Medical student resilience and stressful clinical events during clinical training

ABSTRACT

Background: Medical students face numerous stressors during their clinical years, including difficult clinical events. Fostering resilience is a promising way to mitigate negative effects of stressors, prevent burnout, and help students thrive after difficult experiences. However, little is known about medical student resilience.

Objective: To characterize medical student resilience and responses to difficult clinical events during clinical training.

Design: Sixty-two third-year (MS3) and 55 fourth-year (MS4) University of Chicago medical students completed surveys in 2016 assessing resilience (Connor Davidson Resilience Scale, CD-RISC 10), symptoms of burnout, need for resilience training, and responses to difficult clinical events.

Results: Medical student mean resilience was lower than in a general population sample. Resilience was higher in males, MS4s, those without burnout symptoms, and students who felt able to cope with difficult clinical events. When students experienced difficult events in the clinical setting, the majority identified poor team dynamics among the most stressful, and agreed their wellbeing was affected by difficult clinical events. A majority also would prefer to discuss these events with their team later that day. Students discussed events with peers more than with attendings or residents. Students comfortable discussing stress and burnout with peers had higher resilience. Most students believed resilience training would be helpful and most beneficial during MS3 year.

Conclusions: Clinical medical student resilience was lower than in the general population but higher in MS4s and students reporting no burnout. Students had some insight into their resilience and most thought resilience training would be helpful. Students discussed difficult clinical events most often with peers. More curricula promoting medical student resilience are needed.

KEYWORDS:

• Burnout
• resilience
• wellness
• clinical training
• Undergraduate Medical Education

Acknowledgments

The authors wish to thank Holly Humphrey, MD, Michelle Martinchek MD, MPH, the Pritzker School of Medicine, and Marilyn Baetz, MD.

Disclosure statement

No potential conflict of interest was reported by the authors.

Disclaimers

Not applicable.

Ethical Approval

This study was granted an exemption from the Institutional Review Board at the University of Chicago.

Previous Presentations

An abstract containing a significant portion of the content of this article was presented at the 2016 Society of General Internal Medicine Midwest Regional Meeting, the 2017 Clerkship Directors of Internal Medicine Academic Internal Medicine week, and the 2017 Society of General Internal Medicine National Meeting.

Additional information

Funding

This work was supported in part by the University of Chicago Bucksbaum Institute for Clinical Excellence.