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

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Abstract

Objective

Psychological distress is pervasive among medical students and residents (MSR) and is associated with academic under-performance, decreased empathy, burnout, and suicidal ideation. To date, there has been little examination of how demographic and socioeconomic factors influence trainee’s psychological distress levels, despite suggestion that financial concerns are a common source of stress. Recent Canadian studies examining the prevalence of distress, burnout, and resilience in MSR are limited.

Methods

Undergraduate and postgraduate medical trainees attending a Canadian university were surveyed. The questionnaire included standardized instruments to evaluate psychological distress, burnout, and resilience. Additional items explored MSR living and domestic circumstances, and anticipated debt upon training completion. Ordinary least squares regression models determined predictors of psychological distress, risk for burnout, and resiliency. Logistic regression of psychological distress predicted risk of MSR contemplating dropping out of their training program.

Results

Feeling emotionally/psychologically unsupported while attending university was a key predictor of psychological distress and burnout, while feeling supported reduces this risk. Risk for burnout increased with each year of medical training. Psychologically distressed MSR were at significantly greater odds of contemplating dropping out of their medical training program.

Conclusions

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.

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References

  1. Matheson KM, Barrett T, Landine J, McLuckie A, Soh NLW, Walter G. Experiences of psychological distress and sources of stress and support during medical training: a survey of medical students. Acad Psychiatry. 2016;40(1):63–8. https://doi.org/10.1007/s40596-015-0395-9.

    Article  PubMed  Google Scholar 

  2. Stucky ER, Dresselhaus TR, Dollarhide A, et al. Intern to attending: assessing stress among physicians. Acad Med. 2009;84(2):251–7.

    Article  PubMed  Google Scholar 

  3. Dyrbye LN, Thomas MR, Massie FS, et al. Burnout and suicidal ideation among US medical students. Ann Intern Med. 2008;149(5):334–41.

    Article  PubMed  Google Scholar 

  4. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374(9702):1714–21.

    Article  PubMed  Google Scholar 

  5. Ludwig AB, Burton W, Weingarten J, Milan F, Myers DC, Kligler B. Depression and stress amongst undergraduate medical students. BMC Med Educ. 2015;15(1):141.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Dyrbye LN, Thomas MR, Huntington JL, et al. Personal life events and medical student burnout: a multicenter study. Acad Med. 2006b;81:374–84.

    Article  PubMed  Google Scholar 

  7. Goehring C, Gallacchi MB, Kunzi B, Bovier P. Psychosocial and professional characteristics of burnout in Swiss primary care practitioners: a cross-sectional survey. Swiss Med Wkly. 2005;135(7–8):101–8.

    PubMed  Google Scholar 

  8. IsHak W, Nikravesh R, Lederer S, Perry R, Ogunyemi D, Bernstein C. Burnout in medical students: a systematic review. Clin Teach. 2013;10(4):242–5.

    Article  PubMed  Google Scholar 

  9. Cecil J, McHale C, Hart J, Laidlaw A. Behaviour and burnout in medical students. Med Educ Online. 2014;19:1–9. https://doi.org/10.3402/meo.v19.25209.

    Article  Google Scholar 

  10. Ripp J, Fallar R, Babyatsky M, David R, Reich L, Korenstein D. Prevalence of resident burnout at the start of training. Teach Learn Med. 2010;22(3):172–5.

    Article  PubMed  Google Scholar 

  11. Stewart SM, Lam TH, Betson CL, et al. A prospective analysis of stress and academic performance in the first two years of medical school. Med Educ. 1999;33:243–50.

    Article  CAS  PubMed  Google Scholar 

  12. Newbury-Birch D, Walshaw D, Kamali F. Drink and drugs: from medical students to doctors. Drug Alcohol Depend. 2001;64:265–70.

    Article  CAS  PubMed  Google Scholar 

  13. Pagnin D, de Queiroz V, Carvalho YTMS, Dutra ASS, Amaral MB, Queiroz TT. The relation between burnout and sleep disorders in medical students. Acad Psychiatry. 2014;38(4):438–44.

    PubMed  Google Scholar 

  14. Thomas NK. Resident burnout. JAMA. 2004;15:2880–9.

    Article  Google Scholar 

  15. Dyrbye LN, West CP, Satele D, et al. Burnout among US medical students, residents, and early career physicians relative to the general US population. Acad Med. 2014;89(3):443–51.

    Article  PubMed  Google Scholar 

  16. Dyrbye LN, Harper W, Durning SJ, et al. Patterns of distress in US medical students. Med Teah. 2011;33(10):834–9.

    Google Scholar 

  17. Dunn LB, Iglewicz A, Moutier C. A conceptual model of medical student well-being: promoting resilience and preventing burnout. Acad Psychiatry. 2008;32(1):44–53.

    Article  PubMed  Google Scholar 

  18. Pottier P, Dejoie T, Hardouin JB, et al. Effect of stress on clinical reasoning during simulated ambulatory consultations. Med Teach. 2013;35(6):472–80.

    Article  CAS  PubMed  Google Scholar 

  19. Kwong JC, et al. Effects of rising tuition fees on medical school class composition and financial outlook. CMAJ. 2002;166(8):1023–8.

    PubMed  PubMed Central  Google Scholar 

  20. West CP, et al. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306:952.

    Article  CAS  PubMed  Google Scholar 

  21. Kessler RC, Andrews G, Colpe LJ, et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(6):959–76.

    Article  CAS  PubMed  Google Scholar 

  22. Donker T, Comijs H, Cuijpers P, et al. The validity of the Dutch K10 and extended K10 screening scales for depressive and anxiety disorders. Psychiatry Res. 2010;176:45–50.

