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Nguyen T, Pu C, Waits A, Tran TD, Balhara YPS, Huynh QTV, Huang SL. Sources of stress, coping strategies and associated factors among Vietnamese first-year medical students. PLoS One 2024; 19:e0308239. [PMID: 39089322 PMCID: PMC11290621 DOI: 10.1371/journal.pone.0308239] [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: 05/24/2023] [Accepted: 07/10/2024] [Indexed: 08/03/2024] Open
Abstract
OBJECTIVES This study aims to examine the sources of stress among first-year medical students; the frequency of their coping strategies; the factors associated with specific stressors and specific coping strategies adopted by the participants. METHODS We conducted a cross-sectional study with 409 first-year students at the University of Medicine and Pharmacy, Vietnam. The Vietnamese versions of the Higher Education Stress Inventory (V_HESI) and Brief Coping Orientation to Problems Experienced (V_Brief COPE) were validated and were used as measurement instruments for participants' sources of stress and coping strategies frequencies. The survey comprised questions of socioeconomic status, stress-related issues, the six sources of stress (using the V_HESI), and the nine coping strategies (using the V_Brief COPE). RESULTS Among the six sources of stress, "Worries about future competence/endurance" had the highest mean score (3.02±0.64), while "Mismatch in professional role expectations" had the lowest score (1.60±0.53). "Financial concerns" and "Academic workloads" were also significant sources of stress. Regarding coping strategies, Self-distraction was most frequently adopted by the participants (2.80 ± 0.68). Problem-solving (2.72±0.53) and seeking Social support (2.62±0.70) were also common adaptive strategies. Avoidance (1.87±0.55) and substance-use (1.27±0.55) were the least frequent strategies. Students who experienced acute stress event were more likely to have financial concerns compared to others. Substance use was positively associated with stressors from "Mismatch in professional role expectations", "Non-supportive educational environment", "Having physical issues" and "Having part-time job". Self-blame was more frequent among students with "Worries about future competence/endurance", "Financial concerns", and "Academic workload". Male student tended to adopt humor strategy (β = 0.19, p = 0.02), while less likely to utilize religious practices (β = -0.21, p = 0.01). CONCLUSIONS Two-thirds of the participants reported moderate to high levels of stress. "Worries about future competence/endurance" was the most concerned stressor, followed by "Academic workload", and "Financial concerns". The first-year medical students reported high frequency of utilization "Self-distraction", "Problem-solving" and "Social support" when confronting stress. The findings may help inform the school management to better support students' well-being.
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Affiliation(s)
- Tan Nguyen
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Christy Pu
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Alexander Waits
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tuan D. Tran
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | | | | | - Song-Lih Huang
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Sajjad W, Iqbal M, Haziq M, Fatima A, Fatima I, Ismail WU, Ali R, Shah QA, Shaheen A. Uncertainty in Medical and Dental Students of Pakistan Regarding Their Future Career and Its Major Causes: A Cross-Sectional Study. Cureus 2023; 15:e50831. [PMID: 38249227 PMCID: PMC10797223 DOI: 10.7759/cureus.50831] [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: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVES This study aimed to evaluate the extent of confidence in medical and dental students regarding their careers after being enrolled in their germane institutes and to identify the magnitude of uncertainty in medical and dental students about their careers and the important causes of this uncertainty. METHODS This study was conducted among enrolled students in different medical and dental colleges and universities of Pakistan, including the public and private sectors, from March 1 to March 15, 2023. The level of confidence in their career was evaluated using a close-ended questionnaire of a three-point Likert scale developed and tested by the investigators and approved by the Ethical Review Board (ERB) along with the synopsis. Data were managed and analyzed using Microsoft Excel 19 (Microsoft Corporation, USA) and IBM SPSS Statistics for Windows, version 27 (released 2020; IBM Corp., Armonk, New York, United States). RESULTS This study included 1,126 students from public and private medical and dental institutes. The majority of participants 965(85.7%) were satisfied with their chosen profession, and 1,042 (92.5%) students believed they could make a positive contribution to society. Out of the total participants, 246 (21.8%) students showed their intention of changing careers if provided with a comparable/alternative opportunity. A very small proportion, 154 (13.7%), were dissatisfied with their current clinical training and studies. The study also revealed that extra and unjustified academic pressure from institutions is the leading cause of uncertainty among students. Moreover, the lack of psychological support and counseling provided during the academic years adds to the magnitude of uncertainty. CONCLUSION In Pakistan, a staggering number of medical and dental students are unsure of their future careers and career prospects. The main causes of this uncertainty are the extra, unwarranted academic pressure that institutions place on students and the dearth of psychological support and counseling offered during the course of studies. This study not only highlights the prevailing uncertainty among medical students but also identifies the causes behind it. Addressing these causes can alleviate the prevailing uncertainty and bring about satisfactory and productive academic achievements without suffering from worries about the future.
