Medical Student Well-Being Index Research Articles

Well-being and Burnout among Pre-clinical Medical Students in a Caribbean Medical School

Evaluate well-being and burnout among preclinical medical students in a Caribbean medical school and identify the associated factors. It was a questionnaire-based, cross-sectional study which was conducted among preclinical medical students of Trinity Medical Sciences University (TMSU), Saint Vincent & the Grenadines. Medical Student Well-Being Index and Maslach Burnout Inventory-Student Survey were used. The total number of participants who gave informed consent was 82. For statisti­cal analyses, internal consistency of the instruments was tested by Cronbach’s alpha. The Student t-test, Fisher’s exact test, Pearson correlation and multivariate regression model were used. The analysis of well-being index(WBI-MS) showed that during the past month 78% of participants experienced burnout due to emotional exhaustion and 61% due to depersonalization, 63.4% felt depression, 19.5% experienced fatigue, 65.9% suffered from stress. The significant association was found between well-being index, credit hours allotted for the semester, and depersonalization/cynicism. Also there was significant negative correlation among academic efficacy and cynicism. The analysis also showed that once a week or more often 58.5 % of participants experienced emotional exhaustion, 34.2% depersonalization and 26.8% low professional efficacy. But the level (severity) of emotional exhaustion was less in comparison with depersonalization score. Our study revealed that 65.9% of participants had a low well-being index and high level of burnout with very increased score of cynicism, which negatively affected their academic efficacy. The possible causes of the obtained results were identified and necessary strategies will be implemented to improve the outcomes.

Well-being at a Military Medical School and Implications for Military Retention

Physical and psychological well-being play a critical role in the academic and professional development of medical students and can alter the trajectory of a student's quality of personal and professional life. Military medical students, given their dual role as officer and student, experience unique stressors and issues that may play a role in their future intentions to continue military service, as well as practice medicine. As such, this study explores well-being across the 4 years of medical school at Uniformed Services University (USU) and how well-being relates to a student's likelihood to continue serving in the military and practicing medicine.In September 2019, 678 USU medical students were invited to complete a survey consisting of three sections-the Medical Student Well-being Index (MSWBI), a single-item burnout measure, and six questions regarding their likelihood of staying in the military and medical practice. Survey responses were analyzed using descriptive statistics, analysis of variance (ANOVA), and contingency table analysis. Additionally, thematic analysis was conducted on open-ended responses included as part of the likelihood questions.Our MSWBI and burnout scores suggest that the overall state of well-being among medical students at USU is comparable to other studies of the medical student population. ANOVA revealed class differences among the four cohorts, highlighted by improved well-being scores as students transitioned from clerkships to their fourth-year curriculum. Fewer clinical students (MS3s and MS4s), compared to pre-clerkship students, indicated a desire to stay in the military. In contrast, a higher percentage of clinical students seemed to "reconsider" their medical career choice compared to their pre-clerkship student counterparts. "Medicine-oriented" likelihood questions were associated with four unique MSWBI items, whereas "military-oriented" likelihood questions were associated with one unique MSWBI item.The present study found that the overall state of well-being in USU medical students is satisfactory, but opportunities for improvement exist. Medical student well-being seemed to have a stronger association with medicine-oriented likelihood items than with military-oriented likelihood items. To obtain and refine best practices for strengthening engagement and commitment, future research should examine if and how military and medical contexts converge and diverge throughout training. This may enhance the medical school and training experience and, ultimately, reinforce, or strengthen, the desire and commitment to practice and serve in military medicine.

Medical empathy in medical students in Madrid: A proposal for empathy level cut-off points for Spain.

This study evaluates the degree of empathy among medical students and its influencing factors at three critical moments of their degree studies (beginning of first year and end of third and sixth years) as well as establishes low-, medium-, and high-empathy cut-off points to obtain valid and reliable results that can be extrapolated to the general population. This cross-sectional study of the eight (public and private) medical schools in the province of Madrid, used an electronic questionnaire with the Jefferson Scale of Empathy (JSE), Medical Student Well-Being Index, and other independent characteristics as measuring instruments. Of the 2,264 student participants, 1,679 (74.0%) were women, with a 50.7% participation rate. No significant differences were found in empathy levels by academic year. Regarding range, percentile and cut-off point tables were established to identify students with high, medium, and low empathy levels. Women (p<0.001), volunteer workers (p<0.001), and those preferring general specialties (internal medicine, psychiatry, pediatrics, or family medicine) scored higher on the JSE (p<0.02). Moreover, 41.6% presented high level of psychological distress. Women reported a lower well-being level and a higher risk of psychological distress (p = 0.004). In sum, the empathy of medical students in Madrid did not differ among the three critical moments of their university studies. The established cut-off points could be taken into account when accessing the medical degree and identifying students with low levels of empathy to implement curricular interventions to rectify this perceived deficiency. There was a high percentage of medical students with high levels of psychological distress.

