Well-being Of Medical Students Research Articles

Perceived impact of the prolonged COVID-19 pandemic on Malaysian medical students: A descriptive, cross-sectional study

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in the lives of students and health care systems worldwide. Objectives: The study explored the impact of the prolonged COVID-19 pandemic among medical students in Malaysia. Methods: An online, cross-sectional survey was conducted among 397 medical students using Google forms circulated on social networking sites, like WhatsApp. Data were collected on self-reported anxiety and preventive health behaviors, challenges faced in daily activities, perception of e-learning, and changes in social and personal relationships. Results: As compared to before the advent of the pandemic, 83% of the students were more nervous and anxious, 38% washed their hands more often, and 43% bought more cleaning and hygiene supplies during the pandemic. Forty-two percent of the respondents went out less often, and 73% had lesser in-person social contact with their friends. The majority of students practiced a sedentary lifestyle; 47% snacked more often, and 58% had lesser physical activity. Conclusion: This study emphasizes the role of the provision of emotional support and strategies to enhance the well-being of medical students.

A Cross-sectional Study on the Sleep Quality and Excessive Daytime Sleepiness of Filipino Medical Students in a State-run University during the Coronavirus Disease (COVID-19) Pandemic.

Movement restrictions and changes in medical education around the world due to the Coronavirus 2019 pandemic have been sources of stress, which affect sleep and compound the demands of medical education. In the Philippines, stay-at-home orders were implemented in the National Capital Region on 15 March 2020, and despite various readjustments and re-definitions, remain in effect to date, March 2022. This cross-sectional study aims to determine the sleep quality and daytime sleepiness of Filipino medical students during prolonged stay-at-home orders, to compare them with pre-pandemic evaluations, and to explore associations between scores and participant characteristics. The medical student population of a state-run university in the City of Manila was included, while those on a leave of absence were excluded. The Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index which measure excessive daytime sleepiness and sleep quality, respectively, were disseminated via Google Forms from April to May 2021. Response rate was 87.75% (n=709) with a mean age of 22.9 ± 2.0 years and a 1:1.09 male-to-female ratio. Among the respondents, 41.18% had excessive daytime sleepiness, and was significantly higher for first-year premedicine students. Compared to pre-pandemic scores, daytime sleepiness decreased during the pandemic. On the other hand, 62.34% of the respondents had poor sleep quality, with global scores being significantly higher for the first-year pre-medicine students. Relationships between participants' characteristics and their scores were extremely weak, while a moderately significant correlation existed between global daytime sleepiness and sleep quality scores. Both excessive daytime sleepiness and poor sleep quality remain prevalent during prolonged stay-athome orders. These reflect the effect of the pandemic on stress inherent to medical education, and may be additional facets to be regarded in evaluating the general well-being of medical students.

WholeheartedMD: Medical Students Embracing Vulnerability and Finding Fulfillment.

Medical Students experience high levels of stress throughout their four years. When the COVID-19 pandemic exacerbated this, there was a need for programming and this created an opportunity to provide a whole person, lifestyle medicine approach to enhance medical student wellbeing. Two student leaders and one faculty member created a 12-week program that addressed the 6 pillars of lifestyle medicine as well as positive psychology. The program was offered to all first year students, and within 12 hours the roster was full with 15 students. The program was held weekly by Zoom for 1-2 hours. Attendance was high each week with full participation from everyone present. In the post program evaluation form, conducted one year after completion of the program, 100% of respondents reported they would recommend this group to another medical student, 71% reported they used tools learned from the group at least weekly. Participants noted that growth mindset, gratitude, mindfulness, priorities, and relationship building were the most used well-being strategies learned in the program. An intervention that is based on the 6 pillars of lifestyle medicine and positive psychology and presented by Zoom is feasible in medical school and well accepted by medical students.

