Towards an understanding of medical student resilience in longitudinal integrated clerkships

Greenhill, Jennene; Fielke, Ken R.; Richards, Janet; Walker, Leesa; Walters, Lucie

doi:10.1186/s12909-015-0404-4

Cited by 40 publications

(36 citation statements)

References 31 publications

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“…Previous studies have reported the importance of continuity of care from the medical school in providing a supportive and stable environment for students [27]. Given medical school curricula are split between early years and later years and medical students are dispersed at various sites along their training, establishing continuity of care remains challenging.…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Exploration of the Help-Seeking Behaviors of Students Who Experience Psychological Distress Around Assessment at Medical School

2017

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ObjectiveMedical students are at high risk of experiencing psychological distress at medical school and developing mental ill-health during professional practice. Despite efforts by faculty to raise awareness about this risk, many students choose to suffer in silence in the face of psychological distress. The aim of this study was to explore drivers that prompted help-seeking behavior and barriers that prevented individuals prioritizing their well-being around the time of high-stakes assessment at medical school.MethodsSemi-structured interviews were conducted with fifty-seven students who failed high-stakes assessment at two UK medical schools, exploring their experience of academic difficulty and perceptions about causes. A thematic analysis of twenty transcripts that met inclusion criteria was completed to identify key factors that influenced participants’ decisions around seeking help for their psychological distress, and in some cases, mental health problems. Twenty participants who specifically described a deterioration in their mental health around the time of assessment were included in this study.ResultsBarriers to seeking help in these instances included: normalization of symptoms or situation; failure to recognize a problem existed; fear of stigmatisation; overt symptoms of mental distress; and misconceptions about the true nature of the medical school, for example beliefs about a punitive response from the school if they failed. Drivers for seeking help appropriately included: building trust with someone in order to confide in them later on, and self-awareness about the need to maintain good mental health.ConclusionThere are various drivers and barriers for students’ help seeking behaviors when experiencing psychological distress around the time of assessment, particularly self-awareness about the problem and prioritisation of well-being. Students who fail to recognize their own deteriorating mental health are at risk of academic failure and medical schools need to develop strategies to tackle this problem in order to protect these students from harm.

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Section: Discussionmentioning

confidence: 99%

A Qualitative Exploration of the Help-Seeking Behaviors of Students Who Experience Psychological Distress Around Assessment at Medical School

2017

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“…The opposite also held; those who related positive experiences described them as supportive of wellbeing. Previous research has shown that student perception of support and interest in students' education by faculty is associated with increased odds for recovery from burnout [25], and clinical supervisors can serve as sources of stability and continuity for medical students [48]. Our findings suggest that mutually trusting relationships between staff and students could promote wellbeing per se, as well as enhance engagement and uptake of wellbeing initiatives.…”

Section: Staff Attitudes Towards Studentsmentioning

confidence: 55%

Medical student perceptions of curricular influences on their wellbeing: a qualitative study

Byrnes

Ganapathy

Lam

et al. 2020

Preprint

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Background Medical student mental health and wellbeing is highly topical worldwide. Research has tended to be either large-scale, quantitative, prevalence studies of wellbeing and associated factors such as burnout, or evaluations of single institution interventions. While theoretically informed definitions of wellbeing abound, how do medical students themselves understand and perceive wellbeing? What aspects of the curriculum do they regard as affecting their wellbeing and mental health? This study explored these questions, and aimed to identify factors associated with student acceptability of wellbeing programs and interventions. Methods All students at an Australian undergraduate medical school were invited to complete a qualitative online questionnaire between 2017 and 2018 following the introduction of several wellbeing initiatives, including “Wellbeing Days” (WBD). WBD allow students to take single absence days for self-care. Open-ended questions were asked about perceptions and experience of wellbeing and mental health, and views on interventions to improve wellbeing such as WBD. Thematic analysis was performed , initially by three authors who developed preliminary themes, then confirmed by all researchers . Thematic saturation was achieved within the 68 responses, which included participants from all cohorts. Results Participants described wellbeing as positively experienced work/life balance, impacted by four factors; contact hours, peer relationships, staff relationships, and trust in how wellbeing initiatives were used. Long course contact hours were deemed incompatible with self-care activities, maintaining employment, and seeking professional medical/psychological help. Peers could promote wellbeing by offering social and academic support, but also undermine wellbeing by being competitors. Degree of trust, engagement and communication with staff influenced acceptability of interventions. Participants viewed initiatives such as WBD favourably, but distrust of peers, and of staff, led to perceptions that WBD could be prone to misuse, or used for surveillance rather than support. Conclusion Our findings suggest that wellbeing days which allow self-care, reduction in contact hours, and peer support may promote student wellbeing, but the acceptability of any interventions is influenced by relationships between students and staff, and with peers. Further research is recommended to investigate the relationship between trust, perceptions of wellbeing in self and peers, and the effectiveness of wellbeing interventions.

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“…The year 4 results suggest that spending a year rurally and reintegrating into the mainstream encouraged the development of resilience and is reassuring as it suggests that the geographical and academic isolation that can be part of rural placement has not shown negative effects on students’ resilience. This is supported by qualitative research by a study examining the development of resilience during a long‐term rural placement.…”

Section: Discussionmentioning

confidence: 98%

How does studying rurally affect peer networks and resilience? A social network analysis of rural‐ and urban‐based students

Burgis-Kasthala

Elmitt

Moore

2018

Australian J Rural Health

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Objective: To examine differences in peer networks between urban-based students and rural-stream students in an Australian medical school and to examine how characteristics of networks relate to resilience. Design: Cross-sectional survey asking students to signify social, academic and support relationships with students in the same year and to complete a survey on their resilience. Setting and participants: All second-, third-and fourth-year students at the Australian National University Medical School. Main outcome measures: Social network analysis comparing peer networks, t-test comparing mean resilience of urban and rural students. Results: A visual analysis of the peer networks of year 2, 3 and 4 medical students suggests greater integration of rural-stream students within the year 2 and 4 urban cohorts. Resilience is similar between year 2 and 3 students in both urban and rural streams, but is significantly higher in year 4 rural-stream students, compared to their urban-based peers. Networks of rural-stream students suggest key differences between their period spent rurally and on their return and integration within the larger student cohort. Furthermore, rural students, once reintegrated, had larger and stronger social networks than their urban counterparts. Conclusion: The results of the study suggest that the rural experience can instruct support systems in urban settings. However, whether the rural placement creates a more resilient student or resilient students are selected for rural placement is unclear.

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Towards an understanding of medical student resilience in longitudinal integrated clerkships

Cited by 40 publications

References 31 publications

A Qualitative Exploration of the Help-Seeking Behaviors of Students Who Experience Psychological Distress Around Assessment at Medical School

A Qualitative Exploration of the Help-Seeking Behaviors of Students Who Experience Psychological Distress Around Assessment at Medical School

Medical student perceptions of curricular influences on their wellbeing: a qualitative study

How does studying rurally affect peer networks and resilience? A social network analysis of rural‐ and urban‐based students

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