Kötter Thomas, Niebuhr Frank
Institute of Social Medicine and Epidemiology.
Institute of Family Medicine, University of Lübeck, Lübeck, Germany.
Adv Med Educ Pract. 2016 Aug 22;7:497-504. doi: 10.2147/AMEP.S110424. eCollection 2016.
The years spent in acquiring medical education is considered a stressful period in the life of many students. Students whose mental health deteriorates during this long period of study are less likely to become empathic and productive physicians. In addition to other specific stressors, academic examinations seem to further induce medical school-related stress and anxiety. Combined group and individual resource-oriented coaching early in medical education might reduce examination-related stress and anxiety and, consequently, enhance academic performance. Good quality evidence, however, remains scarce. In this study, therefore, we explored the question of whether coaching affects examination-related stress and health in medical students.
We conducted a randomized controlled trial. Students who registered for the first medical academic examination in August 2014 at the University of Lübeck were recruited and randomized into three groups. The intervention groups 1 and 2 received a 1-hour psychoeducative seminar. Group 1 additionally received two 1-hour sessions of individual coaching during examination preparation. Group 3 served as a control group. We compared changes in self-rated general health (measured by a single item), anxiety and depression (measured by the hospital anxiety and depression scale), as well as medical school stress (measured by the perceived medical school stress instrument). In order to further investigate the influence of group allocation on perceived medical school stress, we conducted a linear regression analysis.
We saw a significant deterioration of general health and an increase in anxiety and depression scores in medical students while preparing for an examination. We found a small, but statistically significant, effect of group allocation on the development of perceived medical school stress. However, we could not differentiate between the effects of group coaching only and group coaching in combination with two sessions of individual coaching.
The health of medical students deteriorated while preparing for an examination. Short-term resource-oriented coaching might be an effective means of reducing medical school stress in candidates preparing for an examination.
在许多学生的人生中,接受医学教育所花费的数年时间被视为一段压力巨大的时期。在这段漫长学习期间心理健康恶化的学生,不太可能成为有同理心且高效的医生。除了其他特定的压力源外,学术考试似乎会进一步引发与医学院相关的压力和焦虑。在医学教育早期开展结合小组和个人的资源导向型辅导,可能会减轻与考试相关的压力和焦虑,从而提高学业成绩。然而,高质量的证据仍然稀缺。因此,在本研究中,我们探讨了辅导是否会影响医学生与考试相关的压力和健康这一问题。
我们进行了一项随机对照试验。招募了2014年8月在吕贝克大学参加首次医学学术考试的学生,并将其随机分为三组。干预组1和干预组2参加了一场为时1小时的心理教育研讨会。干预组1在考试准备期间还额外接受了两场为时1小时的个人辅导。第三组作为对照组。我们比较了自我评定的总体健康状况(通过单项测量)、焦虑和抑郁程度(通过医院焦虑抑郁量表测量)以及医学院压力(通过感知医学院压力工具测量)的变化。为了进一步研究分组对感知医学院压力的影响,我们进行了线性回归分析。
我们发现医学生在准备考试期间总体健康状况显著恶化,焦虑和抑郁得分增加。我们发现分组对感知医学院压力的发展有微小但具有统计学意义的影响。然而,我们无法区分仅小组辅导与小组辅导结合两场个人辅导的效果。
医学生在准备考试期间健康状况恶化。短期的资源导向型辅导可能是减轻备考学生医学院压力的有效手段。