Impact of COVID-19 related stressors on mental health in junior medical students

Introduction: Concern for mental health consequences in general population world­wide has been apparent since the start of the actual pandemic. Aim of the study was to assess the impact of COVID-19 related stressors on mental health in junior medical students during December 2020 COVID-19 related lockdown. Material and methods: The investigation included 275 second-year medical students aged 19-28 years, from the Faculty of Medicine, Ss. Cyril and Methodius University in Skopje during December 2020. Self-administered questionnaire containing standardized instruments for assessment of parameters of psychological distress (BAI, BDI and PSS) were used. COVID-19 related attitudes questionnaire for assessment of status of COVID-19 testing and infection, self-perceived levels of concerns related to academics [COVID-19-AA (academic apprehensions)] and those related to the self and family/friends [COVID-19-GA (general apprehensions)] were included. Results: The prevalence of anxiety, depression and stress was 74.9%, 43.3% and 78.9%, respectively. Almost 29% of students reported high anxiety, 6.2% had severe depression and 21.45% reported high levels of perceived stress. There was a significant positive correlation between COVID-19 GA score and BAI, BDI и PSS scores (p<0.05). Correlations between the COVID-19 AA scores and scores on BAI, BDI and PSS scales were also statistically significant (p=0.0000). Academic apprehension was found a predictive factor for high anxiety, depression and high stress (R2 = .12, F (1,273) = 38.79, p < .001. β = 1.12, p < .001). Conclusion: General and academic apprehension related to COVID-19 have negative effects on mental wellbeing in second year medical students.

Risk factors for suicidal ideation and suicide attempt among medical students: A meta-analysis.

BackgroundMedical training poses significant challenge to medical student wellbeing. With the alarming trend of trainee burnout, mental illness, and suicide, previous studies have reported potential risk factors associated with suicidal behaviours among medical students. The objective of this study is to provide a systematic overview of risk factors for suicidal ideation (SI) and suicide attempt (SA) among medical students and summarize the overall risk associated with each risk factor using a meta-analytic approach.MethodsSystemic search of six electronic databases including MEDLINE, Embase, Education Source, Scopus, PsycInfo, and CINAHL was performed from database inception to March 19, 2021. Studies reporting original quantitative or epidemiological data on risk factors associated with SI and SA among undergraduate medical students were included. When two or more studies reported outcome on the same risk factor, a random-effects inverse variance meta-analysis was performed to estimate the overall effect size.ResultsOf 4,053 articles identified, 25 studies were included. Twenty-two studies reported outcomes on SI risk factors only, and three studies on both SI and SA risk factors. Meta-analysis was performed on 25 SI risk factors and 4 SA risk factors. Poor mental health outcomes including depression (OR 6.87; 95% CI [4.80–9.82] for SI; OR 9.34 [4.18–20.90] for SA), burnout (OR 6.29 [2.05–19.30] for SI), comorbid mental illness (OR 5.08 [2.81–9.18] for SI), and stress (OR 3.72 [1.39–9.94] for SI) presented the strongest risk for SI and SA among medical students. Conversely, smoking cigarette (OR 1.92 [0.94–3.92]), family history of mental illness (OR 1.79 [0.86–3.74]) and suicidal behaviour (OR 1.38 [0.80–2.39]) were not significant risk factors for SI, while stress (OR 3.25 [0.59–17.90]), female (OR 3.20 [0.95–10.81]), and alcohol use (OR 1.41 [0.64–3.09]) were not significant risk factors for SA among medical students.ConclusionsMedical students face a number of personal, environmental, and academic challenges that may put them at risk for SI and SA. Additional research on individual risk factors is needed to construct effective suicide prevention programs in medical school.

Bringing Needed Change to Medical Student Well-Being: A Call to Expand Accreditation Requirements

Issue: Noting high rates of burnout, depression, and suicidality among medical students, academic medical communities are trying to identify preventive and curricular measures that protect and promote student well-being. To date, the effectiveness of these efforts is unclear. In addition, evidence increasingly suggests that the major drivers of distress appear to be factors within the social, learning, and work environments. Specific to medical schools in the United States, neither the Liaison Committee on Medical Education nor the Commission on Osteopathic College Accreditation include accreditation standards regarding well-being curricula and, as such, these curricula are not well-integrated into students’ medical school experience. Current accreditation standards also do not specifically require institutions to assess or address systemic factors of the learning environment that negatively affect student well-being. Evidence: This paper proposes expanding current Liaison Committee on Medical Education and Commission on Osteopathic College Accreditation standards on professionalism to incorporate well-being as a core component of professional identity formation by requiring individual and institutional-level actions. Proposed changes to accreditation standards include (1) institutional assessment of the impact of the learning environment on student well-being; (2) continuous quality improvement efforts to address structural factors associated with student well-being and modification of practices that impair student well-being; and (3) integrated curriculum with related assessment to educate students on empirically-supported strategies for well-being. Implications: Refining undergraduate medical education accreditation standards in the United States to include language specific to student well-being will facilitate long overdue changes to the learning environment. In the end, the goal is not just to improve medical student well-being, but to provide a workforce better equipped for a sustainable and meaningful career.

