Identifying cultural and structural barriers and catalyzing institutional policies that support all qualified learners, regardless of disability, throughout the medical education continuum is a worthy and essential goal. This publication weaves together major themes from interviews conducted with 47 students, residents, and physicians with disabilities.
Meeks LM, Jain N. Association of American Medical Colleges [Internet]. Accessibility, Inclusion, and Action in Medical Education: Lived Experiences of Learners and Physicians with Disabilities; 2018 Mar.
The number of students with a disability matriculating into institutions of medical education, including physician assistant programs, is increasing. Educational institutions must develop procedures with regard to the Americans with Disabilities Act (ADA) including the provision of reasonable accommodations to provide equal opportunities for all. These procedures must be compliant with federal and state laws while protecting academic integrity, maintaining technical standards, and successfully navigating the institutional and individual faculty barriers. Knowledge of the ADA and the ADA Amendments Act of 2008 as well as some familiarity with the legal precedent regarding these laws will facilitate planning and decision-making for students with disabilities. This is imperative for educating not just those with specific disabilities but also the evolving learners of today. Such knowledge, coupled with the continued prioritization of technical standards and student outcomes, will assist in the curricular development of the future.
Pavlik, Daniel L. MSPAS, PA-C; Melcher, Betsy Quick MS, MHS, PA-C; Agnew, Donna M. MSPAS, PA-C; Smith, David A. MPAS, PA-C; Marciante, Katelyn MS. The Americans With Disabilities Act, Reasonable Accommodations, and Medical Education. The Journal of Physician Assistant Education 30(4):p 214-218, December 2019. | DOI: 10.1097/JPA.0000000000000277
An estimated 1 in 4 U.S. adults has a disability, and this number continues to increase. Disabled individuals face significant healthcare inequities, including but not limited to inaccessibility and mistreatment. Our current healthcare system is ill-equipped to provide equitable care to this population. There is a lack of accessibility in healthcare environments, lack of accessible medical training to enable disabled people to become healthcare providers serving their own community, and lack of thorough medical education that encompasses care for disabled patients. Furthermore, the increased risk of trauma, as well as increased risk of medical trauma specifically, endured by disabled people puts them at greater risk of long-lasting adverse effects. In this commentary, we analyze three key areas: 1) the current state of healthcare for disabled patients, 2) disability in medical education & physician workforce, and 3) the relationship between trauma and disability. We argue that the road to more equitable care for disabled patients involves changes to medical education that address all three of these areas. Medical training should expose trainees to disability early and throughout their training, should be made more accessible to support disabled physicians, and finally, should be trauma-informed in a manner that explicitly includes caring for disabled patients and their other intersecting identities.
Objective. To examine and compare the prevalence of mental health problems, help-seeking attitudes, and perceptions about mental health problems among US pharmacy and medical students.
Methods. A cross-sectional analysis was conducted using existing, anonymous survey data collected in the Healthy Minds Study during the 2015-2016 academic year. The analysis included 482 students (159 pharmacy students and 323 medical students) from 23 institutions in the United States. Analyzed topics included demographic characteristics, mental health status and symptoms, substance abuse, stigma related to mental health, help-seeking behaviors and attitudes, and mental health treatment perceptions.
Results. Pharmacy and medical students experienced similar rates of depression (18% met clinical cut-offs), but pharmacy students were more likely to meet clinical cutoffs for anxiety (21% vs 11%). Pharmacy students were less likely to seek help from student counseling services (only 11% vs 49%) and also less likely to know where to seek help on campus if needed. Pharmacy students also reported having higher levels of stigma regarding mental health treatment.
Conclusion. There are differences between pharmacy and medical students with regards to their experience of mental health symptoms, willingness to seek help, and perception of stigma. Despite the small sample, this analysis of national data indicates that opportunities exist to improve campus-based mental health education and offerings for pharmacy and medical students.
Fischbein R, Bonfine N. Pharmacy and Medical Students’ Mental Health Symptoms, Experiences, Attitudes and Help-Seeking Behaviors
. Am J Pharm Educ. 2019 Dec;83(10):7558. doi: 10.5688/ajpe7558. PMID: 32001889; PMCID: PMC6983890.
Despite the perception that medical students and doctors should be ‘invincible’, mental health challenges are common in this population. Medical students and doctors have low levels of help seeking for their own psychiatric problems often only presenting to mental health services once a crisis arises. Fear of exposure to stigmatisation is a crucial factor contributing to symptom concealment and is a barrier to accessing mental health services. Autobiographical narratives of the ‘Wounded Healer’ are gaining popularity among medical students and doctors with mental health challenges both as an effective form of adjunctive therapy and as a means to campaign against stigma. Indeed, the results of a randomised controlled trial to assess the efficacy of Coming Out Proud with mental illness revealed immediate positive effects on stigma stress-related variables. We provide an autobiographical narrative from a medical student who has first-hand experience with mental health challenges.
