Thomas Thesen, Geisel School of Medicine at Dartmouth
Wesley Marrero, Thayer School of Engineering, Dartmouth College
Vincent Busque, Geisel School of Medicine at Dartmouth
Bofan Chen, Geisel School of Medicine at Dartmouth
Nicholas Jacobson, Geisel School of Medicine at Dartmouth
Matthew Duncan, Geisel School of Medicine at Dartmouth
Purpose
Medical students face substantial academic demands that often result in chronic stress, poor mental health, and compromised physical well-being. Despite growing recognition of these challenges, there remains limited understanding of how specific curricular structures and stressors influence the dynamic interplay between curriculum, wellness behaviors, and mental health.
Methods
The Wearable Wellness Study (https://wearable-wellness.org/) leverages wearable devices and smartphone-based ecological momentary assessments (EMA) to provide real-time, longitudinal insights into the well-being of 71 first- and second-year medical students across three cohorts over an academic year. Weekly EMA assessments included validated well-being measures such as PHQ-9, GAD-7, and Diener Flourishing Scale, while wearable devices continuously tracked physical activity, autonomic stress markers, and sleep metrics. Application of a precision well-being approach further categorized students into dynamically updated well-being phenotypes, enabling tailored support for individual needs. The study aimed to provide actionable insights through dashboards for curriculum administrators linking curricular stressors to student mental health.
Results
Our findings demonstrate the feasibility of integrating wearable and EMA methodologies in pre-clerkship medical students over extended periods. Results show EMA-based well-being phenotypes worsened over the course of the semester, aligning with the increasing intensity of curricular demands. There was also a robust relationship between curricular demands and biometric outcomes. For example, step counts (p<.001) and high-intensity activity levels (p<.001) decreased significantly in the days leading up to exams, rebounding post-exam periods. Sleep efficiency (p<.001) and heart-rate variability (p<.001) declined significantly as the semester progressed, while sedentary behavior (p<.05) and resting heart rate (p<.01) increased, reflecting heightened stress paired with diminished opportunities for physical activity due to curricular events.
Conclusions
These findings highlight the dynamic impact of curricular demands on student well-being. By combining wearable and EMA technologies with precision well-being strategies and actionable dashboards, we demonstrate a novel, scalable framework for tracking and optimizing student well-being during medical school.