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Affiliation(s)
- Waseem Sajjad
- Department of Community Medicine and Public Health, Mayo Hospital Lahore, Lahore, PAK
| | - Muhammad Iqbal
- Department of Orthodontics, de'Montmorency College of Dentistry, Lahore, PAK
| | - Muhammad Haziq
- Department of Orthodontics, de'Montmorency College of Dentistry, Lahore, PAK
| | - Aleena Fatima
- Department of Orthodontics, de'Montmorency College of Dentistry, Lahore, PAK
| | - Iraj Fatima
- Department of Orthodontics, de'Montmorency College of Dentistry, Lahore, PAK
| | - Wajahat Ullah Ismail
- Department of Community Medicine and Public Health, Mayo Hospital Lahore, Lahore, PAK
| | - Rahmat Ali
- Department of Internal Medicine, Mayo Hospital Lahore, Lahore, PAK
| | - Qayum Ali Shah
- Department of Internal Medicine, Mayo Hospital Lahore, Lahore, PAK
| | - Asmi Shaheen
- Department of Orthodontics, de'Montmorency College of Dentistry, Lahore, PAK
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van Ede AE, Claessen RJM, van Gils M, Gorgels WJMJ, Reuzel RPB, Smeets AGJM, van Gurp PJM. How to coach student professional development during times of challenges and uncertainties. BMC MEDICAL EDUCATION 2023; 23:600. [PMID: 37608301 PMCID: PMC10463913 DOI: 10.1186/s12909-023-04588-4] [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: 03/16/2023] [Accepted: 08/13/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND What we teach our (bio)medical students today may differ from the future context under which they will operate as health professionals. This shifting and highly demanding profession requires that we equip these students with adaptive competencies for their future careers. We aimed to develop a framework to promote and facilitate professional development from day one, guided by self-awareness and self-directed learning. APPROACH Based on self-directed, transformative and experiential learning, patient involvement and teamwork, we developed a 3-year longitudinal personal-professional development (LPPD) program in the (bio)medical sciences undergraduate curriculum to stimulate self-driven professional development in a variable context. Through group meetings and individual coach consultations, students address topics such as self-awareness, self-directed and lifelong learning, collaboration, well-being and resilience. To drive learning students receive extensive narrative feedback on an essay assignment. EVALUATION Experiences and outcomes were evaluated with questionnaires and in-depth interviews. Students and coaches value personal and professional development in a safe learning environment that encourages self-exploration, diversity and connection. Over time, students show more self-awareness and self-directedness and increasingly apply trained skills, resulting in professional identity formation. Students need more clarification to understand the concept of assessment as learning. IMPLICATIONS With the generic content of a longitudinal program embedded in a meaningful environment, the personal and professional development of students can be facilitated and stimulated to face future challenges. When translating to other curricula, we suggest considering the complexity of professional development and the time expenditure needed for students to explore, experiment and practice. An early start and thorough integration are recommended.
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Affiliation(s)
- Annelies E van Ede
- Department of Rheumatology, Radboud University Nijmegen Medical Centre NL, Nijmegen, Netherlands.
| | - Roy J M Claessen
- Department of Internal Medicine, Radboud University Nijmegen Medical Centre NL, Nijmegen, Netherlands
| | - Merel van Gils
- Radboud Health Academy, Radboud University Nijmegen Medical Centre NL, Nijmegen, Netherlands
| | - Wim J M J Gorgels
- Department of Primary and Community Care, Radboud University Nijmegen Medical Centre NL, Nijmegen, Netherlands
| | - Rob P B Reuzel
- Department of Health Evidence, Radboud University Nijmegen Medical Centre NL, Nijmegen, Netherlands
| | - Annemieke G J M Smeets
- Department of Pathology, Radboud University Nijmegen Medical Centre NL, Nijmegen, Netherlands
| | - Petra J M van Gurp
- Department of Internal Medicine, Radboud University Nijmegen Medical Centre NL, Nijmegen, Netherlands
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Sobczak K, Trzciński M, Kotłowska A, Lenkiewicz J, Lenkiewicz O, Przeniosło J, Plenikowski J. Delivering Bad News: Emotional Perspective and Coping Strategies of Medical Students. Psychol Res Behav Manag 2023; 16:3061-3074. [PMID: 37576446 PMCID: PMC10417753 DOI: 10.2147/prbm.s421995] [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: 06/08/2023] [Accepted: 07/26/2023] [Indexed: 08/15/2023] Open
Abstract
Purpose The aim of our study was to analyze students' emotional experiences and coping mechanisms regarding the situation of delivering bad news (DBN). Patients and Methods 291 fifth- and sixth-year students from 14 medical universities took part in our study. Their responses were analyzed from the perspective of their experience - whether the individuals received bad news, delivered bad news themselves, witnessed bad news being delivered, or had no experience at all. We used content analysis (CA) to examine the responses and analyzed classified variables using χ2 tests, logistic regression, and predictive modeling with multiple correspondence analysis (MCA). Results Students who had experience as a deliverer were more likely to experience failure and guilt (p=0.005). Predictions of anxiety (59.3%), stress (41.9%), and sadness (33.7%) were the highest in the students with no DBN experience. These students were most likely to make statements suggesting lack of methods and strategies for coping with difficult emotions. Students, who were immersed in DBN experiences, more often expressed the need to talk about their emotions with an experienced doctor, a family member or a friend, and used those conversations as a coping strategy. Conclusion The most important aspects that influence the quality of delivering bad news are both communication skills and emotional context. Training regarding DBN should not only contain those two elements, but also consider the development of coping mechanisms.
