Student well-being and the learning environment

Abstract

Background: Medical student well-being is a critical issue in medical education and is linked to burnout and resilience. Understanding the impact of the clinical learning environment may be crucial to developing effective curricular interventions. Medical student well-being is a critical issue in medical education OBJECTIVE: To determine factors affecting medical student well-being and perceived stress during clinical clerkships and describe any associations with the learning environment, resilience, and performance.

Methods: This was a retrospective study of one cohort of medical students surveyed at the conclusion of third-year clinical clerkships using the Medical School Learning Environment Scale, Brief Resilience Scale, Perceived Stress Scale, and the World Health Organization Well-Being Index. The United States Medical Licