Beyond prevalence to process: the role of self and identity in medical student well-being

Abstract

2Beyond prevalence to process:The role of self and identity in medical student wellbeing Abstract ContextProblematic stress levels amongst medical students have been well established. This stress can lead to depression, suicidal ideation, substance abuse, burnout and cynicism, having a negative effect on students and their patients. MethodsWe propose to move towards examining the processes underlying wellbeing in some medical students and vulnerability in others. We draw upon social psychological literature to propose that self-complexity, medical student identity and associated norms, all have the capacity to influence medical students' wellbeing in both positive and negative ways. ResultsWe identify two key dilemmas facing medical students with regard to the social psychological factors investigated. Firstly, a diverse set of interests and a high level of self-complexity is thought to buffer against the effects of stress and might also be beneficial for medical practitioners, but the intensive nature of medical education makes it difficult for students to pursue outside interests, leading to a strongly focused identity. Secondly, a strong group identity is associated with high levels of social support and improved wellbeing, but unhealthy group norms may have a greater influence on individuals who have a strong group identity, encouraging them to engage in behaviours that place their wellbeing at risk. A model is proposed 3 outlining how these potentially contradictory social psychological processes may combine to impact upon medical students' wellbeing. ConclusionsThere is great scope for investigating the role of self-complexity, identity and norms in the medical education context, with room to investigate each of these factors alone and in combination. We highlight how our proposed model can inform medical educators as to the students who may be most vulnerable to the effects of stress, and the potential interventions from which they may benefit. We conclude that social psychological factors make a valuable contribution to understanding the complex issue of wellbeing in medical education. 4Beyond prevalence to process:

In their own words: stressors facing medical students in the millennial generation

“…Anxiety and depression have been linked to medical students’ vulnerability to stress [16], and higher levels of psychological distress have been linked to decreases in empathy [17], serious thoughts about dropping out of medical school [5], suicidal ideation [5,10], and poor academic performance [18–20]. Previous research has explored student vulnerability to stress [4,21,22], and several studies have documented major stressors for medical students, including academics [15,18], lack of balance [23], relationships [18], poor student guidance/support [23], volume of information [18,23], finances [23], uncertainty of the future [15], lack of time to oneself [18], time and responsibility [23], and the need to succeed [18]. In addition, a recent review described six major themes associated with student distress: adjustment, ethical concerns, exposure to patient death and suffering, student mistreatment, personal life events, and educational debt [24].…”

Prevalencia de la ideación suicida en estudiantes de Medicina en Latinoamérica: un meta análisis / Prevalence of Suicidal Ideation in Medical Students of Latin America: a Meta-analysis

“…Desde hace más de 15 años (Tyssen et.al., 2001) comenzó a hacerse notorio entre el personal médico y los estudiantes de medicina de cualquier nivel que se presentaban tasas elevadas de depresión y ansiedad, por encima de lo observado en la población en general (Mavor et al, 2014).…”

CEACLIN, un instrumento en español para identificar estrategias para el aprendizaje de la clínica de estudiantes de medicina: Desarrollo y validación

“…Esto suele tener consecuencias negativas sobre la salud, el desempeño académi-co [29][30][31][32][33] y también el profesionalismo 34 . La aparición del tema de cómo manejar el agobio en un cuestionario de estrategias de aprendizaje generado inductivamente, como es el CEACLIN, subraya la importancia que otorgan los propios estudiantes al bienestar para el aprendizaje.…”