    Article  PubMed  Google Scholar 

  23. Andrews G, Slade T. Interpreting scores on the Kessler psychological distress scale (K10). Aust N Z J Public Health. 2001;25(6):494–7. https://doi.org/10.1111/j.1467-842X.2001.tb00310.x.

    Article  CAS  PubMed  Google Scholar 

  24. Baillie AJ. Predictive gender and education bias in Kessler’s psychological distress scale (K10). Soc Psychiatry Psychiatr Epidemiol. 2005;40(9):743–8.

    Article  PubMed  Google Scholar 

  25. Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 3rd ed. Palo Alto: Consulting Psychologists Press; 1996.

    Google Scholar 

  26. West CP, Dyrbye LN, Satele DV, Sloan JA, Shanafelt TD. Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment. J Gen Intern Med. 2012;27(11):1445–52.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Rafferty JP, Lemkau JP, Purdy RR, Rudisill JR. Validity of the Maslach burnout inventory for family practice physicians. J Clin Psychol. 1986;42(3):488–92.

    Article  CAS  PubMed  Google Scholar 

  28. Campbell-Sills L, Stein MB. Psychometric analysis and refinement of the Connor–Davidson resilience scale (CD-RISC): validation of a 10-item measure of resilience. J Trauma Stress. 2007;20(6):1019–28.

    Article  PubMed  Google Scholar 

  29. Vaishnavi S, Connor K, Davidson JR. An abbreviated version of the Connor-Davidson resilience scale (CD-RISC), the CD-RISC2: psychometric properties and applications in psychopharmacological trials. Psychiatry Res. 2007;152(2):293–7.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Stevens GJ, et al. Long-term health and wellbeing of people affected by the 2002 Bali bombing. Med J Aust. 2013;198(5):273–7.

    Article  PubMed  Google Scholar 

  31. Cohen J. A power primer. Psychol Bull. 1992;112(1):155.

    Article  CAS  PubMed  Google Scholar 

  32. Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among US and Canadian medical students. Acad Med. 2006;81(4):354–73.

    Article  PubMed  Google Scholar 

  33. Dyrbye LN, Power DV, Massie F, et al. Factors associated with resilience to and recovery from burnout: a prospective, multi-institutional study of US medical students. Med Educ. 2010;44(10):1016–26.

    Article  PubMed  Google Scholar 

  34. University of Calgary. Campus mental health strategy: creating a community of sharing. http://ucalgary.ca/provost/files/provost/15-unv-018-mental_health_strategy_final.pdf. Published 2015. Accessed Feb 24 2017.

  35. Palladino CL, Ange B, Richardson DS, et al. Measuring psychological flexibility in medical students and residents: a psychometric analysis. Med Educ Online. 2013;18:20932.

    Article  Google Scholar 

  36. Feder A, Nestler EJ, Charney DS. Psychobiology and molecular genetics of resilience. Nat Rev Neurosci. 2009;10(6):446–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Cohn MA, Fredrickson BL, Brown SL, Mikels JA, Conway AM. Happiness unpacked: positive emotions increase life satisfaction by building resilience. Emotion. 2009;9(3):361.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Kjeldstadli K, Tyssen R, Finset A, et al. Life satisfaction and resilience in medical school–a six-year longitudinal, nationwide and comparative study. BMC Med Educ. 2006;6(1):1.

    Article  Google Scholar 

  39. Cheng DR, Poon F, Nguyen TT, et al. Stigma and perception of psychological distress and depression in Australian-trained medical students: results from an inter-state medical school survey. Psychiatry Res. 2013;

  40. Dyrbye LN, Thomas MR, Power DV, et al. Burnout and serious thoughts of dropping out of medical school: a multi-institutional study. Acad Med. 2010;85(1):94–102.

    Article  PubMed  Google Scholar 

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Funding Source

This work was supported by Dalhousie University, Department of Psychiatry Research.

Author information

Authors and Affiliations

  1. University of Calgary, Calgary, AB, Canada

    Alan McLuckie & Gina Dimitropoulos

  2. University of Ottawa, Ottawa, ON, Canada

    Katherine M. Matheson

  3. Virginia Polytechnic Institute & State University, Falls Church, VA, USA

    Ashley L. Landers

  4. University of New Brunswick, Fredericton, NB, Canada

    Jeff Landine

  5. Alberta Health Services, Calgary, AB, Canada

    Jason Novick

  6. Nova Scotia Health Authority, Halifax, NS, Canada

    Tessa Barrett

Authors
  1. Alan McLuckie
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  2. Katherine M. Matheson
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  3. Ashley L. Landers
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  4. Jeff Landine
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  5. Jason Novick
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  6. Tessa Barrett
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  7. Gina Dimitropoulos
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Corresponding author

Correspondence to Alan McLuckie.

Ethics declarations

This study was approved by IWK Research Ethics Board (IWK-REB Project No. 1011440).

Disclosure

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

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McLuckie, A., Matheson, K.M., Landers, A.L. et al. The Relationship Between Psychological Distress and Perception of Emotional Support in Medical Students and Residents and Implications for Educational Institutions. Acad Psychiatry 42, 41–47 (2018). https://doi.org/10.1007/s40596-017-0800-7

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  • DOI: https://doi.org/10.1007/s40596-017-0800-7

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