Well-being Of Medical Students Research Articles

Mindfulness, complex interventions and conceptual clarity

Reduced psychological well-being (the presence of stress, burnout or a mental health disorder) in medical students and doctors is highly prevalent, and this represents a significant threat to the medical workforce and high quality patient care. While there remains limited understanding of the causal factors involved one potential intervention to improve psychological well-being is mindfulness training in medical education.

The well-being of medical students: A biopsychosocial approach.

Mental health problems among medical students have been widely reported, but the predisposing and perpetuating factors and biological concomitants are poorly understood. Adopting a biopsychosocial approach, we studied well-being in a group of Australian medical students, focusing on sleep, autonomic and immune mechanisms, as well as mental, social and physical well-being, health-related behaviours, and daily functioning. Fourth-year medical students (N = 151) completed comprehensive assessments, including laboratory-based and nocturnal autonomic monitoring via ambulatory bioharness, a psychiatric diagnostic interview, and questionnaires assessing sleep quality and psychosocial and physical well-being. A blood sample was taken to quantify the inflammatory marker C-reactive protein. Sleep, mood and activity was additionally monitored daily for 7 days. A sizable minority of students reported diminished physical, mental and psychosocial well-being. We also found concerning levels of sleep disturbance and social and occupational impairment in a subset of students. The strong co-occurrence of problems across symptom domains supported a biopsychosocial interdependence of health and well-being states. Maladaptive coping behaviours were apparent, notably hazardous alcohol consumption, which was associated with a clinically significant elevation in C-reactive protein levels (> 3 mg/L). We documented, for the first time, significantly diminished nocturnal heart rate variability in medical students with a mental health diagnosis. Nocturnal heart rate variability was strongly associated with sleep quality, daytime autonomic stress reactivity, as well as occupational and social functioning. Well-being is a multifaceted phenomenon firmly interlinked with sleep, autonomic and immune function, health behaviours and functional outcomes. Our novel findings supported a key role for nocturnal autonomic function in promoting sleep quality and mental well-being. Interventions could focus on sleep hygiene and health behaviours as a buffer for well-being and teach more adaptive strategies for coping with the stresses of medical training.

A qualitative analysis of the coping reservoir model of pre-clinical medical student well-being: human connection as making it \u2018worth it\u2019

BackgroundBy all indications, well-being among physicians is poor, which manifests in various outcomes, including burnout, depression/anxiety, low life satisfaction, alcohol/substance misuse, suicide ideation, and suicide. Despite the vast literature on physician burnout, there is relatively little research on how pre-clinical experiences in medical school may be an antecedent to subsequent poor health among physicians. Here we focus on two neglected areas within the literature by focusing on the pre-clinical stage of medical school and the positive, as opposed to exclusively the negative, aspects of the medical school experience as it affects well-being.MethodsThis study utilizes the metaphor of the Coping Reservoir Model as a theoretical and analytical framework for understanding medical student well-being by identify the ‘depleting’ and ‘replenishing’ inputs that are deposited into students’ coping reservoirs. We analyze 105 medical students’ reflective writings using a data analytic process consistent with an interpretive description approach, engaging in a hierarchical 3-step coding process to identify the main replenishing inputs deposited into students’ coping reservoirs.ResultsThe main depleting inputs that we identify are consistent with those identified by The Coping Reservoir Model. In addressing our main research question regarding the replenishing inputs, results show the main positive factors are psycho-social resources, intellectual stimulation, and social support/relationships. Most importantly, relationships with patients shape all three of these positive factors and provide the main source of hope that the stress of medical school will get better.ConclusionsWhat allows students to frame their experiences with hope and optimism are the connections they form with each other and with patients. The prolonged stress of medical school is made “worth it” in hopes that it will “get better” with more meaningful patient interaction in the future. These results that emphasize the positive aspects of medical school are discussed in context of their theoretical contributions to The Coping Reservoir Model and the practical implications for medical education to improve medical student well-being by facilitating human connection.

