Medical students’ resilience: a protective role on stress and quality of life in clerkship

Abstract

BackgroundResilience refers to the ability to be flexible and adaptive in response to challenges. Medical students in clerkship who are transitioning from medical studies to clinical practice face a variety of workplace demands that can lead to negative learning experiences and poor quality of life. This study explored whether medical students’ resilience plays a protective role against the stresses incurred during workplace training and on their professional quality of life during clerkships.MethodsThis was a 1-year prospective web-based questionnaire study comprising one cohort of medical students in their fifth year who were working as clerks as part of their 6-year medical education programme at one medical school in Taiwan between September 2017 and July 2018. Web-based, validated, structured, self-administered questionnaires were used to measure the students’ resilience at the beginning of the clerkship and their perceived training stress (i.e. physical and psychological demands) and professional quality of life (i.e. burnout and compassion satisfaction) at each specialty rotation. Ninety-three medical students who responded to our specialty rotation surveys at least three times in the clerkship were included and hierarchical regressions were performed.ResultsThis study verified the negative effects of medical students’ perceived training stress on burnout and compassion satisfaction. However, although the buffering (protective) effects of resilience were observed for physical demands (one key risk factor related to medical students’ professional quality of life), this was not the case for psychological demands (another key risk factor). In addition, through the changes in R square (∆R2) values of the hierarchical regression building, our study found that medical students’ perceived training stresses played a critical role on explaining their burnout but their resilience on their compassion satisfaction.ConclusionsMedical students’ resilience demonstrated a buffering effect on the negative relationship between physical demands and professional quality of life during clerkships. Moreover, different mechanisms (predictive paths) leading to medical students’ professional quality of life such as burnout and compassion satisfaction warrant additional studies.

Levels of stress in medical students due to COVID-19

“…28 29 Further, it has been shown that resilience is related to reduced burnout and increased satisfaction in medical students. 30 The findings of this study corroborate the conceptual framework of resilience. Those students who felt supported by and who had confidence in their university had lower levels of reported stress.…”

Addressing the physician burnout epidemic with resilience curricula in medical education: a systematic review

“…In addition to a substantial workload, medical students and residents are confronted with a wide range of stressors including inflexible work schedules, sleep deprivation, fatigue, time-consuming clerical and administrative responsibilities, insufficient access to allied health personnel and staff (e.g., nurses, social workers), and unwelcoming learning environments [1]. Coupled with societal-and selfexpectations [2], medical students and residents are at high risk for compassion fatigue [3][4][5], low self-esteem [6], decreased mental health [7][8][9][10][11][12][13], and overall poor quality of life [14][15][16][17][18][19][20]. The implications of elevated psychological distress among medical students and residents are welldocumented and include diminished academic accomplishment [21,22], substance abuse [9,[23][24][25], decreased empathy [26,27], increased professional misconduct [28], and suicide [29,30].…”

Prevalence of depressive symptoms and its predicted factors among medical students in University of Bisha, Saudi Arabia

“…This might be due to the increasing demand for clinical training, along with new concerns and responsibilities of students during such academic levels. A recent study highlighted several stressful situations like using psychometric skills, applying clinical knowledge in real-life situations, trauma exposure, understanding the role and regulating of clinical settings during their clerkship [29]. Lin et al argued that medical students, as novices in medical practice, experience greater physical demands resulting from their lack of efficiency or familiarity with the workload, leading to frustration in learning and reducing their compassion satisfaction [29].…”

“…A recent study highlighted several stressful situations like using psychometric skills, applying clinical knowledge in real-life situations, trauma exposure, understanding the role and regulating of clinical settings during their clerkship [29]. Lin et al argued that medical students, as novices in medical practice, experience greater physical demands resulting from their lack of efficiency or familiarity with the workload, leading to frustration in learning and reducing their compassion satisfaction [29]. Therefore, understanding of clinical learning process along with essential supervision by clinicians in various disciplines might lead to a stress-free learning environment for our students in patient care and hospital setting.…”