Determinants and effects of medical students' core self-evaluation tendencies on clinical competence and workplace well-being in clerkship

Growth mindset mediates the effect of core self-evaluation on professional self-efficacy for nursing interns: A cross-sectional study

BACKGROUND

Professional self-efficacy is a key factor in nurses' career development and is associated with individual mindset and self-perception. However, research on the potential influence mechanism of professional self-efficacy in clinical nursing interns from the perspective of individual mindset and self-perception in China, or internationally, is limited.

OBJECTIVES

This study aimed to explore the relationship between core self-evaluation, growth mindset, and professional self-efficacy among nursing interns, and the mediating effect of growth mindset on the relationship between core self-evaluation and professional self-efficacy.

DESIGN

A cross-sectional survey design was used.

SETTINGS AND PARTICIPANTS

Considering the ready accessibility for collecting samples and meeting with the purpose of this study, this study was conducted using a convenience sample of 266 clinical nursing interns from three general hospitals in Hangzhou, China, from March to July 2023.

METHODS

Convenience sampling was used to recruit 266 nursing students [236 female, 30 male] from three comprehensive tertiary hospitals in the provincial capital city of Zhejiang, China. The data were collected using the Core Self-Evaluation Scale, Growth Mindset Scale, and Professional Self-Efficacy Questionnaire from March to July 2023. Data were analyzed using IBM SPSS Statistics (version 26.0; IBM, Armonk, NY, USA). Descriptive analyses of the demographic characteristics, correlation analyses and multivariate linear regressions of the three variables were performed. The PROCESS macro for SPSS (Model 4) was used to examine the relationship between core self-evaluation, professional self-efficacy, and the mediating effect of growth mindset.

RESULTS

The average professional self-efficacy score was (87.95 ± 17.84). Core self-evaluation and a growth mindset were found to have a statistically significant relationship to professional self-efficacy. Growth mindset mediated the relationship between core self-evaluation and professional self-efficacy (β = 0.491, P < 0.001). The results of the nonparametric bootstrapping method confirmed the significance of the indirect effect of core self-evaluation through growth mindset (95 % bootstrap CI = 0.093, 0.241). The indirect effect of growth mindset accounted for 32.6 % of the total variance in professional self-efficacy.

CONCLUSION

The professional self-efficacy of Chinese nursing interns was at a low to medium level and demand extensive attention. On the one hand, clinical nursing managers and teachers should focus on cultivating the core self-evaluation of nursing interns to improve their professional self-efficacy. On the other hand, growth mindset offers a mediating variable between the core self-evaluation and professional self-efficacy of nursing interns. Therefore, it is recommended that growth mindset be developed by incorporating growth mindset training into the curriculum and using school and clinical co-education to enhance students' professional self-efficacy.

Informing factors and outcomes of self-assessment practices in medical education: a systematic review

BACKGROUND

Self-assessment (SA) is increasingly recognized not only as an assessment method but also as a vital learning activity that enables learners to identify their strengths and limitations, fostering a crucial skill for lifelong learning. Despite its acknowledged significance, there remains a gap in understanding SA for and as learning, rather than merely of learning. This review, therefore, explores two primary questions: (1) What factors inform the implementation of medical students' SA practices? (2) How does SA practices contribute to various educational outcomes?

METHODS

A systematic review was conducted across five databases, employing a combination of keywords pertinent to SA and medical education. Our selection criteria deliberately excluded articles that solely focused on the accuracy of SA or used SA exclusively as a measure for other outcome variables. As a result, 39 studies met our inclusion criteria and were analyzed for this review. Qualitative narrative synthesis was used to summarize the informing factors. Furthermore, Kirkpatrick's model was employed to categorize and summarize the effects of SA activities across various educational outcome levels, including reactions, learning, and behavioral changes.

RESULTS

Our review reveals that key factors influencing students' SA includes feedback from various stakeholders, peer assessment, the format of SA, and both learner and teacher training. Among the 39 studies examined, the majority demonstrated positive effects of SA on aspects such as attitudes and skills. However, a minority found no significant associations, with these outcomes frequently linked to contextual variables and how SA was implemented.

CONCLUSIONS

Our review does not focus on SA accuracy or its role as an assessment method; instead it delves into the role of SA as an integral learning practice. We explored its influencing factors and its impact across various outcomes. The findings indicate that for SA to effectively enhance student learning outcomes, it must be implemented with ample support, clear guidelines, and within contexts that encourage feedback and reflection.

