Well-being Of Medical Students Research Articles

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.

Lessons for Medical and Health Education Learned from the COVID-19 Pandemic.

Our paper analyzes lessons for medical education and health education stemming from the experience gained in the course of the COVID-19 pandemic. Moreover, it tackles the issue of the social health and psychological wellbeing of medical students involved in online education during the COVID-19 pandemic. The paper systematizes up-to-date data on how medical schools and universities have adapted to the conditions of the COVID-19 pandemic and implemented novel effective solutions for the learning process, such as transitioning from traditional in-person classes to online learning, incorporating virtual simulations and telemedicine experiences for clinical training, and collaborating with health authorities to provide support in testing and contact tracing efforts. The paper contains an analysis of various aspects of medical education, such as the changes in practical classes, the impact of the pandemic on the formation of communication skills, methods for assessing students' knowledge and skills, and many others. It also considers case studies related to the implementation of educational programs, methodologies, and novel digital technologies in a pandemic. Additionally, the paper features an empirical study that is based on the results of our own survey that was carried out with the help of a snowball convenient sampling that involved 710 medical students between 19 and 25 years of age (56% females and 44% males) from 4 Russian regions (Moscow, Krasnodar, Kazan, and Saint Petersburg). We applied the correlation between stress scores, anxiety scores, factors of stress, and strategies for coping with stress and various economic and demographic variables (age, environment, and gender) that were analyzed using the chi-square test. Our results demonstrate that over 85% of the students in our sample yielded an above-average vulnerability to stress due to the COVID-19 restrictions. At the same time, around 61% of the students experienced severe anxiety during online education in the COVID-19 pandemic. The important factors leading to stress and anxiety were the fear of getting infected and social distancing, and the best strategy to deal with stress and increase wellbeing was self-control. Through a comprehensive review of the literature and empirical estimations, our paper identifies key areas of improvement, including curriculum adaptation, technology integration, faculty development, student support, and interprofessional collaboration. The proposed recommendations aim at strengthening medical education systems and preparing healthcare professionals to effectively navigate future pandemics.

Student-led approaches to mental health support

Mental health issues amongst university students are rife. Increasing mental health literacy and an emphasis on wellbeing have revealed the importance of having a plethora of resources available to students surrounding mental health support. The Welfare Hub is a student-led project created at the University of Nottingham Medical School to destigmatise mental health discussion, enhance mental health education, and share experiences of healthcare professionals regarding their mental health and university support. In this paper, we incorporate discussion around improvements the Welfare Hub can make regarding its content and how to best support future students. This project identified that the Welfare Hub's Instagram account was closely associated with mental health awareness and education, and that the best performing posts were those that offered positive connotations of support relevant to medical students and those that detailed lived medical student's experiences and advice. The Welfare Hub has had a positive impact on committee members and allowed them to fulfil their desires regarding destigmatising and discussing mental health. Future development following these findings aim to produce more educational and supportive content, develop connections of the Welfare Hub within the University and other institutions, and host events for the well-being of medical students.

IMPACT OF COVID-19 PANDEMIC ON PSYCHOLOGICAL, SOCIAL & MENTAL HEALTH: AN EMPIRICAL ANALYSIS

Aim of the study: The purpose of this research was to examine how the COVID-19 epidemic affected the mental, social, and psychological well-being of medical students in Delhi-NCR, India. Design/Methodology: Medical students in the 'Delhi-NCR' region of India were surveyed for a pandemic. The hypothesised relationship was examined by regression analysis, and the conceptual model was confirmed through the results. Findings: This study shows that the mental, social, and psychological impact of COVID-19 among Indian medical students is substantial. Medical students' 'mental, social, and psychological' health was shown to be strongly damaged by the identified risk factors, such as having a family member infected with COVID-19 or losing close ones. The study also indicated that the association between the 'Impact of the Covid 19 Pandemic (ICP)' and 'Psychological Health (PH)' was the strongest (0.818), while the relationship between the 'ICP' and 'Social Health (SH)' was the worst (0.587). Practical Implications: This research has the potential to significantly improve people's health and social functioning by assisting in the design of individualised preventative and intervention programmes to lessen the toll the pandemic has taken on people's physical and mental health. Originality/value: The focus of this study was to analyse how the recent COVID-19 pandemic has affected medical students' emotional, social, and mental well-being. Keywords: COVID-19, Psychological, Social & Mental Health, Regression Analysis Paper Type: Research paper

