Changes in the learning environment of medical students may improve their well-being, though more rigorous studies are needed, a new review conducted by researchers at Columbia University College of Physicians & Surgeons has found.
The review was published in the Journal of the American Medical Association’s medical education theme issue.
Previous studies have shown that medical student well-being worsens during medical school: Rates of moderate to severe depressive or burnout symptoms are higher among medical students than other graduate students or population control samples. One study found that up to 11 percent of medical students had thoughts about suicide.
“Medical school is a formative period for both the educational and the emotional aspects of becoming a physician, and we aspire to immerse students in optimal learning environments,” says the review’s lead author Lauren Wasson, MD, assistant professor of medicine. “We seek evidence-based ways to cultivate well-being among students during this time and in preparation for the rigorous careers ahead them.”
Dr. Wasson and her colleagues identified hundreds of articles on the learning environment of medical schools, but only a small subset of articles contained empirically evaluated interventions.
From those studies, the authors identified five features of the medical school learning environment that seem to improve student well-being:
- pass/fail grading
- accessible mental health programs
- wellness programs that teach stress-reduction skills
- group-based faculty advising and mentoring programs
- a curriculum with increased clinical time
In an editorial accompanying the review, Stuart Slavkin, MD, MEd, wrote: “Medical schools need to step up to address the mental health crisis among medical students. The study by Wasson has provided some evidence for possible approaches to improving the well-being of trainees.”
More thorough research is needed, however. “With so few published studies on the medical school learning environment, there is clearly a need for more rigorous research on an issue that could greatly impact future physicians,” says the review’s senior author, Karina W. Davidson, PhD, vice dean at the College of Physicians & Surgeons and director of the Center for Behavior Cardiovascular Health at Columbia University Medical Center.
The research was supported by the NIH (grants K24 HL084034, K08 HS024598, U24 AG052175 and contract S15-0142).