Effects of grit on medical students' wellbeing during clerkships: a longitudinal observational cohort study

Introduction

In medical education, the clerkship phase is a demanding period during which medical students learn to navigate the responsibilities of medical school and clinical medicine. Grit, a personal quality regarded as a non-cognitive trait, refers to perseverance and passion; specifically, it represents the ability to endure hardship and work industriously toward a goal. Most studies analysed grit as a single concept and few studies have investigated the effect of grit on the well-being of medical students through the whole-specialty training (i.e. surgical and non-surgical specialty rotations) required in clinical clerkships. Therefore, this study investigated whether associations exist between medical students' grit, measured by the two subconstructs of perseverance and passion, and their well-being during clerkships in surgical and non-surgical specialty units.

Methods

This one-year prospective web-based questionnaire study enrolled fifth-year medical students at a tertiary medical centre in central Taiwan between September 2017 and July 2018 in their first-year clerkship. The students' sex, age, and grit were measured at the start of their clerkship. Routine surveys were conducted over one year to assess burnout and compassion satisfaction for students' well-being, and the training specialty characteristics of the surgical and non-surgical specialty departments were recorded. This study included 92 medical students and 1,055 survey responses from individual specialty rotations. Descriptive, univariate and multivariate analyses were performed.

Results

Our results revealed that medical students' perseverance, as part of grit, was related to lower burnout and higher compassion satisfaction during clerkships, but not the subconstruct of passion. Moreover, the positive trait of perseverance measured in our study had greater explanatory power for compassion satisfaction than for burnout. Furthermore, the results revealed that older medical students suffered from less burnout than their younger counterparts, and that male medical students expressed higher compassion satisfaction than their female counterparts.

Discussion

Perseverance, as a subconstruct of grit, is a positive personal quality for medical students' clerkships, and methods driving the cultivation of perseverance in medical education should be considered. In addition, even though positive traits such as perseverance equipped medical students for compassion satisfaction, additional factors attributed to medical students' burnout must be identified.

Measuring wellbeing: A scoping review of metrics and studies measuring medical student wellbeing across multiple timepoints

PURPOSE

Studies have demonstrated poor mental health in medical students. However, there is wide variation in study design and metric use, impairing comparability. The authors aimed to examine the metrics and methods used to measure medical student wellbeing across multiple timepoints and identify where guidance is necessary.

METHODS

Five databases were searched between May and June 2021 for studies using survey-based metrics among medical students at multiple timepoints. Screening and data extraction were done independently by two reviewers. Data regarding the manuscript, methodology, and metrics were analyzed.

RESULTS

221 studies were included, with 109 observational and 112 interventional studies. There were limited studies (15.4%) focused on clinical students. Stress management interventions were the most common (40.2%). Few (3.57%) interventional studies followed participants longer than 12 months, and 38.4% had no control group. There were 140 unique metrics measuring 13 constructs. 52.1% of metrics were used only once.

CONCLUSIONS

Unique guidance is needed to address gaps in study design as well as unique challenges surrounding medical student wellbeing surveys. Metric use is highly variable and future research is necessary to identify metrics specifically validated in medical student samples that reflect the diversity of today's students.

Understanding the interplay of self-regulated learning strategies in medical education: A cross-sectional structural equation modeling study

Background and Aims

Although previous studies have investigated self-regulated learning strategies, a holistic study has not been conducted on note-taking, environmental structuring, self-evaluation, and self-consequence strategies among medical students. The current study focused on the relationships between these four self-regulated learning strategies in a medical context.

Methods

A conceptual model of the four strategies was developed, supported by the relevant literature. This cross-sectional study used an electronic structured questionnaire. The sample consisted of 557 medical undergraduates. The data were analysed using confirmatory factor analysis and structural equation modeling to investigate the hypothetical model.

Results

The conceptual model fits the data well. All relationships between the strategies were significantly positive, except for a regression between environmental structuring and self-evaluation, which was nonsignificant. Self-evaluation strategies represented the highest mean, whereas self-consequence strategies represented the lowest.

Conclusion

The findings of this study have implications for medical students, their teachers, and their universities regarding ways to enhance learners' regulated learning strategies. Future research should be conducted to develop additional statistical and comparison models for use in experimental studies and longitudinal investigations.