Empathy, well-being and stressful experiences in the clinical learning environment

ObjectiveThis study examines whether students in the clinical phase show reduced well-being and lower empathy scores compared to preclinical students. Furthermore, it explores students’ most stressful experiences. MethodsA cross-sectional mixed-methods study was conducted among medical students of the revised patient- and student-centred curriculum at Witten/Herdecke University (Germany). An online survey included questions regarding empathy (JSPE-S), well-being (WHO-5), distressing factors in the learning and clinical environments, mistreatment and thoughts of dropping out. Results176 (34 %) of 517 medical students completed the questionnaire, 73 being preclinical and 103 clinical students. Despite lower well-being, clinical student did not demonstrate lower empathy levels. Main stressors during the clinical phase were negative physician role models and financially focussed care rather than challenging patient encounters. Compared to preclinical students, clinical students showed more mistreatment experiences and higher ratings towards thoughts of dropping out. ConclusionOur results illustrate contemporary challenges to establishing a learner-centred clinical environment that nurtures well-being and empathy of medical students. The sustainment of empathy despite more stressful experiences and lower well-being may be due to protective factors. Practice ImplicationsThe paper suggests activities to support clinical students to find ways to adapt the clinical learning environment to students’ needs.

Association of ADHD symptoms, depression and suicidal behaviors with anxiety in Chinese medical college students

BackgroundAnxiety is one of the most common psychiatric disorder and imposes a great burden on both the individual and the society. Previous studies indicate a high comorbidity of anxiety disorders and Attention Deficit Hyperactivity Disorder (ADHD). However, few studies have examined the comorbidity of anxiety and ADHD among medical college students in mainland China. This study aimed to examine the prevalence of anxiety and the associated risk factor of anxiety disorder as well as to explore the association between ADHD symptoms, depression, suicidal behaviors and anxiety.MethodsA cross-sectional design was employed among 4882 medical college students who were recruited and enrolled with convenience sampling. Self-reported demographic information and clinical characteristics were collected online on a computer or through a social media app named Wechat.ResultsThe prevalence of anxiety in this study was 19.9%. Students with anxiety were more likely to have a poor relationship with parents, be of Han nationality, have smoking or drinking habits, have an extensive physical disorder history and have engaged in suicidal behaviors. The independent risk factors for anxiety were: smoking, physical disorder history, suicidal ideations, suicide attempts, inattention and hyperactivity. Significant associations were observed between anxiety and depression, inattention, hyperactivity, suicide plans and suicide attempts.ConclusionsNearly one in five medical students suffered from anxiety. The findings of this study indicate the importance of addressing both anxiety and ADHD symptoms in order to better promote mental health and the well-being of medical students as well as reduce suicidal behaviors.

The value of mentoring and the ASMS‑NZMSA Mentoring Programme

The wellbeing of medical students is a pressing issue both within New Zealand and globally. The journey through medical school is unique, filled with new experiences, opportunities, learning, challenges, and insights; concurrently, however, there are a variety of stressors and pressures that can negatively impact student wellbeing.1 With increasing awareness, strategies are being implemented to tackle this issue.2 This article will explore common stressors experienced by medical students and the impact of these stressors; the value of mentoring as one avenue to improve student wellbeing; and introduce the exciting Association of Salaried Medical Specialists (ASMS) and New Zealand Medical Students’ Association (NZMSA) Mentoring Programme, launched in 2019 throughout New Zealand.

Waking up to the importance of sleep: why that extra shut eye is key to medical student wellbeing

Sleep is one of the most fundamental of all biological needs. And whilst for most of us (depending on how many days out you are from that big exam) sleep seems to be a simple matter of closing our eyes, it’s in fact a complex and wholly active process. Recent decades have seen a notable rise in understanding not only of sleep itself, but the importance that sleep has to our waking lives. Physically and mentally, sleep is vital to functioning at our very best and is a key component of health and wellbeing.

Prevalence and Health related effects of Internet Addiction on Medical students in a Tertiary care center

Background: Internet usage has increased exponentially in recent years. This growing use of internet has become worrisome as to whether to consider this excessive use as an addiction and if it negatively impacts one’s physical, mental and social health Aim: To investigate the prevalence of internet addiction and its association with health related factors in Medical students. Methods and Materials: A cross-sectional study was conducted with a sample size of 250. The students were asked to self-administer a semi-structured proforma regarding internet usage, Young’s IAT and Duke’s Health Profile. Young’s IAT was used to measure the addition level. Duke’s Health Profile was used to assess the physical, mental and social status. Result: 250 students participated in the study, 62% male and 38% female. 86% were found to be average online user and 1.2% had scores of category of Internet addiction. There was a significantly positive association between monthly expenditure and Young Score Grade. Those falling in category of Internet Addiction had low physical, mental and general health score and high Anxiety and Depression Score. Conclusion: From this study it can be concluded that internet addiction may have negative impact on physical, mental and social well-being of Medical students.

