Science database on burnout in nursing. The variables evaluated were number of publications per year, productivity based on the journal and relationships between authors. Data were analyzed using Bibexcel software, and Pajek was used to visualize the co-authorship network map. A total of 1528 publications related to burnout in nurses were identified. The years with the most productivity were 2016 to 2017, when the publication rate increased noticeably over previous years. The Spanish journal with the most production on the subject was Atención Primaria. The co-authorship network analyzed illustrated collaboration patterns among the researchers. Scientific publications on the subject have increased in recent years due to problems in the healthcare system, which is in need of prevention and intervention programs for healthcare professionals.