Core Self-Evaluation, Emotional Reactivity to Interpersonal Conflict, and Subjective Well-Being: The Moderating Role of Horizontal Collectivism

This study aims to examine a moderated mediation model wherein core self-evaluation (CSE) and horizontal collectivism (HC) interact to predict negative emotional reactivity to interpersonal conflict, and thus HC moderates the indirect effects of CSE on subjective well-being (SWB) through emotional reactivity. A short-term prospective study was conducted with 257 South Korean university students. Participants completed measures of CSE and HC, and then reported their experiences with interpersonal conflict and SWB in an online survey about two weeks later. We found that, among low HC participants, after controlling for the importance of conflict issues, individual differences in CSE predicted emotional reactivity to interpersonal conflict, and emotional reactivity was in turn negatively associated with SWB. By contrast, among high-HC participants, emotional reactivity to interpersonal conflict did not differ as a function of CSE, and the indirect effects of CSE on SWB were not significant. These findings highlight the importance of high CSE and HC values in fostering emerging adults’ resilience against the detrimental effects of interpersonal conflict in sustaining individuals’ SWB. Implications for conflict management interventions are discussed.

The Mediating Roles of Core Self-Evaluation and Career Exploration in the Association Between Proactive Personality and Job Search Clarity

In recent years, university students’ employment has become an increasingly prominent problem worldwide. Improving the job search clarity of students is a great way to boost job-hunting success. Proactive personality may predict job search clarity through the mediating effects of core self-evaluation and career exploration. However, few studies have explored this relationship and the mediating roles of core self-evaluation and career exploration. To identify the relationship between a proactive personality and job search clarity and the mediating roles of core self-evaluation and career exploration, a cross-sectional survey was conducted. A total of 495 students majoring in nursing completed the questionnaire which consisted of the proactive personality scale, core self-evaluation scale, career exploration survey, and job search clarity scale. Correlation analyses and mediation analyses were conducted using SPSS 24.0 and AMOS 24.0 respectively. This study showed that students higher on the proactive personality scale were more likely to perform better on job search clarity. Core self-evaluation and career exploration have fully mediating effects on the relationship between a proactive personality and job search clarity. Therefore, interventions concentrated on cultivating proactive personality, improving core self-evaluation, and strengthening career exploration would be necessary for increasing job search clarity.

Professional Quality of Life Factors and Relationships in Nursing and Psychiatric Nursing Students: An Exploratory Study

INTRODUCTION

Professional quality of life (ProQOL) that encompasses compassion satisfaction (CS) and compassion fatigue (CF) comprised of burnout (BO) and secondary traumatic stress (STS) has been raised as a world-wide issue for the nursing profession. Limited attention has been paid to the vulnerabilities of nursing students to ProQOL and the associated mechanisms.

PURPOSE

Determine what factors are predictive of ProQOL in a population of undergraduate nursing and psychiatric nursing students. Methods: A cross-sectional survey was conducted comprised demographic questions and four validated measures: the Professional Quality of Life Scale (version 5), Core Self-Evaluations Scale, Perceived Stress Scale, and Life Events Checklist (version 5).

RESULTS

Students in long-term care-palliative care rotations reported significantly higher levels of BO in comparison to other care areas. Regression analysis revealed students with low self-efficacy and high perceived stress were predictive of BO. Students with increased exposures to prior traumatizing life events were predictive of STS. Students with high levels of self-efficacy and less intent-to-leave were predictive of having CS.

CONCLUSION

Findings assist educators, clinicians, and policy makers in understanding at-risk clinical settings and predictors of ProQOL in pre-licensure students. Curricular recommendations that include mindfulness, coping and crisis peer-debriefing, and emotional intelligence are discussed.

Development of a Novel Interactive Multimedia E-Learning Model to Enhance Clinical Competency Training and Quality of Care among Medical Students

Clinical competencies consisting of skills, knowledge, and communication techniques should be acquired by all medical graduates to optimize healthcare quality. However, transitioning from observation to hands-on learning in clinical competencies poses a challenge to medical students. The aim of this study is to evaluate the impact of a novel interactive multimedia eBook curriculum in clinical competency training. Ninety-six medical students were recruited. Students in the control group (n = 46) were taught clinical competencies via conventional teaching, while students in the experimental group (n = 50) were taught with conventional teaching plus interactive multimedia eBooks. The outcomes of clinical competencies were evaluated using Objective Structured Clinical Examination (OSCE) scores, and feedback on their interactive eBook experiences was obtained. In the experimental group, the average National OSCE scores were not only higher than the control group (214.8 vs. 206.5, p < 0.001), but also showed a quicker improvement when comparing between three consecutive mock OSCEs (p < 0.001). In response to open-ended questions, participants emphasized the importance of eBooks in improving their abilities and self-confidence when dealing with ‘difficult’ patients. Implementing interactive multimedia eBooks could prompt a more rapid improvement in clinical skill performance to provide safer healthcare, indicating the potential of our innovative module in enhancing clinical competencies.