Risk factors associated with student distress in medical school: Associations with faculty support and availability of wellbeing resources.

It is estimated that over half of medical students experience severe distress, a condition that correlates with low mental quality-of-life, suicidal ideation and serious thoughts of dropping out. While several risk factors for the development of severe distress have been identified, most focus on individual student characteristics. Currently, little is known about the impact medical schools have on student wellbeing. Prospective, observational survey study from 2019-2020 from a national cohort of US medical students. Student wellbeing, school characteristics, and wellbeing resource availability was measured with a 30-question electronic survey. Medical student distress was defined as a Medical Student Wellbeing Index (MS-WBI) of ≥4. Risk factors for the development of severe distress were evaluated in a multivariate logistic regression model. The impact of the number of wellbeing resources available on student wellbeing was measured along multiple wellbeing domains. Independent reviewers categorized free text analysis of survey responses about desired wellbeing resources into themes. A total of 2,984 responses were included in the study, representing 45 unique medical schools. Medical school characteristics independently associated with severe distress included low faculty support (OR 4.24); the absence of mentorship resources (OR 1.63) and the absence of community building programs (OR 1.45) in a multivariate model. Increased availability of wellbeing resources was associated with lower average MS-WBI (4.58 vs. 3.19, p<0;05) and a smaller percentage of students who had taken or considered taking a leave of absence (40% vs. 16%, p<0.05). The resources most desired by students were mental health services and scheduling adjustments. The majority of medical school characteristic that contribute to student distress are modifiable. Improving faculty support and offering more and varied wellbeing resources may help to mitigate medical student distress. Student feedback is insightful and should be routinely incorporated by schools to guide wellbeing strategies.

Polish medical students facing the pandemic-Assessment of resilience, well-being and burnout in the COVID-19 era.

Recent reports indicate that COVID-19 pandemic has significant influence on medical professionals' mental health. Strict limitations in clinical practice and social interactions within academic community, which had to be introduced, could lead to significant psychological distress in medical students. The aim of the study was to assess resilience, well-being and burnout among Polish medical students in the COVID-19 era. The online survey consisting of validated questionnaires assessing resilience (Resilience Scale 14; RS-14), well-being (Medical Student Well-Being Index) and burnout (Maslach Burnout Inventory) as well as self-created survey concerning mental health problems, use of stimulants, SARS-CoV-2 infection, work in COVID-19 units, medical education and social attitude towards health care professionals in the pandemic era was distributed via Facebook and other online students' platforms. 1858 MSs from all polish medical schools agreed to fill in the survey. 'Very low', 'low' and 'on the low end' levels of resilience were found in 26%, 19.1% and 26.9% of the study group, respectively. Students with higher resilience level presented better attitude towards online and hybrid classes. 16.8% of respondents stated that they worked, currently work or plan to work voluntarily at the pandemic frontline. In terms of burnout, these respondents presented lower exhaustion (p = 0.003) and cynicism (p = 0.02), and higher academic efficacy (p = 0.002). That group also showed greater resilience (p = 0.046). The SARS-CoV-2 infection among respondents, their relatives and friends did not influence the results. 39.1% of respondents declared the need of the psychological or psychiatric consultation in relation to pandemic challenges. 231 (26.4%) participants previously diagnosed with mental health disorders noticed worsening of their symptoms. Increased intake of alcohol, cigarettes or other stimulants was noticed by 340 (28.6%) respondents. 80.2% of respondents thought that social aversion and mistrust towards doctors increased during the pandemic and part of them claimed it affected their enthusiasm toward medical career. The majority of medical students presented low levels of resilience and high burnout at the time of pandemic. Providing necessary support especially in terms of mental health and building up the resilience of this vulnerable group seems crucial to minimize harm of current pandemic and similar future challenges.

The Benefits of Using the Healthy Minds Application in Medical Students.

