Attitudes Towards Mental Health Among Physician Assistant Students with Shared Living Experiences Through Synchronous Videoconferencing

Abstract

Purpose We tested the hypothesis that physician assistant (PA) students can benefit from exposure to senior PAs who share their living experiences with mental illness.Methods First-year students from 5 PA programs were asked to participate in this mixed methods study. After completing a pre-activity survey, students from 3 programs participated in an intervention consisting of senior PA faculty sharing their mental health experiences, including treatment and recovery. A facilitated discussion followed, and students not exposed to the intervention served as controls. The qualitative component of the study was based on transcripts from 3 focus groups of students in the exposed group. ResultsWe recruited 167 students from 5 PA training programs, 112 of whom (67%) completed baseline and endpoint assessments (37 in the exposed group, 75 in the control). The intervention resulted in significant improvements on the Opening Minds to Stigma (OMS-HC, p = 0.002, Cohen's d = 0.38) and Self-Stigma of Seeking Help (SSOSH, p = 0.006, d = 0.31) scales. Change in the OMS-HC was driven by its social distance (p = 0.003) and disclosure (p = 0.02) subscales. No comparable changes were found in the control group. We identified 3 overarching themes: 1) active elements of the intervention; 2) mutuality; and 3) peer relationships.Conclusions Senior PAs sharing their lived experiences with mental illness proved to be an effective anti-stigma intervention for PA students. A candid, intimate, and confidential virtual learning space was feasible through synchronized videoconferencing. Our findings can inform programmatic interventions to address stigma, self-stigma, help-seeking behaviors, and the overall mental health of PA students. METHODS Participants, Synchronized Videoconferencing Delivery, and Ethics ApprovalParticipants were first-year PA students enrolled in 5 programs across the United States (one public and 4 private; 3 in the The authors declare no conflict of interest.

Strategies for Improving Mental Health in Physician Assistant Students

“…A study of first-year PA students showed that interventions such as senior PAs sharing their personal experiences with mental illness and facilitated discussions with open reflection are effective at reducing stigma. 20 Given the increased risk of mental illness in PA students, programs should consider adding similar programs to de-stigmatize mental health as well as other strategies to improve mental well-being.…”

Foundational Skill-Building in a Novel Well-being Curriculum

“…The course began in the fifth week of each program's didactic curriculum, a timeline based on feedback from prior studies performed by the research team. 5,6…”

“…5 One such study showed that disclosure of lived experiences of mental illness by practicing providers improved the help-seeking behaviors of medical students, and this has been successfully replicated in PA programs. 5 Additionally, mindfulness has been shown to increase resilience to stress in university students and brief curricular exposure to mindfulness and decentering content has been shown to improve PA students' levels of mindfulness, which significantly predicted change in life satisfaction and perceived stress. 6 Likewise, narrative writing has been shown to provide a space to relate self-reflection with clinical practice.…”

“…Although a variety of effective approaches to prioritizing student and clinician well-being during medical education exist, prior study of these interventions has been small in scale and has typically focused on a single aspect of wellness. 5 One such study showed that disclosure of lived experiences of mental illness by practicing providers improved the help-seeking behaviors of medical students, and this has been successfully replicated in PA programs. 5 Additionally, mindfulness has been shown to increase resilience to stress in university students and brief curricular exposure to mindfulness and decentering content has been shown to improve PA students’ levels of mindfulness, which significantly predicted change in life satisfaction and perceived stress.…”

“…8 The current study built upon prior small-scale interventions to pilot a no-cost, evidence-based, clinician-specific, virtual wellness curriculum for PA students that could be easily adopted by any PA program. 5,6 The primary purpose of this study was to determine if exposure to a mandatory, multifaceted virtual wellness curriculum can mitigate the decline in well-being experienced by first-year PA students as measured by mental health stigma, psychological flexibility, alcohol use, and help-seeking behaviors. The secondary purpose of this study was to determine the role of demographics in wellness curricula effectiveness.…”