Resilience, Grit, and Stress in Medical Students

Outcomes of Small Group Process Work on Medical Students' Resilience, Grit, and Stress Over Multiple Cohorts

The incidence of burnout and mental ill-health begins very early in medical school and continues to be high throughout training. Medical students are under high amounts of stress, which often becomes chronic, and can lead to both physical and psychological issues as a student, resident, and physician. Chronic stress and burnout in medical students are not a new phenomenon, but recent research has highlighted the worsening mental health of medical students, with as high as three-quarters of students reporting mental ill-health. It is vital that ways are found to reduce burnout and assist in improving the mental health of medical students. This quasi-experimental study is an ongoing study which is enrolling cohorts of students as they enter medical school.

Study Overview

• Status: Recruiting
• Conditions: Stress, Psychological
• Intervention / Treatment: Behavioral: Process group

Detailed Description

The investigators will assess the effects of a year-long small process group intervention, led by a psychiatrist, which aims to improve self-awareness, mindfulness, and resilience in first and second-year medical students. Students self-select into the process group, and a similar number are randomly recruited as controls from the rest of the preclinical student body. The psychiatrist is blinded to student participation in the study. Students in the process and control groups will be surveyed with the Perceived Stress Scale, the Connor-Davidson Resilience Scale, and the Grit Scale in September 2023, and again after nine months and 25 sessions, in May 2024, after the academic year. Statistical analysis will be done with R Studio. Bandura's theory of self-efficacy was used to conceptualize the study. Recruitment is done by email, as is data collection. The intervention includes guided exploration of the psychodynamic process, group dynamic theory, cognitive behavioral therapy, dialectical behavioral therapy, boundaries, and empathy.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Edie Sperling, DPT; Phone Number: 5412590229; Email: esperling@westernu.edu
• Study Contact Backup: Name: Mandi Hudson, DO; Phone Number: 541-259-0200; Email: hudsonm@westernu.edu

Study Locations

• United States
  • Oregon
    • Lebanon, Oregon, United States, 97355
      • Recruiting
      • Western University of Health Science, College of Osteopathic Medicine of the Pacific - Northwest
      • Contact: Edie Sperling, DPT; Phone Number: 541-259-0229; Email: esperling@westernu.edu
      • Contact: Mandi Hudson, DO; Phone Number: 5412590200; Email: hudsonm@westernu.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. The participant must be an enrolled student at the College of Osteopathic Medicine of the Pacific-NW
2. Participant must be in their first or second year of medical school
3. Participant must be at least 18 years of age
4. Participant must self-select into either the intervention group or control group
5. Participant must sign informed consent

Exclusion Criteria:

1. Data will be excluded if a student goes on a LOA during the course of the year
2. Data will be excluded if a student does not attend a minimum of 12 out of 25 small group sessions
3. Student does not give informed consent
4. Student withdraws consent at any time

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Process Group; Medical students enrolled in the small process group, led by psychiatrist.	Behavioral: Process group; The medical student process group serves as a space for students to gain increased self-awareness through guided exploration of the psychodynamic processes.
No Intervention: Control Group; Medical students from the same cohorts, not enrolled in the small process group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived Stress Scale-14	Stress measured on a 0-56 scale; higher number means more stress. Each of the 14 questions is measured on a 0-4 scale of 0 = Never, 1 = Almost Never, 2 = Sometimes, 3 = Fairly Often, 4 = Very Often.	34 weeks
Connor-Davidson Resilience Scale-25	Resilience is measured on this 25-item scale, with higher numbers meaning more resilience. The score can range between 0 and 100. Each item has anchors from 0-4.	34 weeks
The Grit Scale	The original 12-item grit scale was used to measure grit; each items is rated 1-5, then scores are summed and divided by 12, so the final score is between 1-5. Higher scores mean more grit.	34 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Medication or diagnosis change	Change in anti-depression, anti-anxiety, or other mental health medications or diagnoses on a binary yes/no scale.	34 weeks

Collaborators and Investigators

• Sponsor: Western University of Health Sciences
• Investigators: Principal Investigator: Edie Sperling, DPT, Western University of Health Sciences

Study record dates

Study Major Dates

• Study Start (Actual): September 13, 2023
• Primary Completion (Estimated): May 30, 2024
• Study Completion (Estimated): May 30, 2024

Study Registration Dates

• First Submitted: September 13, 2023
• First Submitted That Met QC Criteria: September 13, 2023
• First Posted (Actual): September 21, 2023

Study Record Updates

• Last Update Posted (Actual): September 21, 2023
• Last Update Submitted That Met QC Criteria: September 13, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Keywords: stress; medical students; resilience; grit
• Additional Relevant MeSH Terms: Behavioral Symptoms; Stress, Psychological
• Other Study ID Numbers: 1902099-2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: All anonymized demographic and outcome data will be shared in an open-access data repository.
• IPD Sharing Time Frame: Data will be available after being received and cleaned after the second timepoint in May 2024
• IPD Sharing Access Criteria: Data will be open access
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No