Risk factors associated with student distress in medical school: Associations with faculty support and availability of wellbeing resources.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2022
2022
Historique:
received:
24
12
2020
accepted:
10
03
2022
entrez:
8
4
2022
pubmed:
9
4
2022
medline:
15
4
2022
Statut:
epublish
Résumé
It is estimated that over half of medical students experience severe distress, a condition that correlates with low mental quality-of-life, suicidal ideation and serious thoughts of dropping out. While several risk factors for the development of severe distress have been identified, most focus on individual student characteristics. Currently, little is known about the impact medical schools have on student wellbeing. Prospective, observational survey study from 2019-2020 from a national cohort of US medical students. Student wellbeing, school characteristics, and wellbeing resource availability was measured with a 30-question electronic survey. Medical student distress was defined as a Medical Student Wellbeing Index (MS-WBI) of ≥4. Risk factors for the development of severe distress were evaluated in a multivariate logistic regression model. The impact of the number of wellbeing resources available on student wellbeing was measured along multiple wellbeing domains. Independent reviewers categorized free text analysis of survey responses about desired wellbeing resources into themes. A total of 2,984 responses were included in the study, representing 45 unique medical schools. Medical school characteristics independently associated with severe distress included low faculty support (OR 4.24); the absence of mentorship resources (OR 1.63) and the absence of community building programs (OR 1.45) in a multivariate model. Increased availability of wellbeing resources was associated with lower average MS-WBI (4.58 vs. 3.19, p<0;05) and a smaller percentage of students who had taken or considered taking a leave of absence (40% vs. 16%, p<0.05). The resources most desired by students were mental health services and scheduling adjustments. The majority of medical school characteristic that contribute to student distress are modifiable. Improving faculty support and offering more and varied wellbeing resources may help to mitigate medical student distress. Student feedback is insightful and should be routinely incorporated by schools to guide wellbeing strategies.
Sections du résumé
BACKGROUND
It is estimated that over half of medical students experience severe distress, a condition that correlates with low mental quality-of-life, suicidal ideation and serious thoughts of dropping out. While several risk factors for the development of severe distress have been identified, most focus on individual student characteristics. Currently, little is known about the impact medical schools have on student wellbeing.
METHODS
Prospective, observational survey study from 2019-2020 from a national cohort of US medical students. Student wellbeing, school characteristics, and wellbeing resource availability was measured with a 30-question electronic survey. Medical student distress was defined as a Medical Student Wellbeing Index (MS-WBI) of ≥4. Risk factors for the development of severe distress were evaluated in a multivariate logistic regression model. The impact of the number of wellbeing resources available on student wellbeing was measured along multiple wellbeing domains. Independent reviewers categorized free text analysis of survey responses about desired wellbeing resources into themes.
RESULTS
A total of 2,984 responses were included in the study, representing 45 unique medical schools. Medical school characteristics independently associated with severe distress included low faculty support (OR 4.24); the absence of mentorship resources (OR 1.63) and the absence of community building programs (OR 1.45) in a multivariate model. Increased availability of wellbeing resources was associated with lower average MS-WBI (4.58 vs. 3.19, p<0;05) and a smaller percentage of students who had taken or considered taking a leave of absence (40% vs. 16%, p<0.05). The resources most desired by students were mental health services and scheduling adjustments.
CONCLUSIONS
The majority of medical school characteristic that contribute to student distress are modifiable. Improving faculty support and offering more and varied wellbeing resources may help to mitigate medical student distress. Student feedback is insightful and should be routinely incorporated by schools to guide wellbeing strategies.
Identifiants
pubmed: 35395007
doi: 10.1371/journal.pone.0265869
pii: PONE-D-20-40527
pmc: PMC8992977
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0265869Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Teach Learn Med. 2007 Winter;19(1):42-6
pubmed: 17330998
Acad Med. 1999 May;74(5):516-20
pubmed: 10353283
N Engl J Med. 2018 Sep 27;379(13):1196-1198
pubmed: 30257155
Encephale. 2020 Feb;46(1):55-64
pubmed: 31767254
JAMA. 1992 Feb 5;267(5):692-4
pubmed: 1731137
Mayo Clin Proc. 2006 Nov;81(11):1443-8
pubmed: 17120399
Acad Med. 2014 Apr;89(4):573-7
pubmed: 24556765
BMC Med Educ. 2010 Jan 27;10:8
pubmed: 20105312
Arch Intern Med. 2007 Oct 22;167(19):2103-9
pubmed: 17954805
BMJ. 2008 Nov 11;337:a2004
pubmed: 19001492
JAMA. 2016 Dec 6;316(21):2237-2252
pubmed: 27923091
PLoS One. 2020 Dec 3;15(12):e0243250
pubmed: 33270759
Acad Med. 2018 Apr;93(4):537-539
pubmed: 29280756
Med Teach. 2001;23(5):471-5
pubmed: 12098368
Acad Med. 2019 Jun;94(6):861-868
pubmed: 30681453
Acad Med. 2002 Sep;77(9):918-21
pubmed: 12228091
Am J Surg. 2006 Feb;191(2):268-71
pubmed: 16442958
AEM Educ Train. 2019 May 23;3(3):218-225
pubmed: 31360814
BMJ Open. 2019 Jul 2;9(7):e029980
pubmed: 31270123
Acad Psychiatry. 2018 Feb;42(1):94-108
pubmed: 28913621
Acad Med. 2006 Apr;81(4):354-73
pubmed: 16565188
J Racial Ethn Health Disparities. 2015 Sep;2(3):403-13
pubmed: 26413458
Acad Med. 2009 Feb;84(2):258-68
pubmed: 19174682
Med Teach. 2018 Feb;40(2):146-153
pubmed: 29113526
Acad Med. 2004 Aug;79(8):798-804
pubmed: 15277138
JAMA. 2016 Dec 6;316(21):2214-2236
pubmed: 27923088
Med Educ Online. 2020 Dec;25(1):1709278
pubmed: 31902315
Acad Med. 2009 Jan;84(1):117-25
pubmed: 19116489
Acad Psychiatry. 2009 Jul-Aug;33(4):302-6
pubmed: 19690110
Acad Psychiatry. 2008 Jan-Feb;32(1):44-53
pubmed: 18270280
Acad Med. 2014 May;89(5):749-54
pubmed: 24667503
Eur Psychiatry. 2019 Jan;55:36-42
pubmed: 30384110
Acad Med. 2013 Jul;88(7):1038-45
pubmed: 23702523
West J Emerg Med. 2018 Jul;19(4):762-766
pubmed: 30013717
Med Educ. 2014 Oct;48(10):963-79
pubmed: 25200017
Acad Med. 2011 Jul;86(7):907-14
pubmed: 21642810
Med Educ Online. 2018 Dec;23(1):1530558
pubmed: 30286698
Acad Med. 2010 Jan;85(1):103-10
pubmed: 20042835
Acad Med. 2011 Nov;86(11):1367-73
pubmed: 21952063
Arch Intern Med. 2012 Oct 8;172(18):1377-85
pubmed: 22911330
J Gen Intern Med. 2019 Nov;34(11):2602-2609
pubmed: 31485967
Mayo Clin Proc. 2005 Dec;80(12):1613-22
pubmed: 16342655