Relationship among Medical Student Resilience, Educational Environment and Quality of Life

Abstract

ContextResilience is a capacity to face and overcome adversities, with personal transformation and growth. In medical education, it is critical to understand the determinants of a positive, developmental reaction in the face of stressful, emotionally demanding situations. We studied the association among resilience, quality of life (QoL) and educational environment perceptions in medical students.MethodsWe evaluated data from a random sample of 1,350 medical students from 22 Brazilian medical schools. Information from participants included the Wagnild and Young’s resilience scale (RS-14), the Dundee Ready Educational Environment Measure (DREEM), the World Health Organization Quality of Life questionnaire – short form (WHOQOL-BREF), the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI).ResultsFull multiple linear regression models were adjusted for sex, age, year of medical course, presence of a BDI score ≥ 14 and STAI state or anxiety scores ≥ 50. Compared to those with very high resilience levels, individuals with very low resilience had worse QoL, measured by overall (β=-0.89; 95% confidence interval =-1.21 to -0.56) and medical-school related (β=-0.85; 95%CI=-1.25 to -0.45) QoL scores, environment (β=-6.48; 95%CI=-10.01 to -2.95), psychological (β=-22.89; 95%CI=-25.70 to -20.07), social relationships (β=-14.28; 95%CI=-19.07 to -9.49), and physical health (β=-10.74; 95%CI=-14.07 to -7.42) WHOQOL-BREF domain scores. They also had a worse educational environment perception, measured by global DREEM score (β=-31.42; 95%CI=-37.86 to -24.98), learning (β=-7.32; 95%CI=-9.23 to -5.41), teachers (β=-5.37; 95%CI=-7.16 to -3.58), academic self-perception (β=-7.33; 95%CI=-8.53 to -6.12), atmosphere (β=-8.29; 95%CI=-10.13 to -6.44) and social self-perception (β=-3.12; 95%CI=-4.11 to -2.12) DREEM domain scores. We also observed a dose-response pattern across resilience level groups for most measurements.ConclusionsMedical students with higher resilience levels had a better quality of life and a better perception of educational environment. Developing resilience may become an important strategy to minimize emotional distress and enhance medical training.

The Greek Version of the Resilience Scale (RS-14): Psychometric Properties in three Samples and Associations with Mental Illness, Suicidality, and Quality of Life

“…Resilience is associated with better wellbeing, satisfaction with health and health-related quality of life [5,27,33,34]. Accordingly, RS-14 scores should be positively associated with WHOQOL-BREF scores.…”

“…RS-14 scores have been found correlated with measures of satisfaction with life [5] and higher resilience levels as measured by the RS-14 have been found associated with a better quality of life as measured by the WHOQOL-BREF [33]. Also, lower levels of resilience were associated with worse HRQoL in cancer patients [34], while a recent systematic review of resilience in the physically ill found that resilience was associated with factors directly salient to physical illness, including HRQoL [57].…”

“…Moreover, independent studies have used its English [5], Brazilian [11], Chinese [17], Japanese [30], Taiwanese [31] and Korean versions [32]. RS-14 scores have been found to be positively associated with psychological well-being, purpose in life, self-esteem, social support, quality of life, and self-reported good health status [5,26,27,33,34]. Conversely, RS-14 scores seem to be negatively correlated with depression, anxiety, stress, posttraumatic stress disorder, and disability [4,11,26,27,30].…”

Antecedente de Ansiedade, Síndrome do Pânico ou Depressão e Análise do Impacto na Qualidade de Vida em Estudantes de Medicina

“…Assim, a identificação de fatores de risco para o desenvolvimento de transtornos de ansiedade e depressivos é fundamental e será vista como pré-requisito para o bom funcionamento de uma escola de Medicina (Tempski et al, 2015).…”

Review of Grit and Resilience Literature within Health Professions Education

“…In a study of over 1,300 Brazilian medical students, researchers found that higher levels of resilience were associated with a higher quality of life (QoL), as measured by the World Health Organization Quality of Life Questionnaire, and better perception of their educational environment. 30 More specifically, they found that medical students with very high resilience had statistically higher overall QoL than those with very low to moderately high ( p,.001) or even high (p5.013) resilience levels. Evaluators also used the validated Dundee Ready Educational Environment Measure (DREEM) questionnaire to assess five domains (learning, teachers, academic self-perception, atmosphere, and social perception) of the students' educational environment.…”