Intervention For Medical Students Research Articles

A Moderation Model for Bolstering Resilience to Suicidal Psychopathology: Positive Sociopsychological Constructs and Coping Flexibilities Buffering the Impact of Daily Life Stress Among Medical Students.

Positive sociopsychological constructs and coping flexibility may be helpful for alleviating suicidal psychopathology, although relatively little research has examined this possibility among medical students. This survey aimed to investigate whether positive sociopsychological constructs and coping flexibility could buffer the negative impact of daily life stress and bolster the resilience to suicidal ideations and attempts among medical students. This cross-sectional model was based on a study of 787 Indian medical students (725 women and 62 men; mean age, 21.08 years; SD = 2.78; range, 19-37 years) who were asked to complete a battery of self-administered questionnaires. For the purpose of determining the independent and interaction impacts of potential variables of influence, hierarchical multiple linear regression models were used. The moderation analysis investigated that the association between daily life stress and suicidal ideation was buffered among the students having higher levels of positive mental health and coping flexibility, whereas this association was no longer significant at the highest level of positive mental health. Furthermore, the relationship between daily life stress and suicidal attempts continued to be buffered by above-average levels of coping flexibility, emotional stability (ES), and optimism. These findings represent that promoting positive mental health, coping flexibility, ES, and optimism may be a promising approach to mitigate suicidal thoughts and attempts in interventions for medical students at high risk. These modifiable moderating factors can be enhanced by empirically supported treatment and prevention efforts to bolster suicidal resilience.

Association between screen time and depressive symptoms in a sample of Chinese medical students: Mediator role of empathy.

Medical students are at high risk of psychological subhealth under heavy stress with increasing screen time. This study aimed to explore the association between screen time and depressive symptoms and determine empathy as a mediating factor. In this cross-sectional study, a total of 945 medical students were surveyed, and 924 medical students were ultimately included after standard exclusion criteria. They reported their daily screen time and completed the Chinese version of the Jefferson Scale of Empathy-Student Version (JSE-S) and the Self-Rating Depression Scale (SDS). t tests and analysis of variance showed a significant difference in empathy and depressive symptoms by sex, stage, and screen time. The correlation analysis revealed that both affective and cognitive empathy have inverse associations with depressive symptoms. The mediation model confirmed that cognitive empathy played a positive mediating role between screen time and depressive symptoms, reducing the impact of screen time on depressive symptoms. Our study may add empirical evidence to prevent and intervene in depressive symptoms. These findings call for considering controlling screen time and enhancing cognitive empathy as interventions for medical students' depressive symptoms.

What are the effects of mindfulness-based psychological interventions for medical students and junior doctors?

What are the effects of mindfulness-based psychological interventions for medical students and junior doctors?

Effectiveness of online mindfulness interventions on medical students\u2019 mental health: a systematic review

BackgroundMedical school typically presents students with a combination of academic and personal stressors that may lead to substandard mental health wellbeing. Meditation practices such as mindfulness facilitate a greater awareness of one's thoughts and feelings, thereby decreasing emotional reactivity. The use of mindfulness-based interventions delivered online has considerable potential in fostering self-care and helping medical students to handle mental health challenges. We examined the available evidence on the use of online mindfulness interventions in order to determine whether they are feasible and effective for improving medical students’ mental health.MethodsWe performed a systematic review guided by PRISMA guidelines and utilised the following databases: ProQuest, Medline, PubMed, PsycINFO, Web of Science, IEEE Explore, Cochrane, and CINAHL. The key search terms used include mindfulness, cognitive behavioural therapy, acceptance and commitment therapy, online, web, virtual, internet cyber, app, medical students, residency students, and residents. English-language articles published in the last ten years that described online interventions for medical students or residents were included in the review.ResultsTwo studies describing the impact of online mindfulness interventions on medical students’ mental health were identified. Research in this domain is nascent; available qualitative and quantitative evidence suggests benefits in self-compassion, perceived stress, cognitive skill use, mindfulness, creating coping mechanisms, and greater awareness of emotions and feelings. There was no evidence of the effectiveness of online mindfulness interventions on depression, anxiety and burnout. There was, however, general low program usage and participation tended to diminish near the conclusion of the interventions.ConclusionsThe evidence found in the systematic review exhibits the potential for online mindfulness interventions to be effective in addressing some mental health challenges of medical students. There was insufficient evidence to support the use of online mindfulness interventions for burnout, depression, and anxiety. Longitudinal studies with randomised controlled trials are required to generate stronger and robust evidence.