Impact of Resilience and Viral Anxiety on Psychological Well-Being, Intrinsic Motivation, and Academic Stress in Medical Students During the COVID-19 Pandemic.

We aimed to explore the association between academic stress or motivation and the psychological well-being of medical students during the coronavirus disease-2019 (COVID-19) pandemic. We also explored the effects of their resilience or viral anxiety on this association. This online surveyed for medical students was done during October 20-28, 2021. Participants' age, sex, grades, and COVID-19-related experiences were collected. Their symptoms were measured with Stress and Anxiety to Viral Epidemics-6 items, Medical Stress Scale (MSS), intrinsic motivation using Academic Motivation Scale, Connor Davidson Resilience Scale-2 items (CD-RISC2), the 5-item World Health Organization Well-Being Index (WHO-5), and GRIT scale. Among 251 medical students, linear regression performed to explore the predicting factors for psychological well-being or medical stress showed that WHO-5 score was predicted by age (β=0.16, p=0.02) and CD-RISC2 (β=0.29, p<0.001) (F=15.5, p<0.001). In addition, the MSS score was predicted by age (β=0.20, p=0.004), intrinsic motivation (β=-0.31, p<0.001), GRIT (β=0.21, p=0.003), and CD-RISC2 (β=-0.31, p<0.001) (F=15.6, p<0.001). The resilience of medical students partially influenced their intrinsic motivation, affecting their psychological well-being or academic stress. However, no significant association was observed in the case of viral anxiety as a mediator, indicating that viral anxiety did not mediate the association. This study highlights the importance of resilience in mediating the relationship between intrinsic motivation and psychological well-being or academic stress. However, viral anxiety was not found to be a mediator in this relationship.

A Mixed-Methods Systematic Review of Group Reflective Practice in Medical Students.

Used primarily as a pedagogical evaluation tool for didactic teaching and skill development, reflective practice (RP) for its own merits is poorly understood. This study aimed to systematically review the literature regarding the role of group RP in fostering empathy, wellbeing, and professionalism in medical students. Electronic searches of empirical studies published between 1 January 2010 and 22 March 2022 from Medline, Embase, and PsychINFO databases were conducted. Empirical studies of any design (qualitative or quantitative) which included RP (1) involving medical students; (2) with a focus on fostering empathy, or professionalism, or personal wellbeing; and (3) provided in a group setting were included. Duplicates, non-English articles, grey literature and articles using RP to examine pedagogy and specific technical skills were excluded. Both authors screened articles independently to derive a final list of included studies, with any discrepancies resolved by discussion, until consensus reached. Articles were rated for methodological quality using the Attree and Milton checklist for qualitative studies; the Oxford Centre for Evidence-Based Medicine criteria, and the Alberta Heritage Foundation for Medical Research Standard Quality Assessment Criteria for quantitative studies. Of 314 articles identified, 18 were included: 9 qualitative; 4 quantitative and 5 mixed methodology. Settings included United States (6), United Kingdom (3), Australia (3), France (2), Taiwan (2), Germany (1), and Ireland (1). Themes were (i) professionalism: bridging theoretical paradigms and practice; (ii) halting empathy decline; (iii) wellbeing: shared experience. Additional themes regarding the "successful" delivery of RP groups in facilitating these outcomes also emerged. This first systematic review of group RP in medical students shows that RP may bring theory to life in clinical dilemmas, while fostering collegiality and mitigating against isolation amongst students, despite the absence of studies directly examining wellbeing. These findings support the value of RP integration focusing on emotive and humanitarian processes into contemporary medical education for medical students. PROSPERO CRD42022322496.