Emergency Medicine Program Directors' Perspectives on Changes to Step 1 Scoring: Does It Help or Hurt Applicants?

IntroductionThe United States Medical Licensing Examination (USMLE) Step 1 score is one of the few standardized metrics used to objectively review applicants for residency. In February 2020 the USMLE program announced that the numerical Step 1 scoring would be changed to a binary (Pass/Fail) system. In this study we sought to characterize how this change in score reporting will impact the application review process for emergency medicine (EM) program directors (PD).MethodsIn March 2020 we electronically distributed a validated anonymous survey to EM PDs at 236 US EM residency programs accredited by the Accreditation Council for Graduate Medical Education.ResultsOf 236 EM PDs, 121 responded (51.3% response rate). Overall, 72.7% believed binary Step 1 scoring would make the process of objectively comparing applicants more difficult. A minority (19.8%) believed it was a good idea, and 33.1% felt it would improve medical student well-being. The majority (88.4%) reported that they will increase their emphasis on Step 2 Clinical Knowledge (CK) for resident selection, and 85% plan to require Step 2 CK scores at application submission time.ConclusionOur study suggests most EM PDs disapprove of the new Step 1 scoring. As more objective data is peeled away from the residency application, EM PDs will be left to rely more heavily on the few remaining measures, including Step 2 CK and standardized letters of evaluation. Further changes are needed to promote equity and improve the overall quality of the application process for students and PDs.

Mindfulness-based psychological interventions for improving mental well-being in medical students and junior doctors.

Mindfulness interventions are increasingly popular as an approach to improve mental well-being. To date, no Cochrane Review examines the effectiveness of mindfulness in medical students and junior doctors. Thus, questions remain regarding the efficacy of mindfulness interventionsas a preventative mechanism in this population, which is at high risk for poor mental health. OBJECTIVES: To assess the effects of psychological interventions with a primary focus on mindfulnesson the mental well-being and academic performance of medical students and junior doctors. We searched the Cochrane Central Register of Controlled Trials (CENTRAL),MEDLINE, Embase and five other databases (to October 2021) and conducted grey literature searches. SELECTION CRITERIA: We included randomised controlled trials of mindfulness that involved medical students of any year level and junior doctors in postgraduateyears one, two or three.We included any psychological intervention with a primary focus on teaching the fundamentals of mindfulness as a preventative intervention. Our primary outcomes were anxiety and depression, and our secondary outcomes included stress, burnout, academic performance, suicidal ideationand quality of life. DATA COLLECTION AND ANALYSIS: We used standard methods as recommended by Cochrane, including Cochrane's risk of bias 2 tool (RoB2). MAIN RESULTS: We included 10 studies involving 731 participants in quantitative analysis. Compared with waiting-list control or no intervention, mindfulness interventions did not result in a substantial differenceimmediately post-intervention for anxiety(standardised mean difference (SMD) 0.09, 95% CI -0.33 to0.52; P = 0.67, I2= 57%; 4 studies, 255 participants; very low-certainty evidence). Converting the SMD back to the Depression, Anxiety and Stress Scale 21-item self-report questionnaire (DASS-21) showed an estimated effect size which is unlikely to be clinically important. Similarly, there was nosubstantial differenceimmediately post-intervention for depression (SMD0.06, 95% CI -0.19to0.31; P = 0.62, I2 = 0%; 4 studies, 250 participants; low-certainty evidence). Converting the SMD back to DASS-21 showed an estimated effect size which is unlikely to be clinically important. No studies reported longer-term assessment ofthe impact of mindfulness interventionson these outcomes. For the secondary outcomes,the meta-analysis showed a small, substantial differenceimmediately post-intervention for stress, favouring the mindfulness intervention (SMD -0.36, 95% CI -0.60to-0.13; P < 0.05, I2= 33%; 8 studies, 474 participants; low-certainty evidence); however, this difference is unlikely to be clinically important.The meta-analysis foundno substantialdifferenceimmediately post-intervention for burnout (SMD -0.42, 95% CI -0.84 to 0.00; P = 0.05, I² = 0%; 3 studies, 91 participants; very low-certainty evidence). The meta-analysis founda small, substantial differenceimmediately post-intervention for academic performance(SMD-0.60, 95% CI -1.05to -0.14; P < 0.05, I² = 0%; 2 studies, 79 participants; very low-certainty evidence); however, this difference is unlikely to be clinically important. Lastly, there was nosubstantial differenceimmediatelypost-intervention for quality of life (mean difference(MD) 0.02, 95% CI -0.28 to0.32; 1 study, 167 participants; low-certainty evidence). There were no data available for three pre-specified outcomes of this review: deliberate self-harm, suicidal ideation and suicidal behaviour. We assessed thecertainty of evidence to range from low to very low across all outcomes. Across most outcomes, we most frequently judged the risk of bias as having 'some concerns'. There were no studies with a low risk of bias across all domains. AUTHORS' CONCLUSIONS: The effectiveness of mindfulness in our target population remains unconfirmed. There have been relatively few studies of mindfulness interventions for junior doctors and medical students. The available studies are small, and we have some concerns about their risk of bias. Thus, there is not much evidence on which to draw conclusions on effects of mindfulness interventionsin this population. There was no evidence to determine the effects of mindfulness in the long term.