A descriptive study of mental health and burnout among Nigerian medical students.

Increasing attention is being paid to medical students' mental wellbeing globally due in part to their exposure to stressors inherent in medical education and the numerous reports of elevated rates of mental health conditions in this population. This study aimed to identify stressors and determine prevalence rates of psychiatric morbidity, substance use and burnout in a sample of Nigerian medical students. In a cross-sectional online survey, 505 medical students from 25 Nigerian medical schools completed a socio-demographic questionnaire, short version of the General Health Questionnaire (GHQ-12), the CAGE questionnaire and the Oldenburg Burnout Inventory (OLBI). The most commonly reported sources of stress were study (75.6%), money (52.3%) and relationships (30.1%). Nine students (1.8%) had received a mental health diagnosis prior to medical school but this number had increased to 29 (5.7%) whilst in medical school, with the majority being cases of anxiety and depressive disorders. The prevalence of psychological distress was 54.5%, but <5% of affected students had received any help for their mental health conditions. Twenty five students (5%) met criteria for problematic alcohol use and 6% had used cannabis. The proportions of students who met criteria for disengagement and exhaustion domains of the OLBI were 84.6% and 77.0% respectively. The prevalence of psychological distress and burnout is high among medical students. Interventions for medical students' well-being should be tailored to their needs and should target risk factors related to personal, organisational and medical school academic structure attributes.

Philosophy for Resilience: A Meaningful Intervention for Medical Students

Philosophy and ethics in medicine is an interesting and often fascinating topic of enquiry, however uptake amongst medical students is highly variable and it is often regarded as a nonessential component of the medical curriculum. Medical students themselves are often overwhelmed by the demands of medical study, and cite high rates of burnout. This paper describes a novel intervention provided at Western Sydney University as part of the Professional Development curriculum, which provided three broad tutorial interventions in their first clinical year. The tutorials gave an overview regarding philosophy theory, but are specifically designed to encourage resilience amongst students. The tutorials were highly regarded and represent a novel way of engaging young doctors. It is suggested that orienting philosophy teaching towards issues immediately relevant to training doctors can greatly improve student acceptability.

An educational intervention for medical students to improve self-efficacy in firearm injury prevention counseling

BackgroundMost physicians support counseling patients about firearm injury prevention (FIP), but infrequently do so due to lack of training and low confidence. Interventions to increase counseling frequency should focus on improving physician self-efficacy. Firearm injuries affect many clinical specialties; therefore, trainees would benefit from early FIP education. This study aims to determine if a 20-min educational intervention improves self-efficacy in FIP counseling in third-year medical students. Knowledge and beliefs were also assessed as secondary indicators of self-efficacy.MethodsThis was a prospective study performed at a medical school associated with a tertiary care children’s hospital during the 2016–17 academic year. Groups of 12–15 different third-year medical students were selected to receive either a 20-min intervention or control lecture during their monthly pediatric lectures. The intervention consisted of two clinical vignettes, a brief discussion about the importance of FIP, and suggestions for clinical integration. The control session was a case-based lecture about pediatric emergencies. Participants completed baseline electronic assessments. Intervention students also completed post-intervention assessments immediately following each session. All participants completed final assessments at 6 months. Data were analyzed using Wilcoxon signed-rank tests and Wilcoxon rank-sum.ResultsWe surveyed a total of 130 students. Sixty-five students completed the entire series of assessments – 22 from the control and 43 from the intervention group. There were no significant differences between the control and intervention groups at baseline. Immediately after, intervention, participants reported feeling more self-efficacious, had improved knowledge of FIP risk factors, and had beliefs more consistent with providing FIP anticipatory guidance (p < 0.001 for all three measures). After 6 months, participants sustained improvement in one of two self-efficacy questions (“I feel ready to counsel patients about firearm injury prevention”) and retained knowledge of risk factors (p < 0.05 for both). However, their beliefs did not significantly favor FIP counseling, and they were not more likely to engage in a conversation about firearm safety.ConclusionsA 20-min educational intervention acutely improved self-efficacy in FIP counseling in third-year medical students, but improvements weakened after six months. Without further training, the beneficial effects of a one-time intervention will likely wane with time.

