Presentation 1 - LASTing Wellness: A Medical Student Longitudinal Wellness Activity-Stress-Sleep Tracking Wellness Initiative
Kara Sawarynski

Oakland University William Beaumont School of Medicine

 

PURPOSE Medical students usually matriculate with good mental health status, but concerns often arise during their course of study. These include sleep disturbances, depression, and emotional regulation issues.  Burnout can develop quickly through alterations in stress, mood, and sleep, and frequently results in serious personal and professional repercussions.  In this innovative initiative, we are analyzing biometric data and wellness scales via a longitudinal non-invasive mechanism. METHODS M1 & M2 participants wear FitBits (n = 53) and complete validated wellness surveys at salient time-points.  Research software tools enable biometric data collection (sleep, heart rate and physical activity). Analysis is focused on relationships between wellness scale scores and biometric data, particularly as it pertains to curricular structure.  Study results will be compared to national aggregate AAMC M2 and GQ surveys. RESULTS Baseline wellness areas with the highest rates of concern were for sleep quality and insomnia symptoms (60.5 - 90% of participants), with emotional regulation difficulties as the second highest group (53.7% of participants).  Mid-year surveys show sleep and stress concerns trending upward in M1 students, while M2 students have decreases in stress levels . Although average total sleep amounts are in the healthy range, there is frequent fragmentation and inconsistency in sleep schedule.  Sleep duration, quality, fragmentation, sleep debt, and physiological stress will be correlated to curriculum structure. CONCLUSION The number of students with concerning wellness scores early in their academic training, and the strong student interest in the initiative, warrants further study.  Lessons learned on the implementation of biometric data collection and analysis will be presented. Results from this study will add detail and context to the wellness aspects of the AAMC M2 and GQ surveys.  Gaining a better understanding of our student population's emotional and personal well-being, and how these factors relate to educational initiatives and mechanisms, will be extremely valuable.

 

Presentation 2 - TYPES OF ERROR MADE IN FORMATIVE AND SUMMATIVE ASSESSMENTS
Andrew Binks

Virginia Tech Carilion School of Medicine

 

PURPOSE: We propose assessment can be used to determine both student mastery of content, and for them to determine the type of errors they make in exams. This data may be used to 1) determine whether increased focus on error-type reduces occurrence of that error in future assessments, and 2) focus student support and determine its efficacy. We have begun to address the first of these objectives by measuring the type of error pre-clinical medical students make in formative (FE) and summative exams (SE). METHODS: Students at VTCSOM completed a questionnaire during FE and SE reviews. The questionnaire gave students 10 possible error types that could lead to the student getting a question incorrect. Error types fitted into two broad categories of 1) cognitive errors or 2) study/exam-taking errors. RESULTS:  To date, 102 questionnaires have been completed over seven exam reviews (3 FE, 4 SE) to encompass 1090 incorrectly answered questions. Comparison of errors made in FE and SE showed no difference in the number of errors (FE 11.3 ± 11.9, SE 7.3 ± 3.25, p=0.176) or error types (p=0.942). The most common form of error was the same in FE (35%) and SE (32%), "the content looked familiar but I couldn't determine the correct answer". Cognitive errors were nearly three times more common than study/exam taking errors (p=0.006). CONCLUSIONS: We propose that the surprising lack of difference in the number of errors between FE and SE is due to the variability in how students use the FE (either taking it before or after preparation). The lack of difference in type of error between the two exams is consistent with students taking both assessments seriously and the lack of exam taking errors likely reflects our population was comprised of seasoned exam-takers.

 

Presentation 3 - PROBLEMS OF LOW PERFORMING STUDENTS AND COMPARISON OF STUDY HABITS TO HIGH PERFORMING YEAR 1 MEDICAL STUDENTS
Jean Peduzzi

Wayne State University School of Medicine

 

PURPOSE: In an effort to advise Year 1 medical students who were having trouble in classes, surveys of study habits were conducted of low and high-performers at Wayne State School of Medicine (class size=296) in a newly instituted systems-based curriculum with a robust practice of formative and summative assessments.   METHODS This study identified problems of those who were at risk of failure (<65%, n=21) and compared the habits of low-performing to high-performing students (>89%, n=11) in the first 2 curriculum units. All students who did poorly were offered the assistance of a Student Instructional Leader (SIL, Year 2 medical students).   RESULTS Struggling students (>90%) found SILs helpful. Almost all study habits (e.g. outside resources, group studying) and other factors (e.g. exercise, sleep, prior knowledge) were similar in the two groups. The significant difference was that the majority of high-performing students did not fall behind while most struggling students were often behind. The most common problem given by struggling students was that they didn't have to time to finish studying all of the material before the formative and summative exams. This correlation was more frequent for those who did poorly in the subsequent unit (n=10, separate survey). Struggling students were also more likely to attend lectures (that are also streamed) versus high-performers. For material difficult to remember, high-performing students are more likely to try to talk it out while low-performers were more likely to use repetitive writing of the content. CONCLUSION This study identified distinctions between students who performed at the top of the class in comparison to those who were at risk academically. A well-developed and consistently executed study plan was a key indicator of success; other attributes of high-performing students will be discussed. These findings will be applied to future classes as part of the academic support program.

 

Presentation 4 - Analysis of Medical Student Exhaustion and Perseverance in a Three-Year Medical Degree Program
Robert Treat
Medical College of Wisconsin

 

PURPOSE: Medical students are amazingly resilient in the face of academic challenges, studying relentlessly  the  complex  dynamics  of course materials, with minimal time for personal endeavors.¹ The strain of these combined effects on students can lead to emotional exhaustion.² Recently, the creation of a three-year medical program at a Midwestern medical school³ suggested that there may be an increase in these challenges and elevate exhaustion levels further which can impact student wellness.   The purpose of this study is to analyze the relationship of medical student perseverance and emotional exhaustion between three-year and four-year medical degree programs.   METHODS: In 2017/18, 205 of 500 medical students (130 M-1/75 M-2) voluntarily completed these self-reported surveys: RS-25 Resilience Scale and Maslach Burnout Student Scale. Inter-item reliability determined with Cronbach's alpha. Differences in mean scores analyzed with independent t-tests and Cohen's d effect sizes. Pearson correlations (r) used for associating emotional exhaustion with perseverance. IBM® SPSS® 24.0 generated statistical analysis. This research approved by institution's IRB.   RESULTS: Emotional exhaustion (alpha=0.9) mean scores were significantly higher (d=0.3, p<.011) for three-year students (mean(sd)=25(6)) than four-year students (23(7)). Sixty-three percent of four-year program student exhaustion scores were above the instrument's midline score=20, which increased to eighty percent for three-year students.   Perseverance (alpha=0.7) mean scores were significantly lower (d=0.3, p<.015) for three-year students (mean(sd)=22(7)) than four-year students (25(7)).   Exhaustion scores were higher (d=0.2, p<.192) for M2 students (23.9(7.1)) than M1 students (22.8(5.9)). Perseverance scores were significantly higher (d=1.3, p<.001) for M2 students (24.7(7.4)) than M1 students (17.5(1.9)). Exhaustion was significantly correlated to perseverance (r=-0.3, p<0.001).   CONCLUSIONS: Medical student perseverance remained higher in the traditional four-year program where emotional exhaustion scores were lower. However, both perseverance and exhaustion scores remained higher for M2 students than M1 students. Therefore, student perseverance can counter exhaustion with adequate time.