BackgroundThe demands placed on medical trainees pose a challenge to personal wellbeing, leading to burnout and erosion of empathy. However, it is unclear at what point in medical education this decline begins. Although many schools have begun to design and implement wellness programs for their students, the medical education community’s experience in evaluating their impact is limited.MethodsThe authors designed a wellness needs assessment of all medical students at the Albert Einstein College of Medicine in order to assess students’ health behaviors, stress and depressive symptoms. The online survey was administered to all medical students from the classes of 2014 and 2015 at the beginning of their first year of medical school and again at the end of their third year. Chi-square and T-tests were run comparing the survey responses of the two classes.ResultsThere was a significant increase in perceived stress from an average of 5.51 in the first year to 6.49 in the third year (p = .0001). The number of students at risk for depression, defined as a CES-D score greater than 16, was 94 (28.4 %) in the first year and 131 (39.0 %) in their third year (p = .004).ConclusionsThis study demonstrates a significant increase in the proportion of students at risk for depression in their third year as compared to the first year as well as an increase in perceived stress. In response to these findings, the authors took a multi-disciplinary approach in the development of a comprehensive program to address student wellness, including efforts to address issues specific to the clinical clerkships. This program is unique in that its design, inception and ongoing evaluation have taken the needs of an entire medical school class into account.

BACKGROUND:While there are numerous benefits of smartphone use for physicians, little is known about the negative effects of using these devices in the context of patient care.OBJECTIVE:To assess resident and faculty smartphone use during inpatient attending rounds and its potential as a source of distraction during transfer of clinical information.DESIGN:Cross‐sectional survey.SETTING:University‐affiliated public teaching hospital.PARTICIPANTS:All housestaff and inpatient faculty in the departments of Medicine and Pediatrics.METHODS:Participants were asked about smartphone ownership, usage patterns during attending rounds, and whether team members had ever missed important data during rounds due to distraction from smartphones. Attendings were asked whether policies should be established for smartphone use during rounds.RESULTS:The overall response rate was 73%. Device ownership was prevalent (89% residents, 98% faculty), as was use of smartphones during inpatient rounds (57% residents, 28% attendings). According to self‐reports, smartphones were used during rounds for patient care (85% residents, 48% faculty), reading/responding to personal texts/e‐mails (37% residents, 12% faculty), and other non‐patient care uses (15% residents, 0% faculty). Nineteen percent of residents and 12% of attendings believed they had missed important information because of distraction from smartphones. Residents and faculty agreed that smartphones “can be a serious distraction during attending rounds,” and nearly 80% of faculty believed that smartphone policies should be established.CONCLUSIONS:Smartphone use during attending rounds is prevalent and can distract users during important information transfer. Attendings strongly favored the institution of formal policies governing appropriate smartphone use during inpatient rounds. Journal of Hospital Medicine 2012;. © 2012 Society of Hospital Medicine

A GOSCE is a valuable resource for use in formative assessment of clinical communication, and it offers the benefit of group collaboration and peer feedback. These findings support the broader use of GOSCEs in undergraduate medical education.