Measuring psychological flexibility in medical students and residents: a psychometric analysis

Abstract

PurposePsychological flexibility involves mindful awareness of our thoughts and feelings without allowing them to prohibit acting consistently with our values and may have important implications for patient-centered clinical care. Although psychological flexibility appears quite relevant to the training and development of health care providers, prior research has not evaluated measures of psychological flexibility in medical learners. Therefore, we investigated the validity of our learners’ responses to three measures related to psychological flexibility.MethodsFourth-year medical students and residents (n=275) completed three measures of overlapping aspects of psychological flexibility: (1) Acceptance and Action Questionnaire-II (AAQ-II); (2) Cognitive Fusion Questionnaire (CFQ); and (3) Mindful Attention and Awareness Questionnaire (MAAS). We evaluated five aspects of construct validity: content, response process, internal structure, relationship with other variables, and consequences.ResultsWe found good internal consistency for responses on the AAQ (α=0.93), MAAS (α=0.92), and CFQ (α=0.95). Factor analyses demonstrated a reasonable fit to previously published factor structures. As expected, scores on all three measures were moderately correlated with one another and with a measure of life satisfaction (p<0.01).ConclusionOur findings provide preliminary evidence supporting validity of the psychological flexibility construct in a medical education sample. As psychological flexibility is a central concept underlying self-awareness, this work may have important implications for clinical training and practice.

Functional neuroimaging correlates of thinking flexibility and knowledge structure in memory: Exploring the relationships between clinical reasoning and diagnostic thinking

“…In addition to the role the mPFC plays in spontaneous and creative behavior (Limb & Braun 2008), activation of medial frontal regions has also been associated with reasoning (Ruff et al 2003) and promoting flexibility in behavior by resolving interference between two competing alternatives (Peters et al 2013). Indeed, cognitive flexibility may enhance self-awareness and promote originality in thinking and creativity that could result in better clinical reasoning abilities (Nijstad et al 2010;Palladino et al 2013). Furthermore, our results suggest that during clinical reasoning the mPFC may work in tandem with the parahippocampal gyrus to enhance social perception, empathy and mentalizing, which may facilitate making appropriate judgments about fMRI correlates of the DTI patient health (Vollm et al 2006).…”

Data on the relationship between caffeine addiction and stress among Lebanese medical students in Lebanon

“…This mandates thorough actions to be considered by both medical institutions and medical students to fight this stress and maintain a healthier life and academic development.Our data are concurrent with previous research studies, thus making it of interest to other researchers. This topic was tackled by multiple previous studies in Lebanon, where it found that Lebanese medical students and mainly 97% of them were unconsciously becoming addicted to caffeinated substances [[1], [2], [3], [4]], and showing signs of anxiety, burnout and depression [[5], [6], [7], [8], [9]]. The data can be used to carry out comparative studies in the same field of research.…”

Assessing the Efficacy of an Individualized Psychological Flexibility Skills Training Intervention App for Medical Student Burnout and Well-being: Protocol for a Randomized Controlled Trial

“…For example, students who transition away from healthy behavior patterns during their medical training are at an increased risk of experiencing burnout [31] as are those who tend not to engage in values-driven behavior [32]. The risk is more than double for students who engage in maladaptive coping repertoires, such as avoidance-based coping (including cognitive, emotional, and behavioral avoidance) [32][33][34][35]. Longitudinal evidence suggests that medical students who demonstrate problematic coping patterns are unlikely to spontaneously adopt more effective behavioral repertoires over time [31], and this may have adverse consequences regarding long-term burnout and well-being outcomes [30].…”

“…In light of these factors, the provision of individual psychological resource-building interventions as early as during undergraduate medical training is receiving growing support [18,20,22,[29][30][31]33,38]. The past 10 years have seen a marked increase in the number of studies investigating such interventions [23].…”