A qualitative analysis of the coping reservoir model of pre-clinical medical student well-being: human connection as making it 'worth it'.

Burnout Coping Curriculum Distress Doctor-patient relationship Hope Optimism Pre-clinical medical students Qualitative research methods Wellness

Journal

BMC medical education
ISSN: 1472-6920
Titre abrégé: BMC Med Educ
Pays: England
ID NLM: 101088679

Informations de publication

Date de publication:
19 May 2020
Historique:
received: 27 05 2019
accepted: 07 05 2020
entrez: 21 5 2020
pubmed: 21 5 2020
medline: 12 3 2021
Statut: epublish

Résumé

By all indications, well-being among physicians is poor, which manifests in various outcomes, including burnout, depression/anxiety, low life satisfaction, alcohol/substance misuse, suicide ideation, and suicide. Despite the vast literature on physician burnout, there is relatively little research on how pre-clinical experiences in medical school may be an antecedent to subsequent poor health among physicians. Here we focus on two neglected areas within the literature by focusing on the pre-clinical stage of medical school and the positive, as opposed to exclusively the negative, aspects of the medical school experience as it affects well-being. This study utilizes the metaphor of the Coping Reservoir Model as a theoretical and analytical framework for understanding medical student well-being by identify the 'depleting' and 'replenishing' inputs that are deposited into students' coping reservoirs. We analyze 105 medical students' reflective writings using a data analytic process consistent with an interpretive description approach, engaging in a hierarchical 3-step coding process to identify the main replenishing inputs deposited into students' coping reservoirs. The main depleting inputs that we identify are consistent with those identified by The Coping Reservoir Model. In addressing our main research question regarding the replenishing inputs, results show the main positive factors are psycho-social resources, intellectual stimulation, and social support/relationships. Most importantly, relationships with patients shape all three of these positive factors and provide the main source of hope that the stress of medical school will get better. What allows students to frame their experiences with hope and optimism are the connections they form with each other and with patients. The prolonged stress of medical school is made "worth it" in hopes that it will "get better" with more meaningful patient interaction in the future. These results that emphasize the positive aspects of medical school are discussed in context of their theoretical contributions to The Coping Reservoir Model and the practical implications for medical education to improve medical student well-being by facilitating human connection.

Sections du résumé

BACKGROUND BACKGROUND
By all indications, well-being among physicians is poor, which manifests in various outcomes, including burnout, depression/anxiety, low life satisfaction, alcohol/substance misuse, suicide ideation, and suicide. Despite the vast literature on physician burnout, there is relatively little research on how pre-clinical experiences in medical school may be an antecedent to subsequent poor health among physicians. Here we focus on two neglected areas within the literature by focusing on the pre-clinical stage of medical school and the positive, as opposed to exclusively the negative, aspects of the medical school experience as it affects well-being.
METHODS METHODS
This study utilizes the metaphor of the Coping Reservoir Model as a theoretical and analytical framework for understanding medical student well-being by identify the 'depleting' and 'replenishing' inputs that are deposited into students' coping reservoirs. We analyze 105 medical students' reflective writings using a data analytic process consistent with an interpretive description approach, engaging in a hierarchical 3-step coding process to identify the main replenishing inputs deposited into students' coping reservoirs.
RESULTS RESULTS
The main depleting inputs that we identify are consistent with those identified by The Coping Reservoir Model. In addressing our main research question regarding the replenishing inputs, results show the main positive factors are psycho-social resources, intellectual stimulation, and social support/relationships. Most importantly, relationships with patients shape all three of these positive factors and provide the main source of hope that the stress of medical school will get better.
CONCLUSIONS CONCLUSIONS
What allows students to frame their experiences with hope and optimism are the connections they form with each other and with patients. The prolonged stress of medical school is made "worth it" in hopes that it will "get better" with more meaningful patient interaction in the future. These results that emphasize the positive aspects of medical school are discussed in context of their theoretical contributions to The Coping Reservoir Model and the practical implications for medical education to improve medical student well-being by facilitating human connection.

Identifiants

pubmed: 32429893
doi: 10.1186/s12909-020-02067-8
pii: 10.1186/s12909-020-02067-8
pmc: PMC7236216
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

157

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Auteurs

Kelly Rhea MacArthur (KR)

Department of Sociology and Anthropology, University of Nebraska Omaha, 6001 Dodge St, Omaha, NE, 68182, USA. kmacarthur@unomaha.edu.

Jonathon Sikorski (J)

Department of Psychiatry, University of Nebraska Medical Center, 985575 Nebraska Medical Center, Omaha, NE, 68198, USA.

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Classifications MeSH