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Affiliation(s)
- Krzysztof Sobczak
- Department of Sociology of Medicine & Social Pathology, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Trzciński
- Student Scientific Circle of Medical Communication, Medical University of Gdansk, Gdańsk, Poland
| | - Agata Kotłowska
- Student Scientific Circle of Medical Communication, Medical University of Gdansk, Gdańsk, Poland
| | - Julia Lenkiewicz
- Student Scientific Circle of Medical Communication, Medical University of Gdansk, Gdańsk, Poland
| | - Oliwia Lenkiewicz
- Student Scientific Circle of Medical Communication, Medical University of Gdansk, Gdańsk, Poland
| | - Julia Przeniosło
- Student Scientific Circle of Medical Communication, Medical University of Gdansk, Gdańsk, Poland
| | - Jan Plenikowski
- Student Scientific Circle of Medical Communication, Medical University of Gdansk, Gdańsk, Poland
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Neufeld A. "Grabbing" Autonomy When the Learning Environment Doesn't Support it: An Evidence-based Guide for Medical Learners. MEDEDPUBLISH 2023; 12:43. [PMID: 37637179 PMCID: PMC10450255 DOI: 10.12688/mep.19182.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
According to self-determination theory (SDT), environments which support the basic psychological needs for autonomy, competence, and relatedness will facilitate autonomous motivation, learning, and wellness. On the other hand, environments which introduce external controls and power dynamics into the equation will do the opposite. Educational studies support these principles, yet most have focused on learners' need satisfaction as a passive process (e.g., via support or hindrance by educators), rather than the agentic pursuit that SDT emphasizes. In this commentary, I draw on my experience as a practicing physician and SDT researcher, and focus on how medical learners can "grab" more autonomy when the learning environment does not support it. I present a hypothetical case of a preceptor whose teaching style is controlling and unfortunately well-known to medical learners. I then unpack the case and outline different strategies that medical learners can use to navigate this type of interpersonal conflict.
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Affiliation(s)
- Adam Neufeld
- Academic Family Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada
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Neufeld A. Towards an autonomy-supportive model of wellness in Canadian medical education. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:143-151. [PMID: 37465740 PMCID: PMC10351625 DOI: 10.36834/cmej.75312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Purpose Learner distress is a huge problem in medicine today, and medical institutions have been called upon to help solve this issue. Unfortunately, the majority have responded not by addressing the system and culture that have long plagued the profession, but by creating individual-focused "wellness" interventions (IFWs). As a result, medical learners are routinely being forced to undergo training on resilience, mindfulness, and burnout. Approach Grounded in well-supported theory and empirical evidence, my central argument in this commentary is that IFWs are inappropriate, insulting, and psychologically harmful to learners, and that they need to stop. Contribution Extending prior work in this area, I first present three fundamental problems with IFWs. I then recommend a paradigm shift in how we are approaching "wellness" in medical education. Conclusion Finally, I provide an evidence-based roadmap, in self-determination theory, for how system-level improvements could be made in a timely, sustainable, and socially responsible way, that would benefit everyone in medicine-from leaders, to educators, to learners, to patients.
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Affiliation(s)
- Adam Neufeld
- Department of Family Medicine, University of Calgary, Alberta, Canada
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Emilia O, Suhoyo Y, Utomo PS. Teacher as role model in developing professional behavior of medical students: a qualitative study. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2023; 14:55-62. [PMID: 37146184 PMCID: PMC10693392 DOI: 10.5116/ijme.6443.ae49] [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: 07/11/2022] [Accepted: 04/22/2023] [Indexed: 05/07/2023]
Abstract
Objectives This study aimed to explore students' perspectives on the attributes of medical teachers as role models to students' professional behaviour in the educational process. Methods A phenomenological study was conducted to obtain participants' perceptions concerning the professional attributes of medical teachers. The participants were 21 final-year medical students in the School of Medicine, Universitas Gadjah Mada, who had completed and passed the national examination. The participants were recruited purposively to represent genders and performance (i.e., high-performing and average-performing students). The participants were divided into two focus groups based on their performance, each facilitated by non-teaching faculty members to avoid bias. Thematic analysis was conducted to analyze focus group transcripts by two independent coders. Codes were synthesized into themes related to the study aims. Results Seven themes were identified related to observed role model attributes, for instance, passionate lecturers, caring and empathetic, supportive and involving, objectivity, incompetence and compromising, poor communication and conflict, and time management. Subsequently, five themes were identified in participants' responses towards the observed role model, for instance, exemplary models, respect and motivating, confusion and inconvenience, avoiding and hate, and value collision and harmonization. Conclusions This study revealed a range of role model attributes and responded positively and negatively during learning encounters. As negative attributes are also prominent and observed by students, there is a need for medical schools to perform faculty development for the professional enhancement of medical teachers. Further study should be conducted to investigate the impact of role modelling on learning achievement and future medical practice.
