C.C. Ferguson is associate professor, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
T.K. Ark is assistant professor, Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education, Medical College of Wisconsin, Milwaukee, Wisconsin.
Acad Med. 2022 Aug 1;97(8):1164-1169. doi: 10.1097/ACM.0000000000004715. Epub 2022 Jul 21.
The extent of medical student unwellness is well documented. Learner distress may impact patient care, workforce adequacy, and learners' performance and personal health. The authors describe the philosophy, structure, and content of the novel REACH (Recognize, Empathize, Allow, Care, Hold each other up) curriculum and provide a preliminary evaluation.
The REACH curriculum is a mandatory, longitudinal well-being curriculum for first- and second-year medical students at the Medical College of Wisconsin (MCW) designed to prepare them for the emotional life of being a physician. The curriculum uses a framework, core concepts, and skills from the field of trauma stewardship. It builds on effective medical student well-being interventions (e.g., mindfulness-based training) and the sharing of personal stories by instructors during didactic and small-group sessions that are integrated into the regular MCW curriculum. During the first 2 years of implementation (2018-2019 and 2019-2020), the curriculum was evaluated using mid- and postcurriculum student surveys.
Over 700 students have completed the REACH curriculum as of March 2022. Overall, most students who responded to the surveys in 2018-2020 reported that they felt the REACH curriculum material was important, that the curriculum met their expectations for a quality medical school course, and that they would recommend other schools incorporate a similar curriculum. Respondents to the 2019-2020 postcurriculum survey indicated the REACH curriculum helped them develop self-care (84% [85/101]), mindfulness (76% [76/101]), and help-seeking (71% [72/101]) skills.
The initial outcomes show that integrating a mandatory well-being curriculum is feasible and acceptable to medical students. The authors plan to examine the relationships between student-reported well-being metrics, academic and clinical performance data, and professional identity formation. They are also prototyping electronic dashboards that will allow students to interact with their well-being data to promote timely help-seeking and behavior change.
医学生的不适程度已有充分记录。学习者的痛苦可能会影响患者护理、劳动力充足性以及学习者的表现和个人健康。作者描述了新型 REACH（识别、共情、允许、关心、相互支持）课程的理念、结构和内容，并提供了初步评估。
REACH 课程是威斯康星医学院（MCW）为一年级和二年级医学生开设的强制性纵向健康课程，旨在使他们为成为医生的情感生活做好准备。该课程使用创伤管理领域的框架、核心概念和技能。它建立在有效的医学生健康干预措施（例如，基于正念的培训）和教师在理论和小组课程中分享个人故事的基础上，这些内容都整合到了 MCW 的常规课程中。在实施的头两年（2018-2019 年和 2019-2020 年），使用课程中期和课程结束后的学生调查来评估课程。
截至 2022 年 3 月，已有超过 700 名学生完成了 REACH 课程。总体而言，2018-2020 年期间对调查做出回应的大多数学生表示，他们觉得 REACH 课程的材料很重要，课程符合他们对优质医学院课程的期望，他们会推荐其他学校开设类似课程。对 2019-2020 年课程结束后调查的回应者表示，REACH 课程帮助他们发展了自我保健（84%[85/101]）、正念（76%[76/101]）和寻求帮助的能力（71%[72/101]）。
初步结果表明，整合强制性健康课程对医学生来说是可行且可接受的。作者计划研究学生报告的健康指标、学术和临床表现数据以及专业身份形成之间的关系。他们还在开发电子仪表板原型，以便学生可以与他们的健康数据进行交互，以促进及时寻求帮助和行为改变。
