Research Department, Canadian College of Naturopathic Medicine, Toronto, ON, Canada.
Med Educ Online. 2022 Dec;27(1):2133986. doi: 10.1080/10872981.2022.2133986.
Medical students experience significant stress and impacts on mood due to multiple factors. Unmitigated stress impacts both physical and mental health while increasing the risk of unethical behavior. It is important for medical institutions to identify strategies that effectively reduce perceived stress and improve the well-being of their students.
The authors undertook a scoping review of the literature to identify strategies implemented by medical educational programs to improve the well-being of medical students.
Of 1068 articles identified, 19 studies met the inclusion criteria. Interventions were categorized as mindfulness-based programs, reflection groups, curriculum changes, and 'miscellaneous.' All studies assessed outcomes of student stress/resilience, as well as additional domains including academic performance, mental health, and interpersonal skills. Some also assessed the acceptability of the intervention to students.
Despite the heterogeneity of interventions and outcome measures, a clear theme emerged that institutionally-provided strategies to promote student well-being tend to be effective when students opt into the program. It was noted that adding mandatory content or activities to a medical program without creating adequate space or support for it can have the opposite effect. Further high quality intervention studies involving randomization, blinding and rigorous controls are warranted.
由于多种因素,医学生经历着巨大的压力和情绪影响。未得到缓解的压力会影响身心健康,同时增加不道德行为的风险。医疗机构识别出能有效减轻学生感知压力和改善他们福祉的策略非常重要。
作者对文献进行了范围性回顾,以确定医学教育计划中实施的改善医学生福祉的策略。
在 1068 篇文章中,有 19 项研究符合纳入标准。干预措施分为基于正念的项目、反思小组、课程变化和“其他”。所有研究都评估了学生压力/韧性的结果,以及包括学术表现、心理健康和人际关系技能在内的其他领域。一些研究还评估了干预措施对学生的可接受性。
尽管干预措施和结果衡量标准存在异质性,但一个明确的主题出现了,即机构提供的促进学生福祉的策略往往在学生选择参与该计划时是有效的。有人指出,在没有为其创造足够空间或支持的情况下,将强制性内容或活动添加到医学课程中可能会产生相反的效果。需要进一步进行涉及随机化、盲法和严格对照的高质量干预研究。