Edmonds Victoria S, Chatterjee Krishanu, Girardo Marlene E, Butterfield Richard J, Stonnington Cynthia M
Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona, USA.
Teach Learn Med. 2023 Jan-Mar;35(1):52-64. doi: 10.1080/10401334.2021.2004415. Epub 2022 Feb 2.
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. 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. 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. 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. 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 .
医学培训压力很大,对学生的幸福感有着公认的影响。尽管医学院校为通过健康计划减轻学生倦怠做出了广泛努力,但关于学生对健康的认知以及他们参与这些计划情况的文献却很匮乏。因此,我们试图评估:1)医学生对多方面健康课程的参与程度;2)学生认为对幸福感重要的因素;3)与幸福感和感知压力的纵向测量指标之间的关联。2017年,梅奥诊所阿里克斯医学院 - 亚利桑那分校(MCASOM - AZ)设立了多管齐下的健康课程。这包括心理健康服务、课程嵌入式研讨会、由健康委员会(由学生、教师和行政人员组成)推动的计划,以及由学生提出并经委员会审核和资助的健康活动。作者邀请本校学生在2018 - 2019学年的三个时间点完成问卷调查。问卷要求参与者对八个因素按对其总体幸福感的重要程度从低到高进行排序。参与者自行报告他们参与健康课程各方面的情况,并对每一方面对其总体幸福感的影响进行排序。在每个时间点使用经过验证的心理测量工具测量他们的幸福感和感知压力。由于MCASOM - AZ于2017年开学,研究时的学生群体由一年级和二年级医学生组成。所有学生都有机会参与健康课程的各个方面并参与本研究,但参与是自愿的,所有回复均为匿名。在由100名学生组成的MCASOM - AZ学生群体中,58人同意参与研究,其中41.4%是一年级学生,58.6%是二年级学生。收集了参与者的年龄和性别信息,这些信息代表了更大的学生群体。学生对学生发起的健康活动参与度最高。他们认为非计划时间对其总体幸福感影响最大,学生发起的活动影响次之。感知压力较高的学生比其他学生更有可能使用心理健康资源,而心理健康资源在重要性方面原本排名较低。将学业成绩列为对幸福感重要与更高的幸福感相关。参与健康课程的学生和未参与的学生在幸福感方面没有差异。然而,学生的总体幸福感在这一年中有所提高,而感知压力则有所下降。医学院校的课程可能会从允许学生指导或参与自身健康课程的设计中受益。此外,医学教育应努力营造一个更具支持性的学习环境,提高灵活性,以便在不影响教育的情况下更好地满足学生的个人需求。尽管心理健康资源总体利用率较低,但它们仍是学生支持服务的重要方面,因为与同龄人相比,压力较大的学生更常使用这些资源。
本文的补充数据可在网上获取,网址为https://doi.org/10.1080/10401334.2021.2004415 。