The promise of longitudinal learning experiences for medical education and student well-being

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University of Alabama Libraries

There is a need to improve medical student well-being both for individual wellness and for the well-being of patients. A fundamental role of medical education is to develop socially and clinically competent, compassionate physicians and address the factors that impact student well-being. Research and intervention efforts within medical education are limited by a narrow, individual-level focus on the prevention of psychological pathology and health promotion through self-care, stress reduction, and social support. Moreover, these efforts lack theoretically framed operational definitions which consider well-being as environments that foster students’ needs and goals in pursuit of the full functioning of the whole self. Strengthening conceptualizations of well-being provides a way to optimize student personal and professional growth and patient care. The purpose of this three-article dissertation is (1) to introduce a theory-based approach to medical student well-being that targets the individual and the broader medical education ecology and (2) examine exemplars from the learning environment to understand the conditions which may support well-being in medical education settings. The first article introduces well-being frameworks grounded in Self-Determination Theory and community psychology. These frameworks are then utilized in two separate studies exploring medical students’ experiences in longitudinal learning environments. The first study used focus groups to explore student experiences in a longitudinal integrated clerkship and the second used focus groups to explore student leaders’ experiences with a student-run free clinic. Findings indicate that long-term learning experiences promote educational continuity, or connection among learning experiences, with patients and faculty. Continuity experiences with faculty facilitate trusting workplace relationships, promote autonomy support, and create opportunities for positive, formative feedback. Continuity with patients provides students the opportunity for high-quality learning and competency supportive feedback. Additionally, longitudinal learning experiences with vulnerable patients can affirm one’s value to others and promote a sense of mattering. In all, the two studies find that longitudinal, clinical experiences appear to support the student well-being through need supportive conditions that foster a sense of purpose and meaning through service to others.

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Educational psychology