Shared Living Experiences by Physicians have a Positive Impact on Mental Health Attitudes and Stigma among Medical Students: A Mixed-Methods Study.

Autor: Martin A; Child Study Center, Yale School of Medicine, New Haven, CT, USA.; Standardized Patient Program, Teaching and Learning Center, Yale School of Medicine, New Haven, CT, USA.; Tel-Aviv University Faculty of Medicine, Ramat-Aviv, Israel., Chilton J; Child Study Center, Yale School of Medicine, New Haven, CT, USA., Paasche C; Tel-Aviv University Faculty of Medicine, Ramat-Aviv, Israel., Nabatkhorian N; Tel-Aviv University Faculty of Medicine, Ramat-Aviv, Israel., Gortler H; Tel-Aviv University Faculty of Medicine, Ramat-Aviv, Israel., Cohenmehr E; Tel-Aviv University Faculty of Medicine, Ramat-Aviv, Israel., Weller I; Narrative Medicine Program, Columbia University School of Professional Studies, New York, NY, USA., Amsalem D; Tel-Aviv University Faculty of Medicine, Ramat-Aviv, Israel.; Sheba Medical Center, Tel-Aviv, Israel., Neary S; Physician Assistant Online Program, Yale School of Medicine, New Haven, CT, USA.
Jazyk: angličtina
Zdroj: Journal of medical education and curricular development [J Med Educ Curric Dev] 2020 Oct 26; Vol. 7, pp. 2382120520968072. Date of Electronic Publication: 2020 Oct 26 (Print Publication: 2020).
DOI: 10.1177/2382120520968072
Abstrakt: Introduction: Medical culture can make trainees feel like there is neither room for mistakes, nor space for personal shortcomings in the makeup of physicians. A dearth of role models who can exemplify that it is acceptable to need support compounds barriers to help-seeking once students struggle. We conducted a mixed-methods study to assess the impact of physicians sharing their living experiences with medical students.
Methods: Second-year medical students participated, through synchronized videoconferencing, in an intervention consisting of 3 physicians who shared personal histories of vulnerability (e.g. failure on high-stakes exams; immigration and acculturation stress; and personal psychopathology, including treatment and recovery), followed by facilitated, small-group discussions. For the quantitative component, students completed the Opening Minds to Stigma Scale for Health Care Providers (OMS-HC) before and after the intervention. For the qualitative component, we conducted focus groups to explore the study intervention. We analyzed anonymized transcripts using thematic analysis aided by NVivo software.
Results: We invited all students in the class (n = 61, 46% women) to participate in the research component. Among the 53 participants (87% of the class), OMS-HC scores improved after the intervention ( P  = .002), driven by the Attitudes ( P  = .003) and Disclosure ( P  < .001) subscales. We conducted 4 focus groups, each with a median of 6 participants (range, 5-7). We identified, through iterative thematic analysis of focus group transcripts, active components before, during, and after the intervention, with unexpected vulnerability and unarmored mutuality as particularly salient.
Conclusions: Sharing histories of personal vulnerability by senior physicians can lessen stigmatized views of mental health and normalize help-seeking among medical students. Synchronous videoconferencing proved to be an effective delivery mechanism for the intervention in a 'virtual wellness' format. Candid sharing by physicians has the potential to enhance students' ability to recognize, address, and seek help for their own mental health needs.
Competing Interests: Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2020.)
Databáze: MEDLINE
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