Purpose: Studies have shown that medical students have an increased risk for depression and suicide compared with the general population and that risk increases throughout medical training. 1 These mental health issues are evident beginning in the first year of medical school and if not addressed, negative outcomes such as burnout, substance abuse, and suicidality are more likely to occur. 2,3 We studied the effects of using a Healthy Minds Program mobile application (app) on the well-being of medical students. This app was created by Healthy Minds Innovations, Inc (HMI) in collaboration with the Center for Healthy Minds at the University of Wisconsin—Madison. The app is aimed at the cultivation of 4 key attributes of wellness: awareness, connection, insight, and purpose. The goal of the study was to understand the benefit of the app on important health and well-being outcomes and if this would depend on usage amount. Approach: Sixty-one first-year medical students at the Medical College of Wisconsin Milwaukee campus volunteered for the study that was run between February and May 2020. Half received access to the app at the start of the study for 6 weeks (intervention group), and the other half did not gain access until the 6 weeks passed (control group). Outcomes were assessed at baseline (T0), at the midpoint (T1), and the end of the study (T2). Outcome measures included basic demographics (T0), the Depression, Anxiety, and Stress Scale - 21 Items (DASS-21) (T0, T2), the Medical Student Well-Being Index (MSWBI) (T0, T1, T2), the Healthy Minds Index (HMI) developed by Healthy Minds Innovations, Inc. (T0, T1, T2), Human Flourishing Index (T0, T2), Maslach Burnout Inventory (T0, T2), Self-Compassion Scale (SCS) (T0, T2), Insomnia Severity Index (T0, T2), perceived social support (PSS) (T0, T2), and connectedness (T0, T2). Completion and usage (measured as time spent in each module) of the app were collected and analyzed. Delta scores were computed for outcomes measured at T0 and T2, and repeated measures analysis of variance was conducted on measures collected at all 3 time points. Outcomes: Fifty-six participants completed the midpoint survey (n = 28 in each group), and 48 individuals completed all 3 surveys (n = 25 in group 1, n = 23 in group 2). Overall, a significant improvement was found between T0 and T2 for the following outcomes: overall self-compassion scores (0.23, P < .01), PSS (2.98, P < .01), and overall human flourishing (0.46, P < .001). Participants in the intervention group had a significant mean increase in their mindfulness scores (subdomain of the SCS) between T0 and T2 (delta = 2.98, P < .01). The HMI and connections scores were significantly higher at T2 than the T1 or T0 (P < .05) regardless of group. Time and interaction between the intervention group and time was found (P < .01). MSWBI scores at T2 was significantly higher than T0 (P < .05). The interaction revealed the intervention group had significantly improved mean MSWBI scores at T1 from T0 compared to the control group. The control group had improved mean MSWBI scores at T2 from T1 or T0 compared to the intervention group. Overall, participants app completion ranged from 92% to 16% for the wellness attributes in the foundations module, followed by the awareness module (completion ~16%). Discussion: MSWBI is a measure of psychological distress with a unique dimension of measuring dropout risk. Our results suggest that using the application improves MSWBI. The improvement in mindfulness (SCS subdomain) and connections (HMI) scores suggests a potential mechanism by which this improvement could be operating given the goals of the application. Significance: The results of this study suggest that medical students may be supported through their first year of medical school training using the Healthy Minds Program app. Even during the COVID-19 pandemic, it was encouraging to find students improved on various health and well-being measures. Acknowledgments: The authors would like to acknowledge the contributions of the Ohio State University Student Life team, Dr. Carol Lay, Clinical Psychologist and Consultant for University of Illinois College of Medicine Rockford Learning Specialist Team, and Matthew Strobel, Program Assistant for Student Affairs for the University of Illinois College of Medicine Rockford.

Incidence of and Risk Factors for Major Hemorrhage in Patients Treated with Ibrutinib: Results from an Integrated Analysis

Incidence of and Risk Factors for Major Hemorrhage in Patients Treated with Ibrutinib: Results from an Integrated Analysis

What is the association between student well-being and high-stakes examination scores?