Improving stress management, anxiety, and mental well-being in medical students through an online Mindfulness-Based Intervention: a randomized study

Pressures and responsibilities of medical school put a strain on medical student's personal wellbeing, leading among all to high rates of anxiety, emotional discomfort and stress. In this work we evaluated the effectiveness of a comprehensive Mindfulness-Based Intervention (MBI) in reducing this load. The intervention comprised 10 twice-a-week Integral Meditation classes, dietary advice, and brief yoga sessions. We performed a randomized trial on two cohort of medical students from Italian universities: 239 in cohort 1 (106 treated and 133 controls), and 123 in cohort 2 (68 treated and 55 control) for a total sample of 362 students. Nine questionnaires for evaluating the effectiveness of our intervention on stress (PSS), state anxiety (STAIX-1), well-being (WEMWBS), mind-wandering (MW-S), overall distress (PANAS), emotion regulation (DERS), resilience (RS-14), and attentional control (ACS-C and ACS-D) were collected both pre and post intervention. Linear mixed effect models were run on the whole sample showing that, after multiple testing correction, our intervention was effective in reducing perceived stress (β = − 2.57 [− 4.02; − 1.12], p = 0.004), improving mental well-being (β = 2.82 [1.02; 4.63], p = 0.008) and emotional regulation (β = − 8.24 [− 12.98; − 3.51], p = 0.004), resilience (β = 3.79 [1.32; 6.26], p = 0.008), reducing the tendency to wander with the mind (β = − 0.70 [− 0.99; − 0.39], p = 0.0001), ameliorating the ability to maintain attention (AC-S (β = − 0.23 [− 0.44; − 0.02], p = 0.04) and AC-D (β = − 0.19 [− 0.36; − 0.01], p = 0.04)), and the overall distress (β = 1.84 [0.45; 3.23], p = 0.02).

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.

Profiles of Military Medical Students’ Well-being, Burnout, and Retention

ABSTRACT Background Well-being concerns among medical students are more prevalent than their age-matched peers in the United States. It remains unknown, however, if individual differences in well-being exist among U.S. medical students serving in the military. In this study, we sought to identify profiles (i.e., subgroups) of well-being in military medical students and examine the associations between these well-being profiles and burnout, depression, and intended retention in military and medical fields. Methods Using a cross-sectional research design, we surveyed military medical students and then conducted latent class analysis to explore profiles of well-being, and applied the three-step latent class analysis method to assess predictors and outcomes of well-being profiles. Results Heterogeneity in well-being was identified among the 336 military medical students surveyed, portraying medical students’ falling into three distinct subgroups: High well-being (36%), low well-being (20%), and moderate well-being (44%). Different subgroups were associated with different risks of outcomes. Students in the subgroup of low well-being were at the highest risk of burnout, depression, and leaving medicine. In contrast, students in the moderate well-being group were at the highest risk of leaving military service. Conclusions These subgroups may be clinically important as burnout, depression, and intention to leave medical field and/or military service occurred with varying likelihoods among medical students across the different well-being subgroups. Military medical institutions may consider improving recruitment tools to identify the best alignment between students’ career goals and the military setting. Besides, it is crucial for the institution to address diversity, equity, and inclusion issues that may lead to alienation, anxiety, and a sense of wanting to leave the military community.