Quality and Safety in Healthcare, Part LXVIII: Consequences and More Solutions Regarding Poor Well-Being in Medical Students.

Suggestions to improve the well-being in medical students include establishing learning communities, having pass-fail grading at least in the freshman and sophomore years, giving the students some control over their learning environment (such as with evaluations and serving on the curriculum committee), encouraging more protected time and more money for faculty teaching and mentoring, and eliminating mistreatment of medical students. Also, the Medical Student and Physician Well-Being Index should be freely available to the medical students and staff for both self-evaluation and for evaluating the learning environment. Burnout in medical school may continue in residency and not only causes misery to the individual, but adversely affects professionalism and patient care.

The mediating effect of resilience on the relationship between the academic burnout and psychological well-being of medical students

PurposeThis study aimed to examine the medicating effect of resilience on the relationship between academic burnout and psychological well-being of medical students.MethodsThe participants were a group of 97 medical students. Scales measuring Maslach Burnout Inventory-Student Survey, Ryff’s Psychological Well-Being, and Korean Resilience Quotient-53 were utilized. The data were analyzed by descriptive statistics, correlation analysis, t-test, and multiple regression analyses using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA).ResultsAccording to the study results, the medical students’ psychological well-being was negatively correlated with their academic burnout and positively correlated with their resilience; the degree of academic burnout experienced by the first and second year preclinical students was greater than that experienced by the third and fourth year clinical students; the male students’ average score for cynicism was higher than that of the female students; and the significant effects of academic burnout on the medical students’ psychological well-being were mediated by resilience.ConclusionIt was confirmed that medical students’ academic burnout and resilience are significant factors that explain their psychological well-being; resilience is also an important variable in improving psychological well-being. This suggests that education and counseling support are needed to increase medical students’ resilience in order to increase their psychological well-being.

Quality and Safety in Healthcare, Part LXVI: Contributing Causes of Poor Well-being in Medical Students.

Problems in the learning environment are the main contributing factors to medical student burnout. These issues include stresses from mistreatment, poor support, cynical supervisors, pressure to get good grades and learn a huge amount of information quickly, fatigue, lack of control, and so on. Personal risk factors include having been seriously ill recently, having a low grit score, being in debt, and having a job.

How medical students’ perceptions of instructor autonomy-support mediate their motivation and psychological well-being

Purpose: Medical student well-being is an increasing concern in medical education. Understanding the role instructors and programs have in supporting well-being is an important puzzle piece. This study explores the relationship between medical students’ perceptions of instructor autonomy-support, motivation, and well-being. Using self-determination theory, we aim to provide a practical framework through which medical instructors can support student autonomy and well-being in the learning environment.Materials and methods: Students from the University of Saskatchewan completed a survey measuring perceptions of the learning climate (LC) (instructor autonomy-support), satisfaction/frustration of basic motivational needs (autonomy, competence, relatedness), and psychological well-being. Multiple linear regression was used to determine whether age, gender, and year of study affected students’ well-being, before a mediation model was tested to assess the direct effect of the LC and indirect effects of students’ basic need fulfillment on their well-being.Results: The response rate was 183/400 (46%). Higher ratings of autonomy-support significantly predicted better student well-being. This was mediated completely by students’ feelings of basic need fulfillment. Relatedness satisfaction contributed most to ratings of instructor autonomy-support.Conclusions: Cultivating autonomy-support for medical students is critical to their well-being. Learning environments that optimize autonomy-support will also support students’ feelings of relatedness and competence.

Leah Dickstein, APA Leader and Mentor to Many, Dies

Leah Dickstein, APA Leader and Mentor to Many, Dies

Physician mistreatment in the clinical learning environment

BackgroundMistreatment has been correlated with burnout and poor well-being in medical students, but data regarding residents and faculty are limited. The objective was to investigate the prevalence of mistreatment towards surgical housestaff and faculty and characterize such experiences. MethodsIn 2018, the Department of Surgery surveyed housestaff and faculty on incidents of mistreatment. ResultsClinical faculty (63%) and residents (72%) completed the mistreatment survey. Excluding public embarrassment, 48% of residents and 29% of clinical faculty experienced mistreatment. Residents experienced public embarrassment and public humiliation more frequently than faculty, however faculty were subjected to racially or ethnically offensive remarks/names more frequently than residents (p < .05). Faculty within and external to their department were most cited as instigators of mistreatment. Residents experienced mistreatment most often by faculty, co-residents, and nurses. Reporting of the behaviors was low. ConclusionsIncidents of mistreatment are frequently occurring for surgical residents and faculty.