Tool for Predicting Medical Student Burnout From Sustained Stress Levels: Factor Analysis of the Medical Education Hassles Scale-R.

Acute stress during medical school affects the health of students and is associated with burnout. The Medical Education Hassles Scale-R (MEHS-R) is designed to measure acute stress among medical students. Researchers using the MEHS-R primarily report overall hassles scores, which are unable to discriminate between different categories of hassles encountered. The present study examined the factor structure of the MEHS-R to identify subscales that would be useful to categorize hassles for research and assessment purposes. Longitudinal, observational study. Two osteopathic medical schools. Five hundred six first-year medical students. The MEHS-R was administered at orientation and 9 to 10 times throughout the first year, classified into examination, vacation, and routine medical school activity periods. Students rated the 101 items on a 4-point scale (0=none to 3=a great deal) to indicate how much of a hassle each item had been during the previous week. Demographic subgroups were males, females, married students, single students, whites, and ethnic minorities. Exploratory factor analysis was conducted on data collected at the first school during orientation. Seven subscales were identified: Academic and Time Pressures, Financial, Social, External Influences, Day-to-Day Functioning, Relationships With Immediate Family, and Health. Cronbach α were ≥0.75. Stability of these subscales was examined using confirmatory factor analysis. Both of the fit indices used indicated the 7-subscale model for the MEHS-R adequately fit the data obtained during examination and routine medical school activity periods, one fit index indicated adequate fit for the vacation period, and neither indicated adequate fit for the data from the second school. Of the 7 subscales, 5 had a strong correspondence with categories identified by the scale developers. Fit indices also indicated the 7-subscale model was adequately generalizable to the demographic subgroups with the exception of the ethnic minorities subgroup. Exploratory factor analysis performed on the MEHS-R supported formation of subscales similar to categories identified during MEHS-R development. Results of the current study supported the use of the MEHS-R for the investigation of acute stress in medical students. In future research, targeted wellness interventions for medical students may be developed based on student responses to this instrument.

Medical student INtervention to promote effective nicotine dependence and tobacco HEalthcare (MIND-THE-GAP): single-centre feasibility randomised trial results

BackgroundAlthough brief cessation advice from healthcare professionals increases quit rates, smokers typically do not get this advice during hospitalisation, possibly due to resource issues, lack of training and professionals’ own attitudes to providing such counselling. Medical students are a potentially untapped resource who could deliver cessation counselling, while upskilling themselves and changing their own attitudes to delivering such advice in the future; however, no studies have investigated this. We aimed to determine if brief student-led counselling could enhance motivation to quit and smoking cessation behaviours among hospitalised patients.MethodsA mixed-methods, 2-arm pilot feasibility randomised controlled trial with qualitative process evaluation enrolled 67 hospitalised adult smokers, who were recruited and randomized to receive a brief medical student-delivered cessation intervention (n = 33) or usual care (n = 34); 61 medical students received standardised cessation training and 33 were randomly assigned to provide a brief in-hospital consultation and follow-up support by phone or in-person one week post-discharge. Telephone follow-up at 3- and 6-months assessed scores on the Motivation to Stop Smoking Scale (MTSS; primary outcome) and several other outcomes, including 7-day point prevalent abstinence, quit attempts, use of cessation medication, and ratings of student’s knowledge and efficacy. Data were analysed as intention to treat (ITT) using penalised imputation, per protocol, and random effects repeated measures. Focus group interviews were conducted with students post-intervention to elicit their views on the training and intervention process.ResultsAnalyses for primary and most secondary outcomes favoured the intervention group, although results were not statistically significant. Point prevalence abstinence rates were significantly higher for the intervention group during follow-up for all analyses except 6-month ITT analysis. Fidelity was variable. Patients rated students as being “very” knowledgeable about quitting and “somewhat” helpful. Qualitative results showed students were glad to deliver the intervention; were critical of current cessation care; felt constrained by their inability to prescribe cessation medications and wanted to include cessation and other behavioural counselling in their normal history taking.ConclusionsIt appears feasible for medical students to be smoking cessation interventionists during their training, although their fidelity to the intervention requires further investigation. A definitive trial is needed to determine if medical students are effective cessation counsellors and if student-led intervention could be tailored for other health behaviours.Trial registrationNCT02601599 (retrospectively registered 1 day after first participant recruited on November 3rd 2015).