Development of a Spiritual Health Curriculum: An Applied Study in Iran

Background: Today, prioritizing the spiritual well-being of medical students holds significant importance in numerous countries worldwide. An educational curriculum serves as a comprehensive written document that delineates educational objectives, content, as well as teaching and assessment methods. Objectives: This study aims to formulate and construct a curriculum for a master's degree program in spiritual health. Methods: The initial phase of this study aims to ascertain the existing state of spiritual health education programs by conducting a thorough literature review. In the subsequent phase, a focus group discussion was conducted with eight experts and scholars to deliberate on the spiritual health curriculum, utilizing Tyler's curriculum development model as a framework. Finally, the nominal group process was employed to reach a consensus among the experts, ensuring the formulation of the final draft. Results: The spiritual health education curriculum was developed following Tyler's curriculum planning framework, encompassing four distinct components. Part one outlines the goals of the spiritual health curriculum, while part two focuses on defining the content of the curriculum. Part three addresses the learning opportunities and strategies for teaching spiritual health within the curriculum. Lastly, part four involves the evaluation process to assess the effectiveness and impact of the spiritual health curriculum. Conclusions: Spiritual health education has been recommended in various references. Recognizing discipline as spiritual health has fostered the growth of spiritual concepts in the healthcare environment, bringing attention to the needs of patients.

Headache-a challenge across medical students' life: a systematic review and meta-analysis.

Headache is a disabling disease that affects psychosocial factors. Medical students are recognized to be more susceptible to psychological stress than other. Quantitative summaries of prevalence studies on this subject are limited. The aim of this study was to quantify and comprehend the variance in prevalence at the global and regional levels. We used a comprehensive search approach to find studies on headaches prevalence in the medical literature published between November 1990 and May 5, 2022. Database searched were PubMed, Scopus, EMBASE, and Google Scholar. Studies that reported headaches (unspecified, migraine, or tension-type headache (TTH)) in medical students were included. Subgroup analysis and meta-regression were applied to investigate heterogeneity, with the risk of bias tool employed to assess study quality. PROSPERO number CRD42022321556 was assigned to the study protocol. Out of 1561 studies, 79 were included. The pooled prevalence estimates of unspecified headache, migraine, and TTH were 70.44% (95% CI: 63.32-77.57), 18.9% (95% CI: 15.7-22.0), and 39.53% (95% CI: 31.17-47.90), respectively. TTH and migraine were more prevalent in Eastern Mediterranean and American region. TTH and migraine were less prevalent in higher income countries. Although the prevalence of headaches among medical students varies in different countries, it is higher than the general population of the same age. Higher stressors and overwork in these students may contribute to this condition. The well-being of medical students should be a priority for the relevant authorities.

Mindfulness-based resilience training on the psychological well-being of medical students during the COVID-19 pandemic

Background: In recent years, research has witnessed an exciting change toward well-being and health instead of emphasizing disorders and inefficiency. The current study aimed to assess the effect of a mindfulness-based resilience training program on the psychological well-being of medical students during the COVID-19 pandemic. Methods: The current study was quasi-experimental with a control group and a pre/post design. A sample of 30 students was randomly selected from a community of medical students at the Tabriz University of Medical Sciences in the academic year 2021-2022. These students were randomly divided into two groups of 15 participants. The tools used in this research included Ryff’s Psychological Well-Being Questionnaire (PWB-18) and an integrated training program for resilience and mindfulness. Results: The findings showed an integrated training program of resilience and mindfulness positively affected students’ psychological well-being. In addition, this intervention was able to explain 59% of the combined variance of psychological well-being variables. Conclusion: The results of the current study found that an integrated training program of resilience and mindfulness can improve individuals’ psychological well-being during a difficult situation such as the COVID-19 pandemic.

