Mental health and self-determination profiles of the diverse population of medical students in Malaysia during the COVID-19 pandemic

Abstract

Introduction Medical schools throughout the world were forced to modify their programming during the COVID-19 pandemic. In Malaysia, virtual learning plans were implemented for non-clinical programming, while clinical posting modifications were designed to meet local SOPs. The prolonged enforcement of these modifications to undergraduate medical education will have affected student experiences, including well-being. Since these feelings can relate to perceived relatedness, autonomy, and competence, it is important to identify any potential factors that may lead to reduced intrinsic motivation in students. It is also important to consider how demographic features may contribute to student perspectives, which can be studied using the unique diversity represented by Malaysian students. Methods A quantitative survey was distributed to Malaysian medical students to assess their overall wellbeing, autonomy in educational decision making, student experiences, and position on changes to graduation timing. Intrinsic components were identified using Principal Component Analysis and were aligned with the three needs for self-determination, namely relatedness, autonomy, and competence. Finally, trends in responses for participants from various sub-populations were assessed using ANOVA testing. Results Responses were collected from 442 students representing 23 accredited Malaysian medical schools. Upon validation and reliability testing, eight components were identified with themes relating to: mental health, social concerns, communication, timing of modifications, depth of learning, and student-centred learning. Of these, gender was related to mental health, student-centred learning, and delayed graduation, while stage was related to student-centred learning and delayed graduation in addition to concerns about depth of learning and timing of modifications. Interestingly, ethnicity was related to differences in opinions about delayed graduation and income was related to social concerns. Conclusion The results of this study indicate that, while students were satisfied in general with the content and delivery of their programmes given the circumstances, there is evidence to suggest negative effects on emotional wellbeing and expression of student voice, due to the modifications that were made. Additionally, these feelings related to the three motivational needs, suggesting that students were experiencing a dampened motivational profile during the pandemic. Further, motivational profiles were distinct between student sub-groups, providing insight for developing appropriate and inclusive accommodations moving forward.

“It Ain’t What You Use, It’s the Way That You Use It”: How Virtual Learning Environments May Impact Student Mental Wellbeing

“…Studies during the COVID-19 pandemic reported students feeling lonely and not being able to communicate with teaching staff and their peers as frequently as they would like [16]. However, our study found that students enrolled on courses delivered predominantly inperson could also experience loneliness, because the VLE's flexibility could create, or even be used to create, barriers between students, teaching staff, and peers.…”

“…Course-related environmental factors such as workload, assessment stress, lecturers' support for student autonomy, peer relationships, and feelings of belonging have been found to have a greater association with student mental wellbeing compared to factors such as concern about finances, English language skills, or future employment [14]. The sudden shift to online learning because of the COVID-19 pandemic generated worldwide interest in the wellbeing of university students in online environments, where courses are delivered 80-100 percent online, e.g., in Canada, Malaysia, and India [15][16][17]. However, to our knowledge, little research has focused on the impact on students' mental wellbeing from online learning environments used for courses delivered in-person and on-campus [18].…”

Quantitative and qualitative analysis of medical students’ symptoms and feelings during a catastrophic event

“…COCKBURN et al ( 2022), a study of medical students during the pandemic, observed that female students had significantly worse mental health [34]. PEDRAZ-PETROZZI et al (2021) studied 375 people, including health care professionals and medical students, and demonstrated that being female and younger were associated with pandemic-related depression and stress, in addition to being frontline personnel [35].…”

Quantitative and qualitative analysis of medical students’ symptoms and feelings during COVID-19 pandemic

“…They used a single questionnaire with twelve items (GHQ-12) and showed that the pandemic led to psychological distress, which was more significant in females than in males (Idowu et al, 2022). COCKBURN et al (2022), in a study of medical students during the pandemic, observed that female students had significantly worse mental health (Cockburn et al, 2022). PEDRAZ-PETROZZI et al (2021) studied 375 people, including health care professionals and medical students, and demonstrated that being female and younger were associated with pandemic-related depression and stress, in addition to being frontline personnel (Pedraz-Petrozzi et al, 2021).…”