As educators seek to improve medical student well-being, it is essential to understand the interplay between distress and important outcomes. Performance on Step 1 of the United States Medical Licensing Examination has played a significant role in selection for postgraduate residency positions in the United States and consequently has been a source of great stress for medical students. The purpose of this study was to examine whether student well-being correlates with performance on a high stakes licensing examination. Between 2014 and 2016, three sequential cohorts of medical students at the University of Michigan Medical School completed the Medical Student Well-Being Index (MSWBI) at the end of their 2nd-year curriculum, shortly before taking Step 1. Associations between well-being and Step 1 scores were investigated while adjusting for MCAT scores and cumulative second-year course scores. In total, 354 students were included in the analysis (68.1% of potential responders). On bivariate analysis, poor student well-being (0=low distress [high well-being], 7=high distress [poor well-being]) was associated with lower Step 1 examination scores (slope=-2.10, P<.01), and well-being accounted for 5% of overall Step 1 score variability (R2 =.05). However, after adjustment for MCAT scores and cumulative GPA (full model R2 =.51), the relationship between well-being and Step 1 score was no longer significant (slope=-0.70, P-value=.06). When controlling for metrics of academic performance, student well-being prior to taking Step 1 was not associated with how well students performed on Step 1 for the study sample.

Medical students in distress: The impact of gender, race, debt, and disability.

In 2012, over half of US medical students experienced burnout and depression. Since that time, there have been many changes to student demographics, school resources and awareness of burnout in the medical field altogether. New tools are also available to screen for student distress, a condition that correlates with low mental quality-of-life, suicidal ideation and serious thoughts of dropping out. Despite increased attention on wellbeing and improved screening methods, no large-scale studies have evaluated student distress in the modern era of medical education. The objective of this study was to determine the current prevalence of medical student distress and contributing risk factors. Student wellbeing from a national cohort of US medical students was measured with an electronic survey in a prospective, observational survey study from 2019-2020. Medical student distress was defined as a Medical Student Wellbeing Index (MS-WBI) of ≥4. Demographic details including age, race, gender, marital status, disability, desired specialty, and debt burden were evaluated in a multivariate logistic regression model to determine possible risk factors for the development of distress. A total of 3,162 students responded to the survey, representing 110 unique medical schools. Of these respondents, 52.9% met criteria for distress and 22% had either taken or considered taking a leave of absence for personal wellbeing. Independent risk factors for distress included involvement in the clinical phase of medical school (OR 1.37); non-male gender (OR 1.6); debt burden >$20,000 (OR 1.37), >$100,000 (OR 1.81), and >$300,000 (OR 1.96); and disability status (OR 1.84). Medical student wellbeing remains poor in the modern era of medical education despite increased attention to wellbeing and increased availability of wellbeing resources. Disability status is a novel risk factor for distress identified in this study. The persistence of previously identified risk factors such as non-male gender, debt burden and clinical phase of school suggest that efforts to curb medical student distress have been inadequate to date.

Temporal Trends in Medical Student Burnout.

There is a paucity of longitudinal data documenting the temporal development of distress and burnout during medical school. The aim of this study was to examine trends and identify stressors associated with medical student distress over 4 years of medical education. Medical students from the class of 2016 at a Liaison Committee on Medical Education-accredited medical school completed surveys nine times from orientation through after the residency match. Surveys included demographic variables and measured distress domains using the Medical Student Well-Being Index. The authors used Microsoft Excel to calculate the proportion of students screening positive for individual distress domains at each of the nine acquisition periods for descriptive analysis. Students completed 886 total surveys for an 85% response rate, which was relatively consistent across collection periods. Medical student distress and burnout increased from two (2%) to 12 (12%) respondents and from 19 (17%) to 37 (38%) respondents, respectively, from matriculation through after the residency match (P&lt;0.01). Depersonalization increased from 15 (13%) to 34 (35%) respondents and emotional exhaustion increased from six (5%) to 22 (22%) respondents across 4 years of medical education (P&lt;0.01). Emotional exhaustion peaked after medical school year 1, at 37 (45%), and year 3, at 45 (44%) respondents, with improvement after summer break and residency match. The results supported the literature demonstrating the development of burnout during medical school. Depersonalization increased early in the education process with minimal regression after development. Emotional exhaustion demonstrated a surprising increase after exposure to clinical clerkships. Further studies could support or refute the universality of these trends and evaluate prevention and intervention efforts targeting these key inflection points.

A Randomized Phase III Study of Ibrutinib (PCI-32765)-Based Therapy Vs. Standard Fludarabine, Cyclophosphamide, and Rituximab (FCR) Chemoimmunotherapy in Untreated Younger Patients with Chronic Lymphocytic Leukemia (CLL): A Trial of the ECOG-ACRIN Cancer Research Group (E1912)

A Randomized Phase III Study of Ibrutinib (PCI-32765)-Based Therapy Vs. Standard Fludarabine, Cyclophosphamide, and Rituximab (FCR) Chemoimmunotherapy in Untreated Younger Patients with Chronic Lymphocytic Leukemia (CLL): A Trial of the ECOG-ACRIN Cancer Research Group (E1912)

Risk Model for Overall Survival for Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia: Validated for Patients on Ibrutinib, Idelalisib, Venetoclax, or Chemoimmunotherapy

Risk Model for Overall Survival for Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia: Validated for Patients on Ibrutinib, Idelalisib, Venetoclax, or Chemoimmunotherapy

Psychological distress and academic self-perception among international medical students: the role of peer social support.