The presence, action, and influence of bystanders who witness sexual harassment against medical students

Purpose Sexual harassment (SH) is a widespread problem in academia, with a disproportionate impact on female medical students and those who experience marginalization via multiple systems of oppression (e.g. racism, heterosexism). Bystander intervention education is a potential approach which frames violence as a community issue where all members have a role to play in response and prevention. This study assessed the presence and influence of bystanders in SH situations for students at two medical schools. Materials and methods Data came from a larger U.S. campus climate study administered online in 2019 and 2020. The sample included 584 students who responded to validated survey questions about sexual harassment experiences, bystander behavior, disclosure, perceptions of the university response to SH, and demographics. Results More than one-third of respondents experienced some form of SH by a faculty/staff member. Bystanders were present for more than half of these incidents, yet they rarely intervened. When bystanders intervened, people were more likely to disclose an incident than not. Conclusions The results indicate that there are many missed opportunities for intervention and given the profound impact that SH has on the well-being of medical students, continued work is needed to determine effective intervention and prevention methods. Practice points One-third of the medical students surveyed in our sample reported experiencing SH; women and LGBT medical students are more likely to experience SH than their counterparts. Bystanders are frequently present during SH incidents; however, the percentage of situations where bystanders actually intervened was extremely low. Bystander intervention was correlated with an increased likelihood to disclose. Thus, the implementation of bystander intervention education programs may help facilitate disclosure and reporting. Bystander intervention education programs are needed within academic medicine but must account for the role of power differentials.

Generalized Anxiety Disorder, Alexithymia, and Defense Mechanisms Among Medical Students of Northeastern Iran

Background: Defense mechanisms are essential to personality and behavior that help individuals deal with stress. These mechanisms might act in different ways, rendering medical students caring physicians or egoistic individuals, and thus, a good understanding of defense mechanisms can contribute to the efforts made to improve the psychological well-being of medical students. Objectives: We studied the prevalence of generalized anxiety disorder (GAD) and alexithymia as determinants of psychological well-being and the mechanisms by which medical students might cope with stress and anxiety. Methods: The present cross-sectional study was conducted on 232 medical students, 126 (60%) females and 96 (40%) males, in northeast Iran. Data were collected through GAD-7, the Farsi version of the Toronto Alexithymia Scale (FTAS-20), and the Defense Styles Questionnaire (DSQ-40). Statistical analysis was performed with IBM SPSS 22.0. Pearson's chi-square test, bivariate correlations, and multiple linear regression analysis were used to identify associations between GAD, alexithymia, and defense mechanisms. Results: A total of 87 (37.5%) participants showed moderate to severe anxiety. Alexithymia was detected in 49 (21%) participants. Mature defense mechanisms had the highest prevalence among participants (56.5%), while immature mechanisms had the least (23.3%). A significant positive correlation was noted between GAD and alexithymia. Also, GAD was positively correlated with immature and neurotic defense mechanisms (P &lt; 0.05). A negative correlation was found between mature defense mechanisms and GAD (P &lt; 0.001). Suppression and humor (mature mechanisms) were the negative predictors of GAD. Reaction formation, somatization, autistic fantasy, splitting, passive aggression, displacement, and pseudo-altruism (an immature and neurotic mechanism) were the positive predictors of GAD. Conclusions: The statistically significant correlations found among GAD, alexithymia, and defense mechanisms suggest that a good understanding of these conditions and mechanisms can contribute to alleviating anxiety among medical students and improving their psychological well-being.

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

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.

The art of seeing: The impact of a visual arts course on medical student wellbeing

Purpose Medical student burnout is becoming increasingly common. The Art of Seeing is a visual arts elective at one US medical school. The purpose of this study was to determine the effect of this course on attributes that are foundational to wellbeing: mindfulness, self-awareness, and stress. Methods A total of 40 students participated in this study from 2019 through 2021. Fifteen students participated in the pre-pandemic, in-person course, and 25 students participated in the post-pandemic, virtual course. Pre and post-tests included open-ended responses to works of art, which were coded for themes, and standardized scales: mindful attention awareness scale (MAAS), situational self-awareness scale (SSAS), and perceived stress questionnaire (PSQ). Results The students had statistically significant improvements on the MAAS (p < .01), the SSAS (p < .01), and the PSQ (p = 0.046). Improvements in the MAAS and the SSAS did not depend on class format. Students also demonstrated increased focus on the present moment, emotional awareness, and creative expression in the post test free responses. Conclusions This course significantly improved mindfulness, self-awareness, and stress levels in medical students, and can be used to help enhance wellbeing and mitigate burnout in this population, both in-person and virtually.