Evaluation of a Novel Wellness Curriculum on Medical Student Wellbeing and Engagement Demonstrates a Need for Student-Driven Wellness Programming

Problem Medical training is stressful and has well-established implications for student wellbeing. Despite widespread efforts to reduce student burnout through wellness programming in medical schools, there is a paucity of literature examining students’ perception of wellness and engagement with these programs. As such, we sought to evaluate: 1) medical students’ level of engagement with a multifaceted wellness curriculum, 2) factors students perceived as important to wellbeing, and 3) associations with longitudinal measures of wellbeing and perceived stress. Intervention: A multipronged wellness curriculum was instituted at Mayo Clinic Alix School of Medicine-AZ (MCASOM-AZ) in 2017. This includes mental health services, curriculum-embedded seminars, wellness committee (composed of students, faculty, and administration) driven programming, and student proposed wellness activities that are reviewed and funded by the committee. The authors invited students at our institution to complete questionnaires at three timepoints during the 2018–2019 academic year. Questionnaires asked participants to rank eight factors from least to most important to their overall wellbeing. Participants self-reported their participation in each prong of the wellness curriculum and ranked the impact of each on their overall wellbeing. Their wellbeing and perceived stress were measured at each timepoint using validated psychological instruments. Context: As MCASOM-AZ opened in 2017, the student body at the time of study consisted of first- and second-year medical students. All students had the opportunity to engage with all aspects of the wellness curriculum and participate in this study, however participation was elective and all responses were anonymous. Of the MCASOM-AZ student body comprised of 100 students, 58 consented to participate in the study, 41.4% of which were Year 1 and 58.6% of which were Year 2 students. Participant age and gender were collected and were representative of the larger student body. Impact: Students engaged most with student-initiated wellness. They perceived unscheduled time as most impactful to their overall wellbeing with student-initiated activities as second-most impactful. Students with higher perceived stress were more likely than others to use mental health resources, which otherwise ranked lower in importance. Ranking academic performance as important to wellbeing was associated with higher wellbeing. There was no difference in wellbeing between students who participated in the wellness curriculum and those who did not. However, overall student wellbeing increased over the course of the year while perceived stress decreased. Lessons Learned: Medical school programs may benefit from allowing students to direct or contribute to the design of their own wellness curriculum. Additionally, medical education should work toward creating a more supportive learning environment with improved flexibility in order to better meet students’ individual needs without compromising their education. Despite having low utilization rates overall, mental health resources remain an important aspect of student support services as they are used by students under greater amounts of perceived stress than their peers. Supplemental data for this article is available online at https://doi.org/10.1080/10401334.2021.2004415 .