Interventions for improving medical students' interpersonal communication in medical consultations

Interventions for improving medical students' interpersonal communication in medical consultations

The Effectiveness of Hand Hygiene Education Intervention for Medical Students in Primary Care Settings : Ismailia City , Egypt

Background: All medical students must be aware and practice hand hygiene procedures as one of the infection control measures that could lower health care acquired infections. Aims: to improve practice of hand hygiene among medical students in health care settings and to evaluate the effectiveness of educational training on hand hygiene among the medical students. Methods: The study is a prospective before-and-after trial of an educational intervention with longitudinal follow up. Pre-post intervention was between April and May 2014 with one month interval and the follow up was 6 months later. The pre post intervention included all the first year medical students with affiliation to Faculty of medicine, Suez Canal University in Ismailia city. The follow up included all the participants who continued their second educational year in the same faculty. The researchers used a validated questionnaire and observation checklist to collect data in all periods of the study. Educational training program was designed and conducted by the researchers on hand hygiene importance, measures, technique, time and compliance. Results: The educational intervention had a significant improvement in KAP, one and six months after the intervention (P <0.001). Non significant decrease in median scores of knowledge with no change in median scores of attitude but significant improvement of median scores of practice and overall KAP scores of hand hygiene in the follow up (P <0.001) was observed. Conclusion: The educational intervention was effective in improvement in KAP of hand hygiene in pre-post intervention with one month interval and in the follow up after six months after the intervention.

Responding to moderate breaches in professionalism: An intervention for medical students

Much has been written about how we understand, teach and evaluate professionalism in medical training. Less often described are explicit responses to mild or moderate professionalism concerns in medical students. To address this need, Baylor College of Medicine created a mechanism to assess professionalism competency for medical students and policies to address breaches in professional behavior. This article describes the development of an intervention using a guided reflection model, student responses to the intervention, and how the program evolved into a credible resource for deans and other educational leaders.

A conceptual framework of stress management intervention for medical students

Teaching stress management skills for medical students has been echoed as an important educational component in medical education. Discussions about approaches to teaching stress management in medical education context are largely unexplored despite of a large number of articles have emphasized on its importance. This paper describes four elements in a framework as an approach to teaching stress management skills in medical education. As one moves through the DEAL elements, it provides a greater degree of insight on stress management ability as is acquired through one’s awareness, experience and conscious effort that allow stressful situations to be handled effectively and efficiently. It may provide a useful educational framework for medical teachers to teach and assess stress management skills of medical students. It also may be used as an aid in planning, implementing and evaluating stress management programs in medical schools. The authors discuss about the implications of this framework for future research in medical education.

