The Relationship Between Psychological Distress and Perception of Emotional Support in Medical Students and Residents and Implications for Educational Institutions

Abstract

Our results point to the important opportunity universities and medical schools have promoting MSR well-being by reducing institutional stressors, as well as teaching and promoting self-care and burnout avoidance techniques, instituting wellness interventions, and developing programs to identify and support at risk and distressed students.

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

“…In addition, certain personal characteristics such as being married (Robles et al, ; Brumpton et al, ; DeWitt et al, ) and difficulties in relationships (Zhang et al, ; Squires et al, ), have also been reported to heighten the sensitivity of students to stressful experiences. Moreover, research studies in the United States seem to indicate that females students, as compared to their male counterparts, appear to be more vulnerable to burnouts (Abeysekera and Dawson, ; Luthar, ; Yan et al, ; McLuckie et al, ). This has been proposed to be due to a greater propensity of females to internalize depressive feelings (Delany et al, ; Kenney et al, ) and experience increased generalized anxiety (Kessler, ; Dyrbye et al, ; Liao et al, ; Dyrbye et al, ).…”

“…However, while an increasing volume of evidence has incriminated the stress associated with an excessive study load as the prime causative factor for the loss of IM, other identifiable factors also exist. In the early phases of the program, students have reported experiencing greater stress due to a perceived lack of support from educators (Dev et al, 2019), regret in choosing health care as a career (Rodriguez Zivic et al, 2013;Yan et al, 2017;Rotenstein et al, 2016), competitiveness among students (Schubert, 2016;Jackson et al, 2019), poor peer relations (West et al, 2016;McLuckie et al, 2018), and previous history of recreational drug use (Elmore et al, 2016;Yang and Shanks, 2018). The most common reasons identified by students in the later part of the program include extended work hours (Skodova and Lajciakova, 2013;Yan et al, 2017;McLuckie et al, 2018), erratic clinical rotations (Rodriguez Zivic et al, 2013;Kreitzer and Klatt, 2017), acuity of clinical cases encountered during training (Voltmer et al, 2013;Elmore et al, 2016), and even exposure to cynical colleagues (Skodova et al, 2017).…”

“…This includes new social relationships (Blomberg et al, 2014;Castaldelli-Maia et al, 2018), greater academic pressure (Read et al, 2017;Cusimano et al, 2018), and stress during exams (Sun et al, 2016;Greene et al, 2019). The broad social epidemiological patterns indicate that pre-health care students experience more depressive symptoms (McLuckie et al, 2018;Rotenstein et al, 2016) and higher levels of burnout than their counterparts in other disciplines (Fang et al, 2012;Rodriguez Zivic et al, 2013) even before they commence health care studies. This is often a combination of rigorous academic commitments (Read et al, 2017;Cusimano et al, 2018;Queen and Hess, 2018), intensive preparations for competitive entrance examinations (Schubert, 2016;Mbanga et al, 2018), and time-consuming extracurricular activities (Dumbili and Williams, 2016;Cheney et al, 2017).…”

“…This combination of academic (Luthar, 2017;Chung et al, 2018;Raza et al, 2018) and social stressors (Croffoot et al, 2010) can combine to erode the psychological well-being of students (Oommen et al, 2017;Mestdagh et al, 2018) and weaken their resilience (Palmen et al, 2015;Joshi et al, 2017;Haque et al, 2018;Rowland and Kumagai, 2018). Consequently, as their educational performance declines maladaptive personalities emerge (Dyrbye et al, 2006;Omigbodun et al, 2006;Yates et al, 2008;Garrud and Yates, 2012;Delany et al, 2015), leading to a vicious cycle of poor grades, stress, self-doubt, and decreased efficacy in these students (Schubert, 2016;McConville et al, 2017;Yan et al, 2017;McLuckie et al, 2018;Rotenstein et al, 2016). It is interesting that even within the pre-health care student community, female students have been observed to be more predisposed to developing stress as compared to males (Pritchard et al, 2007;Garett et al, 2017;Mortier et al, 2017).…”

“…The inherent generational differences between educators and students (Emerson, 2017;Berger et al, 2019), an increasing emphasis on learning styles (Murphy et al, 2004;Kusurkar et al, 2013), and technological tools (Yilmaz et al, 2016) have resulted in a dichotomy in the educational environment (Riley, 2018;Kusurkar, 2019). These issues have also been identified as predisposing factors in the development of stress (Rodriguez Zivic et al, 2013;West et al, 2016) and burnouts (Schubert, 2016;McConville et al, 2017;Yan et al, 2017;McLuckie et al, 2018) in health care students. Though generational differences have acquired a negative reputation as being an impediment to learning (Everly et al, 1994;Gibson, 2018;Riley, 2018), very few educational approaches have attempted to specifically redress this issue.…”