Background: Research regarding the health and wellness of medical students has led to ongoing concerns regarding patterns of alcohol and drug use that take place during medical education. Such research, however, is typically limited to single-institution studies or has been conducted over 25 years ago. Objective: The objective of the investigation was to assess the prevalence and consequences of medical student alcohol and drug use and students’ perceptions of their medical school’s substance-use policies. Design: A total of 855 medical students representing 49 medical colleges throughout the United States participated in an online survey between December 2015 and March 2016. Results: Data showed that 91.3% and 26.2% of medical students consumed alcohol and used marijuana respectively in the past year, and 33.8% of medical students consumed five or more drinks in one sitting in the past two weeks. Differences in use emerged regarding demographic characteristics of students. Consequences of alcohol and drug use in this sample of medical students included but were not limited to interpersonal altercations, serious suicidal ideation, cognitive deficits, compromised academic performance, and driving under the influence of substances. Forty percent of medical students reported being unaware of their medical institution’s substance-use policies. Conclusions: Findings suggest that substance use among medical students in the US is ongoing and associated with consequences in various domains. There is a lack of familiarity regarding school substance-use policies. Although there has been some progress in characterizing medical student alcohol use, less is known about the factors surrounding medical students’ use of other substances. Updated, comprehensive studies on the patterns of medical student substance use are needed if we are to make the necessary changes needed to effectively prevent substance-use disorders among medical students and support those who are in need of help.

Two studies were conducted to revise and empirically test Ellis's framework for inadequate and harmful supervision, and to determine the occurrence of inadequate and harmful clinical supervision from the supervisees' perspective. For Study 1, we delineated 10 criteria for minimally adequate clinical supervision and defined inadequate and harmful supervision by differentiating self-identified and de facto supervision for each. Ratings from 34 supervision experts were used to generate a taxonomy of 16 de facto inadequate and 21 de facto harmful supervision descriptors. Because harmful supervision was distinct from, yet subsumed by, inadequate supervision, we revised the taxonomy and definitions accordingly. In Study 2, the occurrence of inadequate and harmful supervision was assessed for 363 supervisees; 93.0% were currently receiving inadequate supervision and 35.3% were currently receiving harmful supervision. Over half of the supervisees had received harmful clinical supervision at some point. Implications for research, training, and practice are discussed.

BackgroundResearch on student wellness has highlighted the importance of self-care for medical students; however, scholars have yet to identify the extent to which self-reported engagement in self-care behaviors is associated with attenuation of the negative relationship between stress and quality of life during the initial years of medical education.MethodsUsing a self-report survey designed to measure self-care, perceived stress, and quality of life, we hypothesized that self-care would moderate the relationship between stress and psychological quality of life in medical students, as well as stress and physical quality of life.An online questionnaire was completed by 871 medical students representing 49 allopathic medical colleges throughout the U.S. between December 2015 and March 2016. The survey assessed perceived stress, self-care, quality of life and a variety of demographic variables. Regression analyses were used to assess interaction effects of self-care on the relationships between stress and quality of life.ResultsSelf-reported engagement in self-care appeared to moderate the relationships between perceived stress and both physical (p < .001) and psychological (p = .002) quality of life. As the level of reported engagement in self-care increased, the strength of the inverse relationship between perceived stress and both physical and psychological quality of life appeared to weaken.ConclusionsOur findings suggest that self-reported engagement in self-care activities is associated with a decrease in the strength of the relationship between perceived stress and quality of life in medical students. Students who disclose utilizing a multitude of self-care practices throughout their training may also sustain greater resiliency and lower risk for higher levels of distress during medical education.

Ten clusters of self-care activities were identified: nourishment, hygiene, intellectual and creative health, physical activity, spiritual care, balance and relaxation, time for loved ones, big picture goals, pleasure and outside activities, and hobbies. Using results of the two-dimensional scaling analysis, students' individual self-care behaviors were organized within two orthogonal dimensions of self-care activities. Insights: This concept map of student-identified self-care activities provides a starting point for better understanding and ultimately improving medical student self-care. Students' brainstormed responses fit within a framework of varying levels of social engagement and physical-psychological health that included a wide range of solitary, social, physical, and mental health behaviors. As students' preferred self-care practices did not often include programmatic activities, medical educators may benefit from consulting this map as they plan new approaches to student self-care and in counseling individual students searching for more effective ways to ease the burdens of medical school.

Impaired sleep quality may contribute to fatigue in medical students even when sleep quantity seems adequate. Students appear to begin medical school with disrupted sleep patterns that may not improve until their final year of study. Education regarding proper sleep habits and the significant role of sleep quality in sustaining healthy sleep is especially important in the early stages of medical education. Minority, first year, and third year students may benefit the most from learning new behaviors that promote sufficient sleep quality during periods of sustained stress.

Although research has been conducted on rape myth acceptance (RMA) and other factors associated with attribution formation, researchers have not yet determined how the combination of such factors simultaneously affects levels of victim blame and perpetrator blame. The current investigation recruited 221 students from an all-women's college to examine differences in blame attributions across RMA, victim gender, and perpetrator gender, and the relationship between the two parties (i.e., stranger vs. acquaintance). Results suggested that RMA, victim gender, and perpetrator gender account for a significant amount of variance in blame attributions for both victims and perpetrators. In sum, victim blame with female perpetrators was relatively consistent across levels of RMA, but increased substantially for male perpetrators as individuals endorsed higher levels of RMA. Perpetrator blame, however, was highest with male perpetrators when individuals endorsed low levels of RMA and lowest for male perpetrators when individuals endorsed relatively higher levels of RMA. Findings demonstrate the continued influence of RMA on blame attributions for both victims and perpetrators, and the stigma faced by male victims. More research is needed on the differing attributions of male and female victims and perpetrators, as well as differing attributions based on type of relationship. Such research will lead to a better and more thorough understanding of sexual assault and rape.

Due in part to gender roles and their socialization as caretakers, women in health service psychology (HSP) programs may be vulnerable to experiencing stressful events that negatively impact their professional and academic functioning. Two constructs are particularly germane to understanding the stress experienced by women in HSP programs: quality of life and self-care. However, scant literature exists on women in HSP programs, especially concerning the relations among stress, self-care, and quality of life. The purpose of our study was to address some of the conceptual-methodological deficiencies in the literature by empirically testing the application of the health promotion model to women in HSP doctoral programs. The investigation tested the extent to which self-care activities moderated the negative association between stress and quality of life (QL) in a sample of 558 women enrolled in HSP programs throughout the United States. The most salient findings were (a) women in HSP programs, compared to other populations, evidenced substantively higher stress levels and lower self-care and overall QL; (b) stress was uniquely and inversely, though modestly, related to QL, whereas self-care and its moderating effects were not; and (c) self-care and quality of life were best conceptualized and analyzed as multidimensional constructs. The findings suggest stress levels may have a significantly larger effect on QL than self-care for women in HSP doctoral programs. Results also suggest QL and self-care are multidimensional constructs and need to be analyzed as such. Implications for theory, practice, and research are discussed.

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