The Mental Health and Wellbeing of Medical Students - A Case Study Reflection

Introduction: Depression is one of the most commonly diagnosed mental disorders among adults, previously seen as an acute and self-limiting illness, but now recognised as a chronic, lifelong illness. The importance of mental health and wellbeing has been recognised among young adults and moreover healthcare professionals. Interviewing a patient with chronic anxiety and depression, I reflect how these relate to published literature of the metal health and wellbeing of medical students. Methods: Interviewing a patient suffering with chronic anxiety and depressive illness, I highlight a number of areas I found thought provoking and review the published literature relating to mental health and wellbeing of medical students. Results: The prevalence of depression or depressive symptoms in medical students is around 27.2% internationally, with suicidal ideation in approximately 11.1%. The prevalence of anxiety is much higher, 33.8%, most prevalent among medical students from the Middle East and Asia. Furthermore, medical students have a significantly higher prevalence of anxiety related symptoms compared with other non-medical students. Most worryingly two out of three medical students with generalised anxiety symptoms and one in two with depressive symptoms do not seek medical or psychological care. Mindfulness-based interventions decrease stress, anxiety, and depression and improve mindfulness, mood, self-efficacy, and empathy in health care students. Conclusion: There is a high prevalence of anxiety and depression amongst medical students and in those with anxiety symptoms alone, the risk of developing other mental health symptoms long-term is high. Medical student mental health and wellbeing has been recognised by the British Medical Association and proposals to include mental health awareness and promotion of self-care practices as part of the core curriculum. There are many self-help interventions that can help to reduce general anxiety symptoms and medical students should be more encouraged to take part in university societies and extracurricular activities.

Burnout and Well-Being Levels of Medical Students: a Cross-Sectional Study

Abstract: Introduction: The presence of chronic stress, caused by the activities and demands of the medical course, can lead to what is called ‘burnout’, a syndrome characterized by three dimensions: emotional exhaustion, dehumanization (or depersonalization) and reduced professional achievement. Considering the increased incidence of burnout syndrome, anxiety and depression symptoms, suicide attempts and suicide rates among medical students, as a consequence of increasing demands for professional and financial success at the expense of physical and mental health, one understands the importance of studying the subject and proposing measures of prevention and control. The aim of this study was to evaluate and describe the levels of burnout and well-being of medical students at a Brazilian public university. Method: The stress and well-being levels of students from the first to the sixth year for the Medical Course at Universidade Federal de São Paulo were evaluated using MBI-SS and WHOQOL-BREF questionnaires, applied online on the REDCAP platform. Results: A total of 302 students completed the questionnaires. Regarding the MBI-SS, students showed a low value in the emotional exhaustion factor and high levels of professional disbelief and effectiveness, indicating a burnout that ranged from low to moderate. It was also observed that female students showed a greater tendency toward emotional exhaustion when compared to male ones, as well as the fact that students from the 1st and 2nd years showed higher values of professional effectiveness when compared with 3rd and 4th years, with no difference between genders. Based on the answers from WHOQUOL-BREF questionnaire, the students thought they had a good quality of life. Discussion: These results reinforce possible factors that might interfere with the students’ quality of life: excessive workload, teaching model based on extensive lectures, lack of stimulation, recognition for their efforts. Conclusion: The medical students evaluated in this study have a good quality of life and show low or moderate burnout levels.

Video gaming, physiological responses, and well-being in medical students: An essence of intrigue way of learning

Background: Academically, new media technologies are being used which includes video games as well. Studies in college students show that their learning preferences have been strongly shaped by new media technologies. It is important to understand the positive and negative effects on physiological responses and well-being in the lives of medical students. Aims and Objectives: The study aims to assess the effect on blood pressure, resting pulse rate, respiratory rate, and well-being. Materials and Methods: The study was conducted in medical students at Dr. DY Patil Medical College Pimpri, Pune, who were assessed before and after gaming and a framed questionnaire was answered by them and further analyzed. Results: Result shows video game genre, its description, and examples with its positive impact on physiological responses in gamers than non-gamers and overall a better well-being. Conclusion: Video games are becoming a part of the daily lives of people of various age groups and having influence on education, health, and well-being, a more balanced perspective needed.

