Abstract
BackgroundMedical students can experience the transition from theory to clinical clerkships as stressful. Scientific literature on the mental health of clinical clerkship students is scarce and mental health is usually defined as absence of psychological distress without assessing psychological, emotional and social wellbeing, together called ‘positive mental health’. This cross-sectional study examines the prevalence of psychological distress and positive mental health and explores possible predictors in a Dutch sample of clinical clerkship students.MethodsFourth-year medical students in their first year of clinical clerkships were invited to complete an online questionnaire assessing demographics, psychological distress (Brief Symptom Inventory), positive mental health (Mental Health Continuum- SF), dysfunctional cognitions (Irrational Beliefs Inventory) and dispositional mindfulness skills (Five Facet Mindfulness Questionnaire). Multiple linear regression analysis was used to explore relationships between psychological distress, positive mental health (dependent variables) and demographics, dysfunctional cognitions and dispositional mindfulness skills (predictors).ResultsOf 454 eligible students, 406 (89%) completed the assessment of whom 21% scored in the clinical range of psychological distress and 41% reported a flourishing mental health. These proportions partially overlap each other. Female students reported a significantly higher mean level of psychological distress than males. In the regression analysis the strongest predictors of psychological distress were ‘acting with awareness’ (negative) and ‘worrying’ (positive). Strongest predictors of positive mental health were ‘problem avoidance’ (negative) and ‘emotional irresponsibility’ (negative).ConclusionsThe prevalence of psychopathology in our sample of Dutch clinical clerkship students is slightly higher than in the general population. Our results support conclusions of previous research that psychological distress and positive mental health are not two ends of one continuum but partially overlap. Although no conclusion on causality can be drawn, this study supports the idea that self-awareness and active, nonavoidant coping strategies are related to lower distress and higher positive mental health.
Highlights
Medical students can experience the transition from theory to clinical clerkships as stressful
This transition is known to be stressful, scientific literature on the mental health of clinical clerkships students is scarce compared to literature on pre-clinical students and response rates are modest [6,7,8,9]
Prevalence rates of clinical clerkship students scoring above the cut-off for psychopathology vary from 27 to 48% [6, 8, 10, 11]
Summary
Medical students can experience the transition from theory to clinical clerkships as stressful. Scientific literature on the mental health of clinical clerkship students is scarce and mental health is usually defined as absence of psychological distress without assessing psychological, emotional and social wellbeing, together called ‘positive mental health’. The transition from theory to practice can result in problems related to professional socialization, high workload and heightened levels of psychological distress [1,2,3,4,5] This transition is known to be stressful, scientific literature on the mental health of clinical clerkships students is scarce compared to literature on pre-clinical students and response rates are modest [6,7,8,9]. There are no data available on the relationship between student psychopathology and their actual performance during clinical clerkships, we do know that higher distress, burnout, and depression in residents are associated with more self-perceived errors [14,15,16,17]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
