Stressing the journey: using life stories to study medical student wellbeing

Abstract

While previous studies have considered medical student burnout and resilience at discrete points in students' training, few studies examine how stressors and resilience-building factors can emerge before, and during, medical school. Our study focuses on students' life stories to comprehensively identify factors contributing to student wellbeing. We performed a secondary analysis of life-story interviews with graduating fourth year medical students. These interviews were originally conducted in 2012 as part of the Project on the Good Physician, and then re-analyzed, focusing on student wellbeing. Respondents were encouraged to identify turning points in their life stories. De-identified transcripts were then coded using a consensus-based iterative process. 17 of 21 respondents reported feeling burned out at least once during medical school. Students identified three major stressors: negative role models, difficult rotations, and the United States Medical Licensing Examination Step 1. Two "motivational stressors"-financial concerns and personal life events-emerged as sources of stress that also motivated students to persevere. Finally, students identified four factors-positive role models, support networks, faith and spirituality, and passion-that helped them reframe stressors, making the struggle seem more worthwhile. These findings suggest that a life-story approach can add granularity to current understandings of medical student wellbeing. Initiatives to reduce stress and burnout should extend beyond the immediate medical school context and consider how past challenges might become future sources of resilience. This study also provides an example of secondary analysis of qualitative data, an approach which could be useful to future research in medical education.

Burnout syndrome, extracurricular activities and social support among Brazilian internship medical students: a cross-sectional analysis

“…Social support could have a protective effect for BS in medical students [16,37]. Although this study found a difference of self-rated social support sought by women, which reported to rely more on family and partners than men, this not associated with BS.…”

“…There is some evidence about protective factors of BS in medical students, as positive life events (marriage, birth or adoption), social support, extracurricular activities and physical activity [8,[15][16][17]. A cross-sectional Spanish study with health professionals found that individuals with higher and moderate self-esteem are associated with higher social support and empathy and lower frequency of BS [18].…”

Burnout Syndrome, Extracurricular Activities and Social Support Among Brazilian Internship Medical Students: a Cross-Sectional Analysis.

“…Social support could have a protective effect for BS in medical students (16,37). Although this study found a difference of self-rated social support sought by women, which reported to rely more on family and partners than men, this not associated with BS.…”

Stakeholder Groups’ Unique Perspectives About the Attending Physician Preceptor Role: A Qualitative Study

“…23 Medical students report their experiences of emotional abuse within the medical education systems, 24 and mistreatment such as described in our study is associated with student burnout. [24][25][26] In training the next generation of physicians, preceptors may also need to acknowledge and provide additional mentorship around the complexity of their role, and especially their accountability to diverse stakeholders. Within this complex role and environment of multiple accountabilities, preceptors should also teach and role model professionalism through self-improvement.…”