Practical Strategies to Foster a Well-Being Curriculum for Medical Students.

Abstract

To the Editor: I read the report by Ferguson and colleagues1 on their REACH (Recognize, Empathize, Allow, Care, Hold each other up) curriculum with great interest. The authors presented an elegant study describing the problem of learner distress that triggered the curriculum, the approaches used, the curriculum design and educational strategies, and project assessment and evaluation outcomes. However, I thought that the design and assessment of the project should highlight practical strategies concerning the well-being of medical students, not just an integrated curriculum. In this regard, I would like to raise 3 issues. First, students struggling with mental health issues and burnout usually fear stigmatization if they seek help and disclose their symptoms; they also fear being labeled as “not suitable-to-practice.” With these concerns in mind, the program should have a practical stream of resources that run parallel with the curriculum to enable early approaches to detect and support these students.2,3 Second, it would be helpful if storytelling is used to assess curriculum outcomes. Students use their storytelling to talk about how the program changed their behavior and helped them grow, regain their self-confidence, face their areas weakness, and overcome a challenge they met. Such storytelling would be an opportunity to increase connection with peers and conquer fears and worries through volubility moments.4 Third, it would be helpful if staff training on students’ well-being included managing student presentations of learning distress and handling difficult conversations and disclosures. They should recognize when to refer students to other services for specific support. The program may also benefit from adding peer and faculty role models to strengthen the message given to the students.5,6 These components should be developed in tandem with the curriculum to ensure that this critical area is not just addressed as subjects taught and objectives achieved, but as practical strategies guaranteeing the program’s success.