Social support and subjective well-being among postgraduate medical students: the mediating role of anxiety and the moderating role of alcohol and tobacco use

Medical students often face pressures from various sources in the course of postgraduate studies, and these factors have a negative impact on their subjective well-being. Previous researches have revealed that social support is a vital factor influencing subjective well-being, but unfortunately the underlying mechanism for this is unclear, especially for postgraduate medical students. The current study has inspected the effects of social support on subjective well-being of postgraduate medical students, the mediating role of anxiety and the moderating role of alcohol and tobacco use in the association between social support and subjective well-being of postgraduate medical students. A sample of 900 postgraduate medical students (Mage = 27.01 years, SD = 3.33) from The Second Affiliated Hospital of Nanchang University completed the Social Support Rating Scale, the Generalized Anxiety Disorder-7, the Tobacco and Alcohol Use Questionnaire and the Subjective Well-Being Scale. Analysis of the structural equation model revealed that anxiety partially mediated the relationship between social support and subjective well-being of postgraduate medical students, while alcohol and tobacco use moderated the relationship between anxiety and subjective well-being of postgraduate medical students. This study revealed how social support act upon subjective well-being of postgraduate medical students. This study provides a theoretical basis for promoting and enhancing the subjective well-being of postgraduate medical students.

Are Canadian medicine librarians directly supporting medical student health and wellness? A nation-wide survey.

IntroductionStudents in Undergraduate Medical Education (UGME/UME) programs face a variety of stressors that can affect well-being. To address this, the Committee on Accreditation of Canadian Medical Schools (CACMS) mandates that medical schools offer support and programming that promotes student well-being. Academic librarians are accustomed to providing outreach that meets their faculties’ needs. Therefore, the goal of this study was to explore if Canadian undergraduate medical education librarians are supporting medical student wellness at their medical schools, and how.MethodsA bilingual, electronic survey containing multiple choice and open-ended questions was distributed across two Canadian health sciences library listservs during the summer of 2020. Librarians supporting UGME/UME programs now or within the last three years were invited to participate.Results22 Responses were received, and 17 complete datasets were included in the final results. The majority of respondents have encountered a medical student in distress (n=10) and have adjusted their teaching style or materials to help reduce stress in medical students (n=9). Other initiatives such as resource purchasing, wellness-themed displays, planning wellness-themed events and spaces, and partnerships on campus in support of medical student wellness were less common.DiscussionThe data in this study provides evidence that Canadian undergraduate medical education librarians are mindful of medical student well-being, and are taking steps to provide relevant support to this learner group. Librarians could adopt similar initiatives at their libraries to show support for learner wellness, and enhance their programs’ accreditation efforts in this area.

A Virtual Wellness and Learning Communities Program for Medical Students during the COVID-19 Pandemic.

Numerous studies have demonstrated the high risk for burnout and mental illness in medical students. Because of the coronavirus disease 2019 (COVID-19) pandemic, our medical school transitioned to an all-virtual learning environment from March to June 2020, which raised concerns among student leaders and administrators, as reduced interpersonal attachments have known associations with decreased mental health. In an effort to facilitate student well-being during the pandemic, the Virtual Wellness and Learning Communities (VWLC) program was established. VWLC consisted of hour-long events that offered students the opportunity to engage with their peers online. More than 20 events and workshops were conducted from March to June 2020, including trivia nights, song and guitar performances, sketching, video editing tutorials, chess lessons, yoga, and personal investing tips. An institutional review board-approved survey to assess the efficacy of the VWLC program was sent to medical student participants and nonparticipants. The overall response rate of this study was 43% (53/123). The response rate for students who attended a VWLC event was 51% (33/65), and the response rate for students who did not attend a VWLC event was 34% (20/58). Of all of the respondents, 85% (45/53) reported a decreased sense of connectivity with peers because of the pandemic, and 40% (21/53) reported a decrease in their sense of wellness. After attending a VWLC event, 79% (26/33) reported an increased sense of peer connectivity, 61% (20/33) reported improved wellness, and 55% (18/33) believed that these events should continue postpandemic to supplement in-person programming. Those who did not attend a virtual event stated that the main barriers to attending were unfamiliarity with attendees and screen fatigue. The COVID-19 pandemic has worsened medical student well-being and sense of community. VWLC programming may be an effective strategy for promoting medical student wellness and community while social distancing during the COVID-19 pandemic. To our knowledge, this is the first virtual wellness program for promotion of medical student mental health during the COVID-19 pandemic to be described in the literature.