Burnout and Well-Being Levels of Medical Students: a Cross-Sectional Study

Abstract: Introduction: The presence of chronic stress, caused by the activities and demands of the medical course, can lead to what is called ‘burnout’, a syndrome characterized by three dimensions: emotional exhaustion, dehumanization (or depersonalization) and reduced professional achievement. Considering the increased incidence of burnout syndrome, anxiety and depression symptoms, suicide attempts and suicide rates among medical students, as a consequence of increasing demands for professional and financial success at the expense of physical and mental health, one understands the importance of studying the subject and proposing measures of prevention and control. The aim of this study was to evaluate and describe the levels of burnout and well-being of medical students at a Brazilian public university. Method: The stress and well-being levels of students from the first to the sixth year for the Medical Course at Universidade Federal de São Paulo were evaluated using MBI-SS and WHOQOL-BREF questionnaires, applied online on the REDCAP platform. Results: A total of 302 students completed the questionnaires. Regarding the MBI-SS, students showed a low value in the emotional exhaustion factor and high levels of professional disbelief and effectiveness, indicating a burnout that ranged from low to moderate. It was also observed that female students showed a greater tendency toward emotional exhaustion when compared to male ones, as well as the fact that students from the 1st and 2nd years showed higher values of professional effectiveness when compared with 3rd and 4th years, with no difference between genders. Based on the answers from WHOQUOL-BREF questionnaire, the students thought they had a good quality of life. Discussion: These results reinforce possible factors that might interfere with the students’ quality of life: excessive workload, teaching model based on extensive lectures, lack of stimulation, recognition for their efforts. Conclusion: The medical students evaluated in this study have a good quality of life and show low or moderate burnout levels.

The effect of social media usage on the mental well-being of medical college students in Bangalore, Karnataka.

Background and Objectives:Social media offers a platform for its users to share information and spread awareness regarding various issues including mental health problems. In some previous studies it was found that people suffering from mental health issues benefited from social media. However, the use of social media is also significantly associated with increased depression, mood and anxiety disorders in adolescents. Furthermore, it was found that the prevalence of poor mental health was high in medical students. With this background, this study was taken up to contribute to the scarce literature about the impact social media has on the mental well-being of medical students.Methods:The setting was a medical college and research centre, situated in the metropolitan city of Bengaluru in Karnataka. A pretested and predesigned questionnaire was self-administered anonymously by 318 students. The data was analyzed using appropriate statistics.Results:A statistically significant relationship was found between the amount of time spent on social media and the mental well-being score, according to the Sell and Nagpal scale, of students. In participants with scores of < 90.8, (30.2%) of them used social media for 4 hrs or more, as opposed to those with scores ≥ to 90.8, (35.6%) of them spent between 1 and 2 hrs a day on social media, 90.8 being the mean well-being score in India.Conclusions:Students need to monitor their screen time. There is a need to go back to old times of establishing human connections and, families and friendships should be nurtured.

Self-care of Caregivers: Self-Compassion in a Population of Dutch Medical Students and Residents.

This article was migrated. The article was marked as recommended. Objectives: The incidence of burnout in medical students and residents continues to outpace that of the general population. Self-compassion, a concept in the study of well-being, may moderate against adverse mental health outcomes. The aim of this study is to extend prior research by investigating self-compassion levels in relation to sociodemographic variables and self-reported burnout in Dutch medical students and residents. Methods: We used a cross-sectional survey design. After inclusion, 295 participants completed the online survey. Self-compassion was measured using the Self-Compassion Scale Short-Form. Self-defined burnout symptoms were measured using a single-item measure. Data were analysed using multiple linear regression. Results: Being male was associated with having higher levels of self-compassion (β=0.131, p<.001) as well as being of higher age (β=0.175, p<.001). Reporting burnout was negatively associated with self-compassion (β=-.412, p<.001). Discussion: This study substantiated previous research linking low self-compassion to burnout, and showed a potential increased vulnerability of young and female students. Further investigation of causality and the processes underlying self-compassion development are needed to investigate whether self-compassion interventions can enhance the well-being of medical students and residents.