A comprehensive review of compassion fatigue in pre-licensure health students: antecedents, attributes, and consequences

Compassion fatigue has been documented in the nursing and allied health literature as an emerging issue for health professionals. Little is known regarding the experience of compassion fatigue in undergraduate, pre-licensure students entering health care professions. This study used Walker and Avant's concept analysis methodology to explain antecedents, attributes, and consequences of compassion fatigue in undergraduate, pre-licensure students. Exploration of the published literature from January 1992-April 2020 occurred using systematic review criteria based on the Joanna Briggs Institute. Findings revealed three antecedents that included: Coping Ability; Self-Efficacy; and Clinical and Occupational Hazards. Three defining attributes of compassion fatigue included: Psychological Stress; Witnessing Negative Experiences of Others; and Depression. Consequences included: Decreased Well-Being; and Program Withdrawal and Intention-to-Leave. The results offer new perspectives and opportunities for research in pre-licensure health studies undergraduate students expected to uphold the values of their professional program prior to entry into the workforce.

Role of language proficiency and personality traits upon the academic performance of undergraduate medical students

BACKGROUND

Academic performance of medical students is governed by various factors. Personality traits such as core self-evaluation (CSE) and locus of control (LOC) are a few of the most important factors that could govern academic performance. The medium of communication is another important factor, especially in a country with language diversity that could affect the academic performance of the new medical entrants. The study aims to examine the effect of LOC, CSE score, and English Language proficiency on the academic performance of undergraduate medical students.

MATERIALS AND METHODS

Ninety undergraduate medical students of a premier central government medical institute of India has been recruited for the study after due ethical clearance from the Institutional Ethical Committee. A standard questionnaire for all the parameters to be studied had been filled by the participants. The academic performance has been judged on the basis of the professional examination's marks score.

RESULTS

The multiple regression analysis considering all the variables, the English language proficiency appears to be the most important factor with R2 = 0.106 and P = 0.003. Most of the academic performers have shown the dominance of internal LOC and moderately high CSE scores though not statistically significant.

CONCLUSIONS

Language proficiency appears to be one of the most important determinants of academic performance in the medical entrants of Indian subcontinent. LOC and CSE could be an important yardstick for academic performance, but that needs to be confirmed with another study with a bigger data set.

Survey results of job status of residents in a standardized residency training program

BACKGROUND

The history of standardized residency training programs (SRTP) in China is not long. As one of the top medical colleges in China, Peking Union Medical College Hospital (PUMCH) has the history and experience of the oldest SRTP in the country. Understanding the job status of PUMCH residents would be conducive to a better development of the national resident training in the future.

METHODS

This study analyzed the demographic information, job burnout scale, working time, and job status of postgraduate year 1-3 residents that took part in the SRTP of the Department of Internal Medicine of PUMCH in August 2017.

RESULTS

The survey data of 159 residents (including PUMCH residents, local-resident-trainees, and clinical postgraduates) were collected. The average working time was 11.38 ± 1.55 h per day and 83.28 ± 8.80 h per week. The average night shift frequency was 4.74 ± 0.59 days. There were 100 residents (62.2%) with symptoms of job burnout, which had a certain correlation with working time (p < 0.05). The self-evaluation of the clinical postgraduates about their working quality of life was lower than that of other residents (p < 0.05). There were various reasons for long working-time, great work pressure, and job burnout. Job burnout was independently associated with the average working time per day (OR = 2.35, 95% CI: 1.47-3.75, P < 0.001) and average length of duty period (OR = 1.52, 95% CI: 1.26-1.84, P < 0.001).

CONCLUSION

The job burnout of residents that took part in SRTP at the PUMCH could not be ignored, which had a certain correlation with work time and early training background.

Problem-based learning for anesthesia resident operating room crisis management training

BACKGROUND

Senior anesthesia residents must acquire competency in crisis management for operating room (OR) emergencies. We conducted problem based learning (PBL) OR emergency scenarios for anesthesia residents, focused on emergencies in 'Airway', 'Circulation', 'Central venous catheter', and 'Pain management complications'. Non-technical skills are an integral component of team-based OR emergency management.

METHODS

Prior to integrated OR emergency clinical and non-technical skills PBL training, participating 35 anesthesia residents completed two 5-point scale surveys regarding frequency of emergency experiences in the operating room, and self-confidence for anesthesia-related crisis management. Repeat administration of the self-confidence survey was completed immediately following PBL training.

RESULTS

Post-PBL resident clinical management self- confidence improved (P<0.05) in all scenarios on Circulation, Central venous catheter, and Pain treatment related complication topics. Impossible intubation, impossible oxygenation, and awake intubation did not show significant difference following PBL.

CONCLUSION

Our findings suggest that PBL for OR emergency management can improve resident self- confidence in anesthesia residents.