Department of Family Medicine and Office of Diversity, Equity, and Inclusion, Georgetown University School of Medicine, Washington, DC, USA.
Office of Student Learning & Academic Advising, Georgetown University School of Medicine, Washington, D.C, USA.
Teach Learn Med. 2022 Oct-Dec;34(5):504-513. doi: 10.1080/10401334.2021.1984921. Epub 2021 Nov 11.
Medical school can be a socially isolating experience, particularly for students underrepresented in medicine. Social isolation and perceptions of not belonging can negatively impact students' academic performance and well-being. Therefore, interventions are needed to support students and these efforts should be appealing, brief, and low-burden.
Guided by evidence-based approaches, we developed the Build & Belong intervention for medical students as a brief peer-to-peer approach that consisted of four components. First, M3 and M4 students wrote reflections on belonging in medical school. Second, M3 and M4 students video recorded messages for M1 and M2 students using their written reflections. Third, M1 and M2 students watched and discussed the videos in small groups. Fourth, the M1 and M2 students wrote letters to future students. Our intervention differs from previous student belonging interventions in the peer delivery of messages.
The Build & Belong intervention aimed to improve medical students' social belongingness. Using a longitudinal observational study design, the intervention was piloted at a medical school in the Mid-Atlantic United States in 2017-2018. Students completed surveys before and after the intervention. Paired samples tests (t-tests and Wilcoxon) assessed pre- to post-intervention changes in social isolation, social connectedness, and social assurance.
Among 63 medical students, with 25.9% from backgrounds underrepresented in medicine, we assessed follow-up outcomes in 38 students. Social isolation scores significantly decreased from baseline ( = 54.8, = 7.06) to follow-up ( = 51.3, = 6.67; < .001). Social isolation changes were evident regardless of sex, although males reported a greater reduction ( Δ = -5.32, < .001) than females ( Δ = -2.79, = .014). Black/African American students had the largest reduction in social isolation ( Δ = -7.24, = .010). Social assurance and connectedness scores did not change significantly between baseline and follow-up. Medical students appeared to resonate with messages delivered by more experienced peers (M3s and M4s), particularly messages that normalized feelings of not belonging and strategies to reduce those feelings.
The Build & Belong intervention appears to reduce social isolation scores among medical students. This pilot test of the Build & Belong intervention provides initial evidence of the effectiveness of a brief, low-cost intervention. Build & Belong may provide a scalable strategy to reduce medical students' social isolation. Our peer-based approach is distinct from administrator-led strategies; peers were seen as trusted and reliable sources of information about belonging and ways to overcome the challenges experienced during medical school.
医学院的学习可能是一种社交孤立的经历，尤其是对于医学领域代表性不足的学生来说。社交孤立和归属感的缺失会对学生的学业成绩和幸福感产生负面影响。因此，需要采取干预措施来支持学生，这些措施应该具有吸引力、简洁和低负担。
我们根据循证方法，为医学生开发了“建立与归属”干预措施，这是一种简短的同伴方法，包括四个组成部分。首先，M3 和 M4 学生就医学院的归属感写了反思。其次，M3 和 M4 学生使用他们的书面反思为 M1 和 M2 学生录制了视频信息。第三，M1 和 M2 学生在小组中观看和讨论视频。第四，M1 和 M2 学生给未来的学生写信。我们的干预措施与以前的学生归属感干预措施不同，因为它是通过同伴传递信息。
“建立与归属”干预措施旨在提高医学生的社交归属感。使用纵向观察研究设计，该干预措施于 2017-2018 年在美国中大西洋地区的一所医学院进行了试点。学生在干预前后完成了调查。配对样本检验（t 检验和 Wilcoxon）评估了社会孤立、社会联系和社会保障方面的干预前后变化。
在 63 名医学生中，有 25.9%来自医学领域代表性不足的背景，我们在 38 名学生中评估了随访结果。社会孤立评分从基线（ = 54.8， = 7.06）显著下降到随访（ = 51.3， = 6.67；<0.001）。无论性别如何，社会孤立的变化都很明显，尽管男性的报告降幅更大（Δ=-5.32，<0.001），而女性（Δ=-2.79，=0.014）。黑人/非裔美国学生的社会孤立程度下降最大（Δ=-7.24，=0.010）。社会保障和联系评分在基线和随访之间没有显著变化。医学生似乎对更有经验的同龄人（M3 和 M4）传递的信息产生共鸣，尤其是那些将归属感缺失正常化和减少这种感觉的策略。
“建立与归属”干预措施似乎可以降低医学生的社会孤立评分。该“建立与归属”干预措施的试点测试提供了该简短、低成本干预措施有效性的初步证据。“建立与归属”可能提供了一种减少医学生社会孤立的可扩展策略。我们的同伴方法与管理员主导的策略不同；同伴被视为有关归属感和克服医学院期间所面临挑战的信息的可信赖和可靠来源。