BackgroundPsychological distress among medical students is commonly observed during medical education and is generally related to poor academic self-perception. We evaluated the role of peer social support at medical schools in the association between psychological distress and academic self-perception.MethodsAn online survey was conducted in a medical degree program for 138 international students educated in English in the Czech Republic. The Medical Student Well-Being Index was used to define the students’ psychological distress. Perceived peer social support was investigated with the Multidimensional Scale of Perceived Social Support. Poor academic self-perception was defined as the lowest 30% of a subscale score of the Dundee Ready Education Environment Measure. Analyses evaluated the presence of additive interactions between psychological distress and peer social support on poor academic self-perception, adjusted for possible confounders.ResultsBoth psychological distress and low peer social support were negatively associated with poor academic self-perception, adjusted for local language proficiency and social support from family. Students with psychological distress and low peer social support had an odds ratio of 11.0 (95% confidence interval (CI): 2.1–56.6) for poor academic self-perception as compared with those without distress who had high peer social support. The presence of an additive interaction was confirmed in that the joint association was four times as large as what would have been expected to be on summing the individual risks of psychological distress and low peer social support (synergy index = 4.5, 95% CI: 1.3–14.9).ConclusionsPsychological distress and low peer social support may synergistically increase the probability of poor academic self-perception among international medical students. Promoting peer social relationships at medical school may interrupt the vicious cycle of psychological distress and poor academic performance.

Students' psychological distress in an English program embedded in a medical school in a non-English speaking country

ObjectivesTo clarify if medical students in an English program in a non-English speaking country are exposed to a higher risk of psychological distress compared to comparable local medical students.MethodsAn online survey was conducted for all medical students both in the English program exclusively for international students (n=235) and in the local program (n=1043) at the Palacky University in the Czech Republic. The Medical Student Well-Being Index (MSWBI) was used to define the student’s psychological distress. Logistic regressions were conducted to find an effect of the study program on the students’ psychological distress, adjusted by age, study year, marital status, residential status, and frequency of contact with significant others, stratified by gender.Results44% (n=68) of the respondents in the English program screened positive for psychological distress, and 53% (n=221) in the local program. There was an interaction between gender and program in the association with psychological distress. The higher prevalence of psychological distress in the local program was likely attributed to female students who had frequent contacts with their significant others.ConclusionsPsychological distress was highly prevalent in a Czech medical school, but there was no overall difference between the international students in the English program and the comparable local medical students.

Psychometric properties of the Medical Student Wellbeing Index at different interval of measurements in a cohort of medical students

Background : One of important educational climate roles is to provide an environment that promotes positive development of medical students’ psychological wellbeing during training. Unfortunately, many studies have reported that educational climate in medical education are not favourable to them . Therefore, it is a real need for a simple, valid, reliable and stable tool that will help medical schools to screen psychological wellbeing of their students so that early intervention could be done. Objective : This study aimed to explore the psychometric properties of the Medical Student Wellbeing Index (MSWBI) to measure psychological wellbeing at different interval of measurements in a cohort of medical students. Methodology : A prospective study was done on a cohort of medical students. MSWBI was administered to the medical students at five different intervals. The confirmatory factor analysis, Cronbach’s alpha and intra-class correlation analysis were applied to measure construct validity, internal consistency and agreement level at different interval of measurements. Result : A total of 153 (89.5%) medical students responded completely to the MSWBI. The MSWBI showed that the one-factor model had acceptable values for most of the goodness of fit indices signified its construct was stable across multiple measurements. The overall Cronbach’s alpha values for the MSWBI at the five measurements ranged between 0.69 and 0.78. The ICC coefficient values for the MSWBI total score was 0.58 to 0.59. Conclusion : This study found that the MSWBI had stable psychometric properties as a screening tool for measuring psychological wellbeing among medical students at different time and occasions. Continued research is required to refine and verify its psychometric credentials at different educational settings.