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Affiliation(s)
- Ova Emilia
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Yoyo Suhoyo
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
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Ghafaji H, Nordenmark TH, Western E, Sorteberg W, Karic T, Sorteberg A. Coping strategies in patients with good outcome but chronic fatigue after aneurysmal subarachnoid hemorrhage. Acta Neurochir (Wien) 2023; 165:1007-1019. [PMID: 36912975 PMCID: PMC10068657 DOI: 10.1007/s00701-023-05549-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/28/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Fatigue is a highly prevalent and debilitating symptom among patients in the chronic phase of aneurysmal subarachnoid haemorrhage (aSAH) with no identified effective treatment. Cognitive therapy has been shown to have moderate effects on fatigue. Delineating the coping strategies used by patients with post-aSAH fatigue and relating them to fatigue severity and emotional symptoms could be a step towards developing a behavioural therapy for post-aSAH fatigue. METHODS Ninety-six good outcome patients with chronic post-aSAH fatigue answered the questionnaires Brief COPE, (a questionnaire defining 14 coping strategies and three Coping Styles), the Fatigue Severity Scale (FSS), Mental Fatigue Scale (MFS), Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). The Brief COPE scores were compared with fatigue severity and emotional symptoms of the patients. RESULTS The prevailing coping strategies were "Acceptance", "Emotional Support", "Active Coping" and "Planning". "Acceptance" was the sole coping strategy that was significantly inversely related to levels of fatigue. Patients with the highest scores for mental fatigue and those with clinically significant emotional symptoms applied significantly more maladaptive avoidant strategies. Females and the youngest patients applied more "Problem-Focused" strategies. CONCLUSION A therapeutic behavioural model aiming at furthering "Acceptance" and reducing passivity and "Avoidant" strategies may contribute to alleviate post-aSAH fatigue in good outcome patients. Given the chronic nature of post-aSAH fatigue, neurosurgeons may encourage patients to accept their new situation so that they can start a process of positive reframing instead of being trapped in a spiral of futile loss of energy and secondary increased emotional burden and frustration.
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Affiliation(s)
- Hajar Ghafaji
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway. .,Faculty of MedicineInstitute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Tonje Haug Nordenmark
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Elin Western
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | | | - Tanja Karic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Angelika Sorteberg
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway.,Faculty of MedicineInstitute of Clinical Medicine, University of Oslo, Oslo, Norway
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Ardenghi S, Russo S, Bani M, Rampoldi G, Strepparava MG. Supporting students with empathy: the association between empathy and coping strategies in pre-clinical medical students. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04397-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
AbstractHow medical students cope with stress predicts their mental health and academic/clinical performances, making the promotion of functional copy strategies a relevant outcome for medical educators. Empathy has been reported to be connected with coping. This study wanted to explore the most used coping strategies and whether gender differences existed, and to investigate whether and to what extent empathy affected coping in a sample of pre-clinical medical students. In a cross-sectional study design, the Interpersonal Reactivity Index (IRI) and the Coping Orientations to the Problems Experienced - New Italian Version (COPE-NIV) were administered to 398 (53% females) Italian second-year medical students. T-tests and multiple regression analyses were used to explore gender differences and the association between IRI and COPE-NIV scores, respectively. Problem Orientation obtained the highest mean score, whereas Avoidance the lowest one. Females outscored males on Social Support (t = 4.95, p < .001) and Transcendent Orientation (t = 4.04, p < .001). After controlling for gender, Empathic Concern was positively associated with Social Support (β = 0.223, p = .001) and Transcendent Orientation (β = 0.234, p = .001). Perspective Taking was positively and negatively associated with Positive Attitude (β = 0.248, p < .001) and Transcendent Orientation (β = − 0.180, p = .008), respectively. Personal Distress was negatively related to Problem Orientation (β = − 0.250, p < .001). Educational and psychological counselling interventions targeting empathy should be implemented in the pre-clinical years to equip medical students to cope functionally with the emotional distress linked to medical school.
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Cummerow J, Obst K, Voltmer E, Kötter T. Medical students' coping with stress and its predictors: a cross-sectional study. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2023; 14:11-18. [PMID: 36870063 PMCID: PMC10693402 DOI: 10.5116/ijme.63de.3840] [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: 04/13/2022] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
Objectives To analyse stress coping styles of medical students at different time points of medical education and to identify predictors of functional coping. Methods A cross-sectional study was conducted among medical students (N = 497, 361 women and 136 men) before year one (n = 141), after year one (n = 135) and after year five (n = 220). Students answered the Brief Coping Orientation to Problems Experienced Inventory, the Work-Related Behaviour and Experience Patterns, the Perceived Medical School Stress Instrument and the Maslach Burnout Inventory. Multiple regression was used to examine factors associated with functional coping. Results Single factor ANOVA indicated a significant difference for functional coping between the time points (F (2, 494) = 9.52, p < .01), with fifth-year students scoring significantly higher than students before or after year one. There was a significant difference in dysfunctional coping (F (2, 494) = 12.37, p < .01), with students before year one and after year five scoring higher than those after year one. Efficacy (β = 0.15, t (213) = 4.66, p < .01), emotional distancing (β = 0.04, t (213) = 3.50, p < .01) and satisfaction with life (β = 0.06, t (213) = 4.87, p < .01) were positive predictors of functional coping. Conclusions Scores for both functional and dysfunctional coping vary during medical education. The reasons for low coping scores after year one require further explanation. These findings represent a starting point for investigations into how to promote functional coping during early medical education.
