Burnout interventions show promise1–6, the reality is that burnout remains. The weaknesses of existing efforts include the fact that they are:
- Not focused on the unique challenges of the migration of the learning environment from academic to clinical. Individual-focused interventions place minimal emphasis on preparing students for the reality of the clinical environment that will become their lifelong experience. The limited value of the above interventions may be due to this crucial missing element. Other than sporadic real-world exposure to the clinical environment, students are generally left to adjust to the challenges of clinical training via rapid transition from traditional studies to patient care-based instruction.
- Not consistently applied across or within institutions in contrast to a solution that can be deployed consistently and reliably across the entire realm of student learners, independent of their affiliation.
- Lacking in terms of recognizing the role of alcohol use as an ineffective coping strategy despite the common misuse of alcohol in burned-out medical students7–10 and a rate of alcohol use almost twice that of non medical students10.
- Public, a significant hindrance for a population that may be suffering from social isolation, emotional exhaustion, self-doubt, depression, and possible struggles with alcohol and other substance use.
- Competing with other time demands, both academic and relational, versus a solution that can be pursued at the convenience and availability of the student.
- Not tailored to the unique needs of the individual. Students identified a variety of self-care interventions in the realms of social engagement, physical health, and psychological health with widely varying needs and desires; their preference was not programmatic activities11.
- Passive and lacking engagement versus an interactive experience supporting exploration, challenge, “replay” opportunity, experiential learning, and achievement.
- Generic to the individual and unable to provide tailored feedback to establish change strategies and to guide the student to resources that support unique needs.
- Not designed to meet the unique needs of women and minorities. As an example, minority medical students may see greater stress reduction from sleep quality promotion12. And, women medical students experience higher benefit from stress reduction in terms of quality of life, yet self-care efforts may have less of an impact13.
- Hobson K. New Medical School Programs Help Students Battle Burnout. US News World Rep. 2015. https://www.usnews.com/education/best-graduate-schools/top-medical-schools/articles/2013/03/21/new-medical-school-programs-help-students-battle-burnout. Accessed September 19, 2018.
- Tucker T, Bouvette M, Daly S, Grassau P. Finding the Sweet Spot: Developing, Implementing and Evaluating a Burn out and Compassion Fatigue Intervention for Third Year Medical Trainees Eval Program Plann. 2017;65:106-112. doi:10.1016/j.evalprogplan.2017.07.006.
- Dyrbye LN, Shanafelt TD, Werner L, Sood A, Satele D, Wolanskyj AP. The Impact of a Required Longitudinal Stress Management and Resilience Training Course for First-Year Medical Students J Gen Intern Med. 2017;32(12):1309-1314. doi:10.1007/s11606-017-4171-2.
- Ng R, Chahine S, Lanting B, Howard J. Unpacking the Literature on Stress and Resiliency: A Narrative Review Focused on Learners in the Operating Room J Surg Educ. August 2018. doi:10.1016/j.jsurg.2018.07.025.
- Farouk A. Stopping burnout a top priority for physicians in training. AMA Wire. November 2015. https://wire.ama-assn.org/life-career/stopping-burnout-top-priority-physicians-training. Accessed September 19, 2018.
- AMA Wire. Student SOS: 6 ways to avoid “distress” in medical school. AMA Wire. May 2015. https://wire.ama-assn.org/education/student-sos-6-ways-avoid-distress-medical-school. Accessed September 19, 2018.
- Ayala EE, Roseman D, Winseman JS, Mason HRC. Prevalence, perceptions, and consequences of substance use in medical students. Med Educ Online. 2017;22(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678442/. Accessed October 7, 2018 doi:10.1080/10872981.2017.1392824.
- Brian Owens. Growing concern over medical students’ excessive drinking | CMAJ News. September 2018. https://cmajnews.com/2018/09/19/growing-concern-over-medical-students-excessive-drinking-cmaj-109-5662/. Accessed September 27, 2018.
- Dumitrascu CI, Mannes PZ, Gamble LJ, Selzer JA. Substance Use among Physicians and Medical Students Med Stud Res J. 2014;3:26-35.
- Jackson ER, Shanafelt TD, Hasan O, Satele DV, Dyrbye LN. Burnout and Alcohol Abuse/Dependence Among U.S. Medical Students Acad Med J Assoc Am Med Coll. March 2016. doi:10.1097/ACM.0000000000001138.
- Ayala EE, Omorodion AM, Nmecha D, Winseman JS, Mason HRC. What Do Medical Students Do for Self-Care? A Student-Centered Approach to Well-Being Teach Learn Med. 2017;29(3):237-246. doi:10.1080/10401334.2016.1271334.
- Ayala EE, Berry R, Winseman JS, Mason HR. A Cross-Sectional Snapshot of Sleep Quality and Quantity Among US Medical Students Acad Psychiatry J Am Assoc Dir Psychiatr Resid Train Assoc Acad Psychiatry. 2017;41(5):664-668. doi:10.1007/s40596-016-0653-5.
- Ayala EE, Ellis MV, Grudev N, Cole J. Women in Health Service Psychology Programs: Stress, Self-Care, and Quality of Life Train Educ Prof Psychol. 2017;11(1):18-25. doi:10.1037/tep0000141.
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