Mental Stress in Medical Students during the Pandemic and Their Relation to Digital and Hybrid Semester—Cross-Sectional Data from Three Recruitment Waves in Germany

Abstract

Background: Because of the COVID-19 pandemic, students had to interrupt their regular studies, and universities changed their teaching formats. The aim of this study was to analyze medical students’ stress perception, wellbeing, life and work satisfaction, and cool down reactions, and to compare the survey data of online and hybrid semesters with pre-pandemic education formats in-person. Methods: Cross-sectional surveys at three time points enrolling 1061 medical students (58% women; 24.4 ± 3.4 years); 30.8% from pre-pandemic formats in-person, 22.8% from pandemic online semesters, and 46.1% from pandemic hybrid semesters. Results: Both students’ stress perception and psychological wellbeing decreased during the pandemic semesters. Their satisfaction with the university support was at its lowest during the hybrid semesters. Regression analyses indicated that students’ stress perception can be explained only to some extent by their general dissatisfaction with their medical studies or teaching formats. Conclusions: The lockdowns affected students in more ways than simply their teaching formats. Students require individual support to adjust to difficult situations, and particularly medical students in their preclinical phase compared to students in their clinical phases. These are challenges for the medical education system, which must find ways to be prepared for future times of crisis and insecurity.

The impact of the Russian Invasion of Ukraine on the Well-Being of German Medical Students: a mixed-methods study

“…In this study, the non-signi cant changes in work engagement even with the enduring war events within four months might re ect an interesting resilience factor for this felt hopelessness. The course of stable work engagement is comparable to that during the COVID-19 pandemic [10]. Work engagement might constitute a time-stable factor for the studies also for German private medicine students, as previously connoted as a stable and support-worthy resource for the success of job-related tasks and regulation of demands among workers [33,55].…”

“…This is also shown in other cohorts of students of different study elds and may be a key argument for the structural relevance and importance of the consideration of systemic volatility in stress perception, which might decrease in times of cultural, economic and general contact restrictions during the pandemic in contrast to "just" empathy-based concernment and anticipating fear, that the war will also affect Germany in the future after the war act on Ukraine [25,27,40,41]. Interesting to note is that the students of the UW/H seem to regulate their emotions (here: after a time span of 4 months) in a comparable way, showing favorable scores in wellbeing over time [10,40,41]. This will be discussed for further research and student support with a view to the reinforcement of media reports and crisis communication, individual affectedness of the events on the exo-level as well as individual study characteristics on the micro-and meso-level [7,10,13].…”

“…The described risk framework may be both applicable in comparison to previous ndings and related to self-relevance during the COVID-19 pandemic, from which the students may be constantly or more affected over the time, as the infection rates and the scope rose and consequences were perceived more directly [10]. This may be a key point and argument for understanding the differences in stress perception during different types of crises along individual gradients of self-relevance and ongoing event reports as well as health consequences for students [14,47].…”

“…All items refer to emotions and thoughts in the past month, answered on a four-point Likert scale ranging from 1 (never) to 4 (very often). The internal consistency of the scale was good in medical students from Germany (Cronbach's alpha = 0.89) [10]. Subjective wellbeing in the past two weeks was assessed using a scale ranging from 0 (never) to 5 (all the time) as the WHO-Five Well-being Index (WHO-5), where scores above 13 may indicate depressed mood [35].…”

“…It is unclear how different factors of the clinical environment and factors of different study phases might covariate with the individual or well-being of the study cohort or stress perception and further research could try to depict in uencing factors on multi levels in order to separate personal or study wise in uences from those of the war events[66, 67]. On the individual level, previous research suggests covariability of wellbeing and stress perception of students in times of crises in political ideology, gender, phases of study, social media use, the individual capability of emotion regulation and endurance of insecurity as well as other resilience factors[10, 68]. Due to a personal selection process for medicine studies at the UW/H, personality factors may additionally in uence individual crisis processing, possibly limiting the transferability of the ndings to other samples[69,70].…”