Improve Management of Mental Well-being and Empathy in Chinese Medical Students: A Randomized Controlled Study

Abstract

Background: The Chinese medical students suffer from high prevalent mental health-related issues and low empathy. Effective strategies to improve the situations are lacking. This study aims to investigate the efficacy of the well-designed interventional courses to enhance the mental health and empathy of the senior Chinese medical students. Methods: A total of 146 3rd and 4th year medical students were randomized to intervention group (n=74) and control group (n=72). A pilot study including 5 pre-clinical students and 5 interns was first carried out to determine the themes and contents of the interventional courses. The designed courses were delivered in the intervention group once a month for three times, while the control group had no specific intervention. Five self-assessment questionnaires including the General Self-Efficacy (GSE), Medical Outcomes Study Short Form 8 (SF-8), Patient Health Questionnaire-9 (PHQ-9), Maslach Burnout Inventory (MBI), and Jefferson Scale of Empathy-Health Care Provider Student version (JSE-HPS) that separately evaluated the level of self-efficacy (SE), quality of life (QoL), depression, burnout, and empathy were completed by the students before and one month after the courses. Qualitative data were collected via e-mails two year after the intervention.Results: Compared to the control group, the interventional group showed significantly higher scores of the empathy (111.0 [IQR 102.0, 118.0] vs 106.0 [IQR 93.0, 111.5]; P = .01) and QoL (32.0 [IQR 28.0, 35.0] vs 29.5 [IQR 26.0, 34.0]; P = .04). The rate of depression was significantly decreased in the interventional group compared to that in the control group (13.5% vs 29.2%; Chi-square test, P = .02). However, no significant differences of self-efficacy (25.6 ± 4.8 vs 24.3 ± 6.3; P = .16) and burnout (27.0% vs 34.7%; Chi-square test, P = .31) were observed between the two groups.Conclusions: The well-designed interventional courses had a positive impact on the mental well-being and empathy in senior Chinese medical students, which may help provide novel information for incorporation into the medical school curriculum.