Depression among Medical Students of a Medical College: A Descriptive Cross-sectional Study

Medical students encounter multiple psychological changes in the transformation from young insecure students to efficient physicians. They have to balance the personal, social and academic dimention in a busy schedule. So, this study aimed to find out the prevalence of depression among medical students of a medical college. A descriptive cross-sectional study was conducted among medical students of a medical college from 2 May 2017 to 16 October 2017 after taking ethical approval from the Departmental Research Unit (Reference number: Psy/73/078/079). Students participated voluntarily in the study from first to fourth year and written informed consent was taken. Depression, Anxiety and Stress Scale-42 scale was filled by the students taking their own time and privacy to assess their depression, anxiety and stress. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Among 302 medical students, 86 (28.47%) (23.38-33.56, 95% Confidence Interval) had depression. A total of 31 (36.04%) had mild, 31 (36.04%) had moderate, 12 (13.95%) had severe and 12 (13.95%) had extremely severe depression. Among them 55 (63.95%) were males and 31 (36.04%) were females. The prevalence of depression among medical students was similar to the other studies conducted in similar settings. Studies concerning the subjective well-being of medical students should be continued and strategic plans and programs should be conducted to help the students manage their stress and depressive symptoms right from the time they join the medical school and continued till they finish the course. depression; medical students; mental health.

Assessment of Physical and Emotional Wellbeing of Medical Students using SF-36 Questionnaire

Background: The pressures of medical school can be extremely difficult for personal wellness and contribute to anxiety, burnout and depression. High demands for academic performance and restraints of extracurricular activities all add to distress of a medical student. Methodology: A cross sectional study using convenient sampling was carried out in medical students of CPMC, Lahore. A sample size of 208 was taken. The data was collected using the SF-36 questionnaire. Data was presented as percentages, frequencies, mean and standard deviation. Results: The mean score of physical activity was 61.35+27.02 SD. The average score of restraints due to physical health and hindrance due to emotional health was 38.58+37.49 SD and 34.26+15.37 SD. The mean score of discomfort was 59.57+27.70 SD. The Mean+SD of the score for vitality or tiredness was 46.47+16.69 SD. The average score of emotional health, social relationships and general fitness was 51.10+16.64 SD, 52.82+21.57 SD and 54.04+18.76 SD. Practical implication of the study is to observe the physical and emotional health of students enrolled in MBBS program. Conclusion: The questionnaire SF-36 has been used in the past literature for the assessment of physical and emotional well-being of patients suffering from any particular disease. We observed that the female participants had poor physical and emotional health compared to male participants. Keywords: Mental, physical, medical students, assessment.

Evaluation of an App-Delivered Psychological Flexibility Skill Training Intervention for Medical Student Burnout and Well-being: Randomized Controlled Trial