Hankir AK, Northall A, Zaman R. Stigma and mental health challenges in medical students
. BMJ Case Rep. 2014 Sep 2;2014:bcr2014205226. doi: 10.1136/bcr-2014-205226. PMID: 25183806; PMCID: PMC4158203.
Background: Urban parks play a noticeable role in city areas for making connections between nature and the residents of cities, especially from a mental health perspective. This paper investigated how the number and types of urban parks impact city residents’ mental health.
Method: This study used the data collected by the Community Health Survey in Seoul, South Korea in 2020 (n=22915). The type and number of local parks were categorized based on each district, and three variables of mental health were selected, including ‘subjective health awareness’, ‘stress awareness’ and ‘depression rate’. Correlation and interaction analyses were conducted to explore the relationship between variables.
Result: The data indicated that both the quantity and types of the urban parks were associated with mental health of the residents. Positive mental health is likely to be associated with higher density of local parks in a district. It seems that parks characterized by children’s activity and have nature-focused design, are more effective in changing the mental health of residents.
Discussion: The research demonstrates a positive relationship between the quantity of urban parks and mental health in the scale of city districts. However, such a correlation can differ based on the type of parks, as well as the quantity of greenery in an area.
Choi KA, Rezaei M. Assessing the Correlation between Neighborhood Green Areas and the Perceived Mental Health of Residents in Metropolitan Areas. Iran J Public Health. 2022 Sep;51(9):2027-2033. doi: 10.18502/ijph.v51i9.10557. PMID: 36743354; PMCID: PMC9884363.
Background and objectives: Burnout is common among resident physicians. Studies show that those who engage in stress management and mindful practice have improved empathy and lower rates of mood disturbance. This study piloted a program entitled Stress Management and Resiliency Training for Residents (SMART-R) with Family Medicine (FM) and Ob-Gyn residents at an academic medical center.
Methods: The 6-hour SMART-R program, which teaches relaxation strategies, stress awareness, and adaptive coping, was mandatory for all years of residency and delivered in three 2-hour sessions during protected didactic time. Interested residents received a weekly phone text message with mindfulness and resiliency reminders to enhance practice between sessions. We measured burnout, empathy, perceived stress, mindful attention awareness, mind body practices, and program satisfaction.
Results: There were 14 matched pre/post surveys (six FM, eight Ob-Gyn), of which 10 (five FM; five Ob-Gyn) opted to receive weekly texts. Empathy, stress, and burnout remained stable over time. Those who received the weekly texts showed a significant increase in mindful attention awareness and trended toward lower perceived stress compared to those who did not receive texts. Half of those surveyed felt the training should be mandatory and 71% would recommend it to colleagues. While 93% thought it was important to know the current research on mind-body medicine to guide patients, only 29% felt they knew much about this.
Conclusions: This study demonstrated the positive impact a 6-hour stress management and resiliency intervention can have on resident physicians. Unlike other studies that have shown decreased empathy and increased stress and burnout over time, these features remained stable over the academic year. Weekly text reminders supported the training and suggest potential benefit to enhance stress management training for medical professionals.
Citation: Nathan J, McCray L, Feldman N. The Text Effect: Stress Management and Resiliency Training Pilot for Resident Physicians. Fam Med. 2021 Feb;53(2):139-144. doi: 10.22454/FamMed.2021.847102. PMID: 33566350.
There is a developing interdisciplinary research field which has been trying to integrate results and expertise from various scientific areas, such as affective computing, pedagogical methodology and psychological appraisal theories, into learning environments. Moreover, anxiety recognition and regulation has attracted the interest of researchers as an important factor in the implementation of advanced learning environments. The present article explores the test anxiety and stress awareness of university students who are attending a science course during examinations. Real-time anxiety awareness as provided by biofeedback during science exams in an academic environment is shown to have a positive effect on the anxiety students experience and on their self-efficacy regarding examinations. Furthermore, the relevant research identifies a significant relationship between the students’ anxiety level and their performance. Finally, the current study indicates that the students’ anxiety awareness as provided by biofeedback is related to their performance, a relationship that is mediated and explained by the students’ anxiety.
Apostolidis H, Tsiatsos T. Exploring anxiety awareness during academic science examinations. PLoS One. 2021 Dec 15;16(12):e0261167. doi: 10.1371/journal.pone.0261167. PMID: 34910743; PMCID: PMC8673629.
Link to Free Paper: https://pubmed.ncbi.nlm.nih.gov/34910743/