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Affiliation(s)
- Julia Cummerow
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Katrin Obst
- Institute of Social Medicine and Epidemiology, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Edgar Voltmer
- Institute of Social Medicine and Epidemiology, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Thomas Kötter
- Institute of Family Medicine, University Medical Centre Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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Mason A, George Z, Gulick D. Student-Produced Guides alongside First-Year Medical Curriculum: How Peer-Produced Textbooks Change Student Success within Neurology, Cardiopulmonary, and Mixed Systems Courses. South Med J 2023; 116:162-169. [PMID: 36724530 DOI: 10.14423/smj.0000000000001517] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES In the United States, medical schools do not have a unified curricular plan that integrates basic sciences and organ-based systems in undergraduate medical education. Instead, institutions rely on independently created lecture material during the first-year medical school curriculum. The drawback to this approach is that no commercial or organizational resources cater to this individualized study plan. This study explored whether students who use student-produced "course guides" experience increased first-year success and improved skills. METHODS First-year students at an allopathic medical school completed anonymous surveys about their reference guide usage, time management, organization, stress level, and examination scores. Statistical analysis was performed using Spearman's coefficient of correlation and χ2 tests. All of the tests were performed with a significance level of α = 0.05 and a 95% confidence interval. RESULTS In total, 186 total students received the survey three times immediately after completing each organ system-based course. A total of n = 49 viable responses were received. One-fourth of the respondents used the guides for ≥3 hours/week. Respondents who used the reference guides reported improved time management, organization, self-confidence, and reduced student stress levels during the first year of medical school, but examination scores were unaffected. CONCLUSIONS Access to student-produced guides increased confidence in self-rated measures of time management skills, organizational ability, and ability to balance medical course expectations. Because of the small sample size, future work will expand the survey population to increase the power to detect differences in these factors.
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Affiliation(s)
- Ashley Mason
- From the University of South Florida Morsani College of Medicine, Tampa
| | - Zeegan George
- From the University of South Florida Morsani College of Medicine, Tampa
| | - Danielle Gulick
- the Department of Molecular Medicine, University of South Florida Morsani College of Medicine, Tampa
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Healy C, Ryan Á, Moran CN, Harkin DW, Doyle F, Hickey A. Medical students, mental health and the role of resilience - A cross-sectional study. MEDICAL TEACHER 2023; 45:40-48. [PMID: 36214365 DOI: 10.1080/0142159x.2022.2128735] [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: 06/16/2023]
Abstract
BACKGROUND Medical students have reported high prevalence of mental health difficulties and burnout. However, there are limited investigations examining the association between resilience and these difficulties. We investigated: (1) depression, anxiety, personal and professional burnout, and comorbidity; (2) demographic and education characteristics associated with these outcomes; (3) the association between resilience and these outcomes; and (4) whether these results were attributable to sampling bias. METHODS Participants were n = 521 medical students from RCSI University of Medicine and Health Sciences. Outcomes were measured using validated scales. We report descriptive statistics, and risk factors for the difficulties were investigated using generalized linear modelling. RESULTS One-in-three students reported incidence of depression or anxiety (24.5% co-morbidity). 8.9% of students reported all four difficulties. Difficulties were more common in female students and those in middle years of the programme. Resilience was negatively correlated with all outcomes and stable across demographic and educational variables. Weighting the data for sampling bias did not affect these results. CONCLUSIONS Our results emphasise the high incidence of depression, anxiety, burnout, and comorbidity in students. We advocate for further investigation into the role of resilience as a modifiable factor that may ameliorate the incidence of depression, anxiety, and burnout in medical students.
