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An Intervention in Social Connection: Medical Student Reflection Groups

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Abstract

Objective

Rates of medical student depression and suicide are higher than aged-matched peers. Although medical schools have implemented wellness interventions, no program has reported on interventions targeting social support. As one potential intervention, reflection groups for medical students led by psychiatry residents were designed and implemented. It was hypothesized that groups would encourage connectedness among peers, teach coping and emotional self-awareness skills, increase empathy, and decrease loneliness.

Methods

Voluntary, biweekly support groups were implemented between 2017 and 2018 at Stanford University School of Medicine for first- and second-year medical students. Participants were surveyed at baseline and 6 months. Surveys included qualitative assessments of groups and validated surveys to assess empathy, wellness, and loneliness. Separate surveys assessed attrition. Analyses included statistical analyses (descriptive statistics) and thematic analysis.

Results

In both cohorts, a total number of 30 students participated in groups, and 18 completed post-surveys. Students reported groups improved well-being (55.6% strongly agreed, 27.8% agreed), enhanced self-awareness (44.4% strongly agreed, 38.9% agreed) and ability to empathize (50.0% strongly agreed, 27.8% agreed), and promoted connection (61.1% strongly agreed, 33.3% agreed). Initial attrition was high, with 84% of students not continuing due to feeling too overwhelmed by classes.

Conclusions

Thematic analysis demonstrated groups may benefit students in improving impostor syndrome and connection with others (decreased loneliness), allowing exposure and tolerance to diverse perspectives, increasing insight into the importance of self-care and emotional self-awareness, allowing practice for collaborative skills, and increasing thoughtful approaches to patient care. There is preliminary evidence reflection groups may be a feasible, effective intervention to improve loneliness and social belonging in medical school.

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Acknowledgments

The authors wish to thank the reflection group co-facilitators, the Office of Graduate Education, and Rebecca Smith-Coggins, MD, for their support of this program.

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Authors and Affiliations

  1. Washington University in St. Louis, St. Louis, MO, USA

    Jessica A. Gold

  2. Stanford University, Department of Psychiatry and Behavioral Sciences, Palo Alto, CA, USA

    Jessica P. Bentzley, Amanda M. Franciscus, Craig Forte & Sallie G. De Golia

Authors
  1. Jessica A. Gold
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  2. Jessica P. Bentzley
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  3. Amanda M. Franciscus
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  4. Craig Forte
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  5. Sallie G. De Golia
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Corresponding author

Correspondence to Jessica A. Gold.

Ethics declarations

Stanford University IRB granted exemption for this study, original approval 12/1/16 (continuation: 10/16/18), E-Protocol number: 39235, Assurance number: FWA00000935.

Disclosures

On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Gold, J.A., Bentzley, J.P., Franciscus, A.M. et al. An Intervention in Social Connection: Medical Student Reflection Groups. Acad Psychiatry 43, 375–380 (2019). https://doi.org/10.1007/s40596-019-01058-2

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  • DOI: https://doi.org/10.1007/s40596-019-01058-2

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