Physician burnout is a common problem, with onset frequently occurring during undergraduate education. Early intervention strategies that train medical students in psychological flexibility skills could support well-being and mitigate burnout risks associated with unmodifiable career stressors. There is a need for randomized controlled trials to assess effectiveness. As psychological flexibility varies contextually and among individuals, tailoring interventions may improve outcomes. Smartphone apps can facilitate individualization and accessibility, and the evaluation of this approach is an identified research priority. This study aimed to evaluate the effectiveness of a stand-alone app-delivered Acceptance and Commitment Training intervention for improving medical students' self-reported burnout, well-being, psychological flexibility, and psychological distress outcomes. We aimed to explore whether an individualized app would demonstrate benefits over a nonindividualized version. This parallel randomized controlled trial was conducted with a sample of medical students from 2 Australian universities (N=143). Participants were randomly allocated to 1 of 3 intervention arms (individualized, nonindividualized, and waitlist) using a 1:1:1 allocation ratio. Individualized and nonindividualized participants were blinded to group allocation. The 5-week intervention included an introductory module (stage 1) and on-demand access to short skill training activities (stage 2), which students accessed at their own pace. Stage 2 was either nonindividualized or individualized to meet students' identified psychological flexibility training needs. The mean differences in change from baseline between the intervention groups and the waitlist group were not statistically significant for burnout outcomes: exhaustion (primary; individualized: -0.52, 95% CI -3.70 to 2.65, P=.75; nonindividualized: 1.60, 95% CI -1.84 to 5.03, P=.37), cynicism (individualized: -1.26, 95% CI -4.46 to 1.94, P=.44; nonindividualized: 1.00, 95% CI -2.45 to 4.46, P=.57), and academic efficacy (individualized: 0.94, 95% CI -0.90 to 2.79, P=.32; nonindividualized: 2.02, 95% CI 0.02-4.03, P=.05). Following the intervention, the individualized group demonstrated improved psychological flexibility (0.50, 95% CI 0.12-0.89; P=.01), reduced inflexibility (0.48, 95% CI -0.92 to -0.04; P=.04), and reduced stress (-6.89, 95% CI -12.01 to 5.99; P=.01), and the nonindividualized group demonstrated improved well-being (6.46, 95% CI 0.49-12.42; P=.04) and stress (-6.36, 95% CI -11.90 to -0.83; P=.03) compared with waitlist participants. Between-group differences for the individualized and nonindividualized arms were not statistically significant. High attrition (75/143, 52.4%) was observed. This trial provides early support for the potential benefits of Acceptance and Commitment Training for medical student well-being and psychological outcomes and demonstrates that psychological flexibility and inflexibility can be trained using a smartphone app. Although postintervention burnout outcomes were not statistically significant, improvements in secondary outcomes could indicate early risk mitigation. Replication studies with larger samples and longer-term follow-up are required, and future research should focus on improving implementation frameworks to increase engagement and optimize individualization methods. Australian New Zealand Clinical Trials Registry 12621000911897; https://tinyurl.com/2p92cwrw. RR2-10.2196/32992.

Impact of COVID-19 on Rocky Vista University medical students' mental health: A cross-sectional survey.

The COVID-19 pandemic brought immense changes to medical school curriculums world-wide, such as the widespread adoption of virtual learning. We sought to better understand the impact on medical students' mental health at Rocky Vista University College of Osteopathic Medicine, Parker, CO, United States. This study assessed the impact the pandemic had on anxiety and depression levels of medical students. It also assessed the impact of several domains on student mental health during the pandemic and how various sub-groups within the studied population were affected. A cross-sectional survey was sent to students through an online anonymous google survey in May to June 2021, centered around the 7-item questionnaire used to screen for Generalized Anxiety Disorder GAD-7, 9-item questionnaire used to screen for depression PHQ-9, and self-designed questions to assess the personal impact of the pandemic. Data obtained were screened for error and analyzed with significance value of p < 0.05. A total of 152 responses were received (25.5% response rate). Of these, 64.1% identified as female, 75.8% were white, 50.3% were between ages 21-25, and 77.8% were first year medical students. During the pandemic, 79.6% of respondents felt more anxious and 65.1% felt more depressed. 67.8% of students reported feeling social isolation amidst the pandemic. Students living with friends were more likely to see a therapist for depression during the pandemic (p = 0.0169) and prescribed an antidepressant (p = 0.0394). Females and students in relationships were more likely to score higher on GAD-7 (p = 0.0194) and (p = 0.0244), respectively. This study investigated the effect of the pandemic on medical students' mental health and the need to address this issue. Results suggest that the pandemic had a negative impact on medical student's mental health and that anxiety and depression levels worsened for pre-clinical medical students at Rocky Vista University. As such, it is imperative to incorporate additional resources to protect the well-being of medical students as they progress through their medical careers.