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Affiliation(s)
- Colm Healy
- Department of Health Psychology, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
- Department of Psychiatry, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Áine Ryan
- Department of Medical Professionalism, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Catherine N Moran
- Department of Health Psychology, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Denis W Harkin
- Department of Medical Professionalism, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Frank Doyle
- Department of Health Psychology, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Anne Hickey
- Department of Health Psychology, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
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Sperling EL, Hulett JM, Sherwin LB, Thompson S, Bettencourt BA. Prevalence, characteristics and measurement of somatic symptoms related to mental health in medical students: a scoping review. Ann Med 2023; 55:2242781. [PMID: 37552776 PMCID: PMC10411307 DOI: 10.1080/07853890.2023.2242781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/22/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION Somatic symptoms related to mental health in medical students are under-researched, with nothing on the topic being published in the United States in over three decades. This scoping review is the first of its kind to explore the prevalence, type and severity of somatic symptoms induced by stress, anxiety, depression and burnout amongst medical students, with the objective of describing the significance and breadth of this issue. METHODS PRISMA-ScR guidelines were used to guide this review. A comprehensive search was performed of 22 databases, followed by bibliographic and hand searching. Inclusion criteria were published, peer-reviewed articles with a sample of medical students and at least one measure of somatic symptoms related to mental health, in English or with an English-language translation. Excluded were review, companion and editorial articles. Coding was done by an experienced coder trained in systematic review techniques. Two authors reviewed each article. RESULTS Twenty-nine articles met inclusion criteria, representing 16 countries, 31 schools/teaching hospitals and 9,887 medical students. The prevalence of somatic symptoms ranged from 5.7 to 80.1%, and somatic symptoms were overwhelmingly found to be significantly correlated with mental ill-health. Somatic symptoms included back pain, neck pain, headaches, sleep disturbances and functional gastrointestinal disorders. Eleven different outcome measures were used, with varying degrees of validity and reliability, which were compared and assessed. CONCLUSIONS Somatic symptoms appear strongly correlated with mental ill-health in medical students, and are likely highly prevalent. This review highlights the need for further research on somatic symptoms of mental ill-health in medical students, particularly in the United States, and the addition of larger, multi-institutional cohorts to expand our understanding of prevalence, incidence and inciting factors of somatic symptoms. Longitudinal studies tracking somatic symptoms' effect on career trajectory and professional burnout levels are also needed. Finally, future research should explore interventions for reducing physical symptom burden in medical students.
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Affiliation(s)
- Edie L. Sperling
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
- College of Osteopathic Medicine of the Pacific-Northwest, Western University of Health Sciences, Lebanon, OR, USA
| | - Jennifer M. Hulett
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
- Ellis Fischel Cancer Center, University of Missouri, Columbia, MO, USA
| | | | - Sarah Thompson
- Sinclair School of Nursing, University of Missouri, Columbia, MO, USA
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Wu W, Ma X, Liu Y, Qi Q, Guo Z, Li S, Yu L, Long Q, Chen Y, Teng Z, Li X, Zeng Y. Empathy alleviates the learning burnout of medical college students through enhancing resilience. BMC MEDICAL EDUCATION 2022; 22:481. [PMID: 35725422 PMCID: PMC9210704 DOI: 10.1186/s12909-022-03554-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The problem of learning burnout of medical students is becoming prominent, and empathy can play a good predictive role in learning burnout. The present study aimed to investigate the relationship between empathy and learning burnout, as well as the mediation effect of resilience in this relation. METHODS Five hundred and eighty-eighth college students from a key medical university in Yunnan Province was investigated using the Basic Empathy Scale, Learning Burnout Scale, and Connor-Davidson Resilience Scale. All the measures showed good reliability and validity in the present study. Data were analyzed using SPSS 23.0 and Amos 22.0. RESULTS Using structural equation modeling, we tested a conceptual model indicated that: (1) medical students' empathy negatively and significantly predicted learning burnout; (2) medical students' empathy positively predicts mental resilience; (3) resilience of medical students negatively predicts learning burnout; (4) resilience partially mediated the relationship between empathy and learning burnout of medical students, while also controlling for family socioeconomic status. CONCLUSION These findings highlight the mediating role of resilience in the effect of empathy on learning burnout of medical college students. It may contribute to a better understanding of the effect of empathy. Moreover, it can also provide constructive suggestions for protecting and improve empathy and resilience of medical college students.
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Affiliation(s)
- Wenzhi Wu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiao Ma
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Yilin Liu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Qiqi Qi
- School of Maxism, Kunming Medical University, Kunming, China
| | - Zhichao Guo
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Shujun Li
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Lei Yu
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Qing Long
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Yatang Chen
- The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Zhaowei Teng
- The First People's Hospital of Yunnan Province, Kunming, China
| | - Xiujuan Li
- Department of Psychiatry, Shenzhen Mental Health Center, Shenzhen, China.
| | - Yong Zeng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
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15
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Neufeld A. “Grabbing” autonomy when the learning environment doesn’t support it: an evidence-based guide for medical learners. MEDEDPUBLISH 2022. [DOI: 10.12688/mep.19182.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
According to self-determination theory (SDT), environments which assist the basic psychological needs for autonomy, competence, and relatedness will facilitate autonomous motivation, learning, and wellness. On the other hand, environments which introduce external controls and power dynamics into the equation will do the opposite. Educational studies support these principles, yet most have focused on learners’ autonomy satisfaction as a passive process (e.g., via support or hindrance by educators), rather than the agentic pursuit that SDT emphasizes. In this commentary, I draw on my experience as a senior resident and SDT researcher and focus on how medical learners can “grab” more autonomy when the learning environment does not support it. I present a hypothetical case of a preceptor whose teaching style is controlling and unfortunately well-known to medical learners. I then unpack the case and outline different strategies that medical learners can use to navigate this type of interpersonal conflict.