Wellbeing and mental health among medical students in Indonesia: A descriptive study.

Medical students face high pressures to perform academically, which may lead to poor psychological well-being, burnout, and even mental illness. This study aims to evaluate the mental health, degree of burnout and substance misuse among medical students in Indonesia in order to to build a system that supports the prosperity of future doctors. In February to March 2020, we conducted an online survey of Indonesian medical students to assess burnout (using Oldenburg Burnout Inventory, OLBI), minor psychiatric illness (General Health Questionnaire 12, GHQ12), and alcohol abuse (CAGE questionnaire). A total of 1,729 students from 29 universities participated in the study; 93% felt disengaged, 95% felt exhausted, and 74% were identified to have mild psychiatric illness. We discuss potential factors that need to be explored in further research, including further concerns related to developments since the pandemic, and the need for potential interventions at both local and national levels to enhance the wellbeing of medical students.

Gender differences in health-promoting behaviors and psychological well-being of Palestinian medical students based on the HPLP II

Gender differences in health-promoting behaviors and psychological well-being of Palestinian medical students based on the HPLP II

Mental health and wellbeing of Indonesian medical students: A regional comparison study.

Our previous research found very high levels of burnout and mental health problems among medical students across Indonesia, in line with rates in many other countries. This study further analyses the data by comparing six different regions of Indonesia to determine any differences between them on such measures and to look for possible explanations. Our sample of 1,729 students reported high levels of burnout and 'mild' psychiatric illness across all six regions. There were however significant differences between some regions. Sumatran students reported the lowest scores for both the Oldenburg Burnout Inventory (OLBI) and General Health Questionnaire 12 (GHQ12) scales. Sources of stress also varied among regions, with relationships and study the most reported. Further exploration of possible cultural differences is needed as well as prompt mental health support for medical students.

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.

Well-being and perspective of second year MBBS students on online pharmacology classes held during COVID-19 pandemic in a tertiary care teaching hospital

Background: COVID-19 pandemic shifted all the classroom teaching to virtual online platforms. The overnight change in the teaching structure posed serious challenges especially for medical education. This study aims to assess the well-being of medical students undergoing online medical education during COVID-19 pandemic and their perspective on online pharmacology classes.Methods: World health organization (WHO-5) well-being index was used to assess well-being of students. An internally validated questionnaire was used to assess student’s perspective on online pharmacology classes. The questionnaire was administered to eligible consenting students online through Google forms. The data obtained was analysed by SPSS software.Results: The mean wellness score (%) for all participants, (n=118) was 48.87%. The mean wellness score for males (58.67%) was higher than for females (42.41%). The average score for overall benefit of conducting online pharmacology classes was 3.32 out of 5. Objectively assessed online interactions like formative assessment, polls and quiz were rated higher than subjective interactions like debate.Conclusions: COVID-19 pandemic has caused massive disruption in the life of many people. In our study, we report a decreased well-being score in medical students attending virtual classes. The findings on well-being of students have implications on planning redressal mechanism in such extreme situations. Our analysis of student’s perspective about online interactions has implications beyond online classes. Some of the interactions can be instituted into regular curriculum increasing the student’s participation.