Psychometric properties of the Medical Student Well-Being Index among medical students in a Malaysian medical school

This study evaluated the convergent, discriminant, construct, concurrent and discriminative validity of the Medical Student Wellbeing Index (MSWBI) as well as to evaluate its internal consistency and optimal cut-off total scores to detect at least moderate levels of general psychological distress, stress, anxiety and depression symptoms. A cross sectional study was done on 171 medical students. The MSWBI and DASS-21 were administered and returned immediately upon completion. Confirmatory factor analysis, reliability analysis, ROC analysis and Pearson correlation test were applied to assess psychometric properties of the MSWBI. A total of 168 (98.2%) medical students responded. The goodness of fit indices showed the MSWBI had a good construct (χ2=6.14, p=0.803, RMSEA<0.001, RMR=0.004, GFI=0.99, AGFI=0.97, CFI=1.00, IFI=1.02, TLI=1.04). The Cronbach's alpha value was 0.69 indicating an acceptable level of internal consistency. Pearson correlation coefficients and ROC analysis suggested each MSWBI's item showed adequate convergent and discriminant validity. Its optimal cut-off scores to detect at least moderate levels of general psychological distress, stress, anxiety, and depression were 1.5, 2.5, 1.5 and 2.5 respectively with sensitivity and specificity ranged from 62 to 80% and the areas under ROC curve ranged from 0.71 to 0.83. This study showed that the MSWBI had good level of psychometric properties. The MSWBI score more than 2 can be considered as having significant psychological distress. The MSWBI is a valid and reliable screening instrument to assess psychological distress of medical students.

Efficacy of a Brief Screening Tool to Identify Medical Students in Distress

To determine whether the Medical Student Well-Being Index (MSWBI) can serve as a brief assessment tool to identify medical students in severe psychological distress. The authors used data from 2,248 medical students at seven U.S. medical schools who responded to a 2007 survey to explore the accuracy of the MSWBI in identifying medical students with three outcomes: low mental quality of life (QOL; defined by having a Medical Outcomes Study Short-Form Health Survey mental component summary score ≥1/2 standard deviation below that of the age- and gender-matched population norm), suicidal ideation, or serious thoughts of dropping out. The authors confirmed their analyses using data from a separate sample of 2,682 students evaluated in 2009. Students with low mental QOL, suicidal ideation, or serious thoughts of dropping out were more likely to endorse each individual MSWBI item and a greater number of total items than were students without such distress (all P < .001). The likelihood ratio for low mental QOL among students with MSWBI scores <4 was 0.47 as compared with 4.79 for those with scores ≥4. At an MSWBI threshold score of ≥4, the MSWBI's sensitivity and specificity for identifying students with low mental QOL or recent suicidal ideation/serious thoughts of dropping out were both ≥90%. On multivariable logistic regression, all MSWBI items were independently associated with at least one outcome. The MSWBI is a useful brief screening tool to help identify students with severe distress.

Development and preliminary psychometric properties of a well-being index for medical students

BackgroundPsychological distress is common among medical students but manifests in a variety of forms. Currently, no brief, practical tool exists to simultaneously evaluate these domains of distress among medical students. The authors describe the development of a subject-reported assessment (Medical Student Well-Being Index, MSWBI) intended to screen for medical student distress across a variety of domains and examine its preliminary psychometric properties.MethodsRelevant domains of distress were identified, items generated, and a screening instrument formed using a process of literature review, nominal group technique, input from deans and medical students, and correlation analysis from previously administered assessments. Eleven experts judged the clarity, relevance, and representativeness of the items. A Content Validity Index (CVI) was calculated. Interrater agreement was assessed using pair-wise percent agreement adjusted for chance agreement. Data from 2248 medical students who completed the MSWBI along with validated full-length instruments assessing domains of interest was used to calculate reliability and explore internal structure validity.ResultsBurnout (emotional exhaustion and depersonalization), depression, mental quality of life (QOL), physical QOL, stress, and fatigue were domains identified for inclusion in the MSWBI. Six of 7 items received item CVI-relevance and CVI-representativeness of ≥0.82. Overall scale CVI-relevance and CVI-representativeness was 0.94 and 0.91. Overall pair-wise percent agreement between raters was ≥85% for clarity, relevance, and representativeness. Cronbach's alpha was 0.68. Item by item percent pair-wise agreements and Phi were low, suggesting little overlap between items. The majority of MSWBI items had a ≥74% sensitivity and specificity for detecting distress within the intended domain.ConclusionsThe results of this study provide evidence of reliability and content-related validity of the MSWBI. Further research is needed to assess remaining psychometric properties and establish scores for which intervention is warranted.