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Garg S, Chauhan A, Sharma D, Sharma A, Singh S. Coping styles to vitiate the risk of psychological morbidities among pre/para-clinical and clinical undergraduate medical students: a comparative cross-sectional study in India. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00196-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Psychological morbidities are high among undergraduate medical students. They experience the transition between pre/para-clinical and clinical training as a stressful period and cope differently. Research from India in this regard are lacking. The aim of this study is to assess and compare the prevalence of psychological morbidities, associated factors and coping styles between pre/para-clinical and clinical undergraduate medical students. This institution-based cross-sectional observational design study was conducted among pre/para-clinical and clinical group of undergraduate medical students (a total of 382) by using a questionnaire in the period between April and June 2021. Stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like GHQ-28 and Lin-Chen’s coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities, and coping styles between two groups, were compared using chi-square test, independent t-test and binary logistic regression analysis.
Results
Out of the 382 responders, psychological morbidities (GHQ-28 score > 23) were found in 61% participants. Both groups reported high level, a slightly higher preponderance in clinical (61.5%) than pre/para-clinical students (60.6%) and with nonsignificant difference of psychological morbidities. Compared to pre/para-clinical group, clinical group was found to have more substance consumption behavior (p < 0.001), dissatisfaction with academic performance (p < 0.001), sought psychiatric consultation (p < 0.004) and currently on psychiatric treatment (p < 0.04). Overall, coping was found to be average and good among the participants. Active problem coping behavior was more significantly used by pre/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in clinical group.
Conclusions
This study established a significant correlation between psychological morbidities and passive coping styles in clinical group. These students need interventions to encourage the use of more active coping styles during the training to provide advances in future career. A strong correlation with dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.
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Garg S, Chauhan A. Psychological Morbidities and Coping Styles: A Rural Institution-Based Cross-Sectional Comparative Study between Undergraduate Medical Students Undergoing Different Phases of Training. ANNALS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES (INDIA) 2022. [DOI: 10.1055/s-0042-1743138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Background Psychological morbidities are high among undergraduate medical students. They experience the transition between pre-/para-clinical and clinical training as a stressful period, and cope differently. Research studies from India in this regard are lacking.
Aims The aim of this study is to assess and compare the prevalence of psychological morbidities and their respective associated factors and coping styles between pre-/para-clinical and clinical undergraduate medical students.
Materials and Methods This institution-based cross-sectional observational design study was conducted among undergraduate medical students (a total of 382) in pre-/para-clinical and clinical years by using a questionnaire in the period between April and June 2019. A stratified random sampling technique was used to select the study participants. The survey included standard self-administered questionnaires like General Health Questionnaire-28 (GHQ-28) and Lin–Chen's coping inventory to assess psychological morbidities and coping styles, respectively. Associated factors for psychological morbidities and coping styles between two groups were compared using the Chi-square test, independent t-test, and binary logistic regression analysis.
Results Out of the 382 responders, psychological morbidities (GHQ-28 score > 23) were found in 61% participants. Both groups reported high levels of psychological morbidities; a slightly higher preponderance in clinical (61.5%) than in pre-/para-clinical students (60.6%) with a nonsignificant difference. Compared with the pre-/para-clinical group, the clinical group was found to have more substance consumption behavior (p < 0.001), dissatisfaction with academic performance (p < 0.001), sought psychiatric consultation (p < 0.004), and at that time on psychiatric treatment (p < 0.04). Active problem coping behavior was more significantly used by the pre-/para-clinical group, while passive problem coping and passive emotional coping behaviors were positively significantly correlated with psychological morbidities in the clinical group.
Conclusion This study suggests a significant correlation between psychological morbidities and passive coping styles in the clinical group. These students need interventions to encourage the use of more active coping styles during training to provide advances in future career. A strong correlation between psychological morbidities and dissatisfied academic performance may be a call for an efficient and more student-friendly curriculum.