The importance of formal versus informal mindfulness practice for enhancing psychological wellbeing and study engagement in a medical student cohort with a 5-week mindfulness-based lifestyle program

PurposeMedical students commonly experience elevated psychological stress and poor mental health. To improve psychological wellbeing, a 5-week mindfulness-based lifestyle course was delivered to a first-year undergraduate medical student cohort as part of the core curriculum. This study investigated the effects of the program on mental health, perceived stress, study engagement, dispositional mindfulness, and whether any improvements were related to amount of formal and/or informal mindfulness practice.MethodsParticipants were first year undergraduate medical students (N = 310, 60% female, M = 18.60 years) with N = 205 individuals completing pre and post course questionnaires in a 5-week mindfulness-based lifestyle intervention. At pre- and post-intervention, participants completed the Mental Health Continuum-Short Form, the Perceived Stress Scale, the Utrecht Work Engagement Scale for Students, the Freiburg Mindfulness Inventory, and the Mindfulness Adherence Questionnaire.ResultsMental health, perceived stress, study engagement, and mindfulness all improved from pre- to post-intervention (all p values < .001). Improvements on these outcome measures were inter-related such that PSS change scores were negatively correlated with all other change scores, FMI change scores were positively correlated with MHC-SF and UWES-S change scores, the latter of which was positively correlated with MHC-SF change scores (all p values < .01). Finally, observed improvements in all of these outcomes were positively related to informal practice quality while improved FMI scores were related to formal practice (all p values < .05).ConclusionsA 5-week mindfulness-based program correlates with improving psychological wellbeing and study engagement in medical students. These improvements particularly occur when students engage in informal mindfulness practice compared to formal practice.

Effect of Covid-19 pandemic induced lockdown on sleep wake pattern and personal well-being of undergraduate medical students of West Bengal

Background: COVID-19 pandemic induced lockdown and the social restrictions had a profound impact on the circadian rhythm driven sleep-wake schedule of the home confined population. Aims and Objective: Our study explored the effect of COVID-19 pandemic induced lockdown on sleep wake pattern and personal well-being of medical students of West Bengal Materials and Methods: An observational, questionnaire-based online survey was conducted using the URL linked Google form. The online survey was conducted through social media platforms as per CHERRIES checklist guideline. Information on demographic profile, before and after lockdown sleep-wake pattern, social wellbeing and general lifestyle was obtained. Any student with any sleeping disorder or on drugs was excluded. Mean (SE), median, range, proportion was calculated as per attributes. Fisher’s exact chi square test and paired t test was done to test association and to compare means of the attributes. Results: The mean age of students was 20.26 years. The average daily time spent on electronic media got doubled during lockdown. Sleep disorder was reported by 53.0% male and 47.0% students. More than half of respondents reported increased napping during daytime, irregular timing for meal intake and low mood. Anxiety was present in every two out of three participants. Females gained more weight during lockdown. The gender difference in sleep duration became significant. Lockdown effect on the average daily media time was significant. The sleep disturbance at night and physical inactivity was significantly more among female students. Conclusion: COVID-19 lockdown leads to delayed sleep-wake cycle, irregular meal timings and excessive digital exposure among medical students with gender based differential impact.

Exploring the Relationship between Student Engagement and Burnout Syndrome among Undergraduate Medical Students at the Faculty of Medicine, Suez Canal University (A Cross-Sectional Analytical Study)

Background: Burnout is a psychological syndrome that is considered an amalgamation of exhaustion, cynicism, and inefficacy. It is well known that mental well-being of medical students is heavily affected. Student engagement can be defined as a positive state of mind in terms of studying, where the student tends to be more determined. Engaged students are more resilient to academic stress with a sense of well-being and less feeling of burn out in the future. Aim: The study aims at assessing the prevalence of burnout syndrome among undergraduate medical students at the Faculty of Medicine, Suez Canal University (FOM-SCU) and to explore the relationship between student engagement and burnout levels. Subjects and Methods: 300 students from all study years participated in the study. The Utrecht Work Engagement Scale–Student Survey (UWES–S) was used to assess the level of student engagement while the Maslach Burnout Inventory–Student Survey (MBI–SS) was used to gauge the extent of burnout syndrome among medical students. Results: According to our results, 77.3% of the total study population had two-dimensional burnout and 61.7% of them had three-dimensional burnout. Moreover, 49.7% of the total study population had average student engagement level with the highest prevalence in year three with 54.4%. Overall, student engagement levels were moderately negatively correlated with burnout levels. Conclusion: Most of the study population had high levels of burnout. Nearly half of them considered themselves averagely engaged in their studies. Student engagement levels were moderately negatively correlated with burnout levels, denoting the importance of enhancing engagement and preventing burnout.