Gudrun Roling1, Gabriele Lutz2, Friedrich Edelhäuser3, Marzellus Hofmann4, Maria P Valk-Draad1, Caroline Wack5, Aviad Haramati6, Diethard Tauschel1, Christian Scheffer7. 1. Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany. 2. Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany; Department of Psychosomatic Medicine, Gemeinschaftskrankenhaus Herdecke. Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany. 3. Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany; Department of Early Rehabilitation, Gemeinschaftskrankenhaus Herdecke. Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany. 4. Office for Student Affairs, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany. 5. Student Council, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany; Department of Internal Medicine, Gemeinschaftskrankenhaus Herdecke. Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany. 6. Georgetown University, School of Medicine, Center for Innovation and Leadership in Education, USA. 7. Integrated Curriculum for Anthroposophic Medicine, Institute for Integrative Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany; Department of Internal Medicine, Gemeinschaftskrankenhaus Herdecke. Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany. Electronic address: christian.scheffer@uni-wh.de.
Abstract
OBJECTIVE: This study examines whether students in the clinical phase show reduced well-being and lower empathy scores compared to preclinical students. Furthermore, it explores students' most stressful experiences. METHODS: A cross-sectional mixed-methods study was conducted among medical students of the revised patient- and student-centred curriculum at Witten/Herdecke University (Germany). An online survey included questions regarding empathy (JSPE-S), well-being (WHO-5), distressing factors in the learning and clinical environments, mistreatment and thoughts of dropping out. RESULTS: 176 (34 %) of 517 medical students completed the questionnaire, 73 being preclinical and 103 clinical students. Despite lower well-being, clinical student did not demonstrate lower empathy levels. Main stressors during the clinical phase were negative physician role models and financially focussed care rather than challenging patient encounters. Compared to preclinical students, clinical students showed more mistreatment experiences and higher ratings towards thoughts of dropping out. CONCLUSION: Our results illustrate contemporary challenges to establishing a learner-centred clinical environment that nurtures well-being and empathy of medical students. The sustainment of empathy despite more stressful experiences and lower well-being may be due to protective factors. PRACTICE IMPLICATIONS: The paper suggests activities to support clinical students to find ways to adapt the clinical learning environment to students' needs.
OBJECTIVE: This study examines whether students in the clinical phase show reduced well-being and lower empathy scores compared to preclinical students. Furthermore, it explores students' most stressful experiences. METHODS: A cross-sectional mixed-methods study was conducted among medical students of the revised patient- and student-centred curriculum at Witten/Herdecke University (Germany). An online survey included questions regarding empathy (JSPE-S), well-being (WHO-5), distressing factors in the learning and clinical environments, mistreatment and thoughts of dropping out. RESULTS: 176 (34 %) of 517 medical students completed the questionnaire, 73 being preclinical and 103 clinical students. Despite lower well-being, clinical student did not demonstrate lower empathy levels. Main stressors during the clinical phase were negative physician role models and financially focussed care rather than challenging patient encounters. Compared to preclinical students, clinical students showed more mistreatment experiences and higher ratings towards thoughts of dropping out. CONCLUSION: Our results illustrate contemporary challenges to establishing a learner-centred clinical environment that nurtures well-being and empathy of medical students. The sustainment of empathy despite more stressful experiences and lower well-being may be due to protective factors. PRACTICE IMPLICATIONS: The paper suggests activities to support clinical students to find ways to adapt the clinical learning environment to students' needs.