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Affiliation(s)
- Sunny Garg
- Department of Psychiatry, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
| | - Alka Chauhan
- Department of Psychiatry, Bhagat Phool Singh Government Medical College for Women, Khanpur Kalan, Sonipat, Haryana, India
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Maity S, Wray J, Coffin T, Nath R, Nauhria S, Sah R, Waechter R, Ramdass P, Nauhria S. Academic and Social Impact of Menstrual Disturbances in Female Medical Students: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 9:821908. [PMID: 35242785 PMCID: PMC8886240 DOI: 10.3389/fmed.2022.821908] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background The stressful academic schedule of medical students poses an obvious challenge to their daily lifestyle. Psychosomatic discomfort poses a significant risk for inaccurate self-medication for ameliorating menstrual complications and feeling better, thus directly impacting personal and academic wellbeing. Objective The impact of menstrual disturbances on academic life is not extensively explored. Therefore, the primary objective of this research was to probe the prevalence of menstrual disturbances and assess the academic and social impact. Finally, the authors provide an overview of pharmacological and other interventions students adopt to reduce clinical symptoms. Methods A database search was conducted from the year 2016 till September 2021 for the studies reporting the prevalence of menstrual disorders in all geographic locations of the world. Keywords used for searching databases included “menstrual disturbances” and “medical students,” “prevalence” OR “symptoms” of “Premenstrual syndrome” OR “Premenstrual dysphoric disorder” OR “Dysmenorrhea” in medical students. Prospero Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) protocols were followed. The protocol was registered in the International prospective register of systematic reviews (PROSPERO), the Center for Reviews and Dissemination, University of York (CRD42021277962). The quality of the methodologies used in selected studies was evaluated by a modified version of Newcastle Ottawa Scale (NOS). Results Initially, 1527 articles were available. After a review, 26 papers were selected for analysis. A total of 25 citations were identified for quantitative analyses, out of which 16 studies reported Pre-menstrual syndrome, 7 reported Pre-menstrual dysphoric disorder, and 13 articles reported dysmenorrhea. The pooled prevalence of Pre-menstrual syndrome was 51.30%, Pre-menstrual dysphoric disorder was 17.7%, and dysmenorrhea was 72.70%. Most common associated lifestyle factors were stress, excessive caffeine intake and lack of exercise. Painkillers, hot packs and hot beverages were amongst the common measures taken by the students to relieve their symptoms. Conclusions The current situation calls for action to accommodate students' needs and bridge the social gap regarding menstrual health. Proactive measures by medical educators and stakeholders are required for an inclusive, accommodating educational environment which will minimize the gender discrepancy in academic satisfaction and professional life.
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Affiliation(s)
- Sabyasachi Maity
- Department of Physiology, Neuroscience, and Behavioral Sciences, St. George's University School of Medicine, St. George's, Grenada
| | - Jadzia Wray
- Medical Student Research Institute, St. George's University School of Medicine, St. George's, Grenada
| | - Tamara Coffin
- Medical Student Research Institute, St. George's University School of Medicine, St. George's, Grenada
| | - Reetuparna Nath
- Department of Educational Services, St. George's University, St. George's, Grenada
| | - Shreya Nauhria
- Department of Psychology, University of Leicester, Leicester, United Kingdom
| | | | - Randall Waechter
- Department of Physiology, Neuroscience, and Behavioral Sciences, St. George's University School of Medicine, St. George's, Grenada
| | - Prakash Ramdass
- Department of Public Health and Preventive Medicine, St. George's University School of Medicine, St. George's, Grenada
| | - Samal Nauhria
- Department of Pathology, St. Matthew's University School of Medicine, Grand Cayman, Cayman Islands
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Garg S, Lamba S, Rawal M, Singh S, Kumar L, Bansal K. Comparison of prevalence of psychological morbidities, associated factors, and coping styles between pre/para-clinical and clinical undergraduate medical students: A rural institution-based cross-sectional study in a northern state of india. MEDICAL JOURNAL OF BABYLON 2022. [DOI: 10.4103/mjbl.mjbl_105_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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Sitarz R, Forma A, Karakuła K, Juchnowicz D, Baj J, Bogucki J, Karakuła-Juchnowicz H. How Do Polish Students Manage Emotional Distress during the COVID-19 Lockdown? A Web-Based Cross-Sectional Study. J Clin Med 2021; 10:jcm10214964. [PMID: 34768484 PMCID: PMC8584627 DOI: 10.3390/jcm10214964] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 11/27/2022] Open
Abstract
Choices regarding coping strategies during the COVID-19 pandemic outbreak may imply the development as well as the severity of emotional disorders. The aim of this web-based cross-sectional study was to: (1) assess the coping strategies for stress in a population of Polish students and (2) evaluate the impact of those strategies on the severity of depression, stress, and anxiety symptoms during the COVID-19 lockdown. To evaluate emotional distress, we used the DASS-21 scale and coping strategies Brief-COPE Inventory. The study included 2172 respondents (73% female, 27% male) with a mean age of 22.1 ± 2.2. Students more frequently chose stress coping strategies belonging to the ‘approach’ coping strategies (M = 29.60 ± 6.89) compared to ‘avoidant’ coping strategies (M = 22.82 ± 5.78). The intensification of distress in women caused a turn to religion (p = 0.001), while men used substances (p < 0.001) and a sense of humor (p < 0.001). Medical students coped best with emotional distress, which is very encouraging for their future profession. The highest level of DASS total score was associated with the usage of avoidant coping strategies, prior use of psychiatric or psychological support, and loneliness. Planning interventions to prevent emotional disorders in students requires the identification of factors contributing to increased emotional distress.
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Affiliation(s)
- Ryszard Sitarz
- Chair and I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-439 Lublin, Poland;
- Correspondence:
| | - Alicja Forma
- Psychiatry Student Research Group I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-439 Lublin, Poland; (A.F.); (K.K.)
| | - Kaja Karakuła
- Psychiatry Student Research Group I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-439 Lublin, Poland; (A.F.); (K.K.)
| | - Dariusz Juchnowicz
- Department of Psychiatric Nursing, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Jacek Baj
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Jacek Bogucki
- Chair and Department of Organic Chemistry, Faculty of Pharmacy, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Hanna Karakuła-Juchnowicz
- Chair and I Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, 20-439 Lublin, Poland;
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