Consistent prevalence of inadequate micronutrient intakes across six years of second-year medical school students

Background: The dietary behaviors of physicians and medical students are strongly associated with their nutrition counseling practices. Little research to date describes their dietary intakes and no recent studies have assessed the adequacy of their micronutrient intakes. As micronutrient imbalances are associated with a variety of chronic diseases, public guidelines target increasing dietary nutrient density. The purpose of this study was to identify micronutrient imbalances in the diets of medical students and determine whether intakes are becoming more compliant with dietary guidelines over time. Methods: From 2000 to 2006, 409 second-year Vanderbilt University medical students completed the Block Brief 2000 food frequency questionnaire prior to the required “Introduction to Clinical Nutrition” course. Nutrient data were compared to Dietary Reference Intake values. Results: Dietary intakes of male students were consistently inadequate for vitamin E, vitamin D, calcium, magnesium and potassium across the six cohorts. Despite a significant increase over time in the number of vegetable servings consumed, the intakes of female students revealed the same inadequacies, as well as inadequate folate and iron intakes. Multivitamin and multimineral supplementation, consumed regularly by 51% of students, closed the gap in meeting estimated micronutrient requirements, except vitamin E. Conclusions: These data can be used to inform the content of nutrition interventions for medical students focused on making optimal food selection choices as well as the content of nutrition education in the medical school curriculum. It is important to enhance medical students’ preparedness as fu- ture health care providers—not only to serve as role models for healthy dietary behaviors, but also to better recognize the nutrition needs of their future patients.

Inner City Community Oriented Primary Care to Improve Medical Student Skills and Combat Obesity

Background: Efforts to increase medical student knowledge regarding obesity are needed in medical school curriculum. This article examines a third year medical student intervention utilizing obesity group visits.Description: In our third-year family medicine clerkship, we implemented the Health not Cosmetics pilot intervention as part of a Community Oriented Primary Care experience. The intervention consisted of weekly group visits run by third and fourth year medical students to teach lifestyle modification. To evaluate the intervention, medical students filled out an anonymous departmental evaluation form and patients were surveyed using a short questionnaire during a group visit.Evaluation: Medical students rated the intervention as meeting or exceeding expectations and as improving Community Oriented Primary Care skills, especially in the following areas: identifying community needs, participating in an intervention, collecting data and presenting results. Patients adopted more active lifestyles and healthier eating habits.Conclusion: This intervention was well received by medical students and patients.

Safe Prescribing: An Educational Intervention For Medical Students

Background and Purpose: Errors in handwritten medication orders are common and can result in patient harm. We evaluated an intervention for increasing safe prescribing by medical students.Methods: We conducted a pre-post evaluation to evaluate a brief educational intervention to increase safe prescribing by medical students. Two 1-hr, small-group, interactive educational sessions for 3rd-year medical students were held 2 weeks apart at Washington University in St. Louis. Prescribing errors were measured with a verbal transcription test.Results: Twenty-eight students participated. Following the intervention, the average number of error-free orders in the 10-order test increased 5-fold from 0.82 per student to 4.54 per student, and the average number of errors and dangerous errors per student decreased from 13.96 to 7.36 (p <. 0001) and from 4.75 to 2.68 (p <. 0001), respectively.Conclusions: After a brief interactive educational intervention for medical students, the frequency of error-free handwritten orders increased, and prescribing errors decreased. Additional training may be required to further improve and maintain safe prescribing.

Intervention for medical students: Effective infection control

Needlestick injuries, which lead to the transmission of hepatitis B, hepatitis C, and the AIDS virus, are a potentially serious threat to students during their clinical experiences. Exposure to infectious diseases, blood, and hazardous body fluids is one of the most frequently reported injury events by medical students at a health science center in the southwestern region of the United States. This study was conducted to determine the effectiveness of a customized intervention about infection control for second-year medical students (N = 200). Preparation for the intervention included a needs assessment, which included both qualitative and quantitative research methods that incorporated input from fourth-year medical students, medical staff members, and local hospital infection control specialists. The intervention included a pretest, a lecture, a demonstration of standard precautions and infection control procedures with 2 clinical scenarios, an exercise on proper handwashing, and a posttest. The evaluation of the intervention demonstrated a significant increase in posttest knowledge scores about infection control (from 12.6 ± 2.1 pretest to 16.5 ± 1.8 posttest, P < .001). Medical students showed a significant knowledge increase about infection control after participating in the intervention. Thus we recommend that all medical colleges and universities develop and evaluate a similar customized intervention for their medical students. (AJIC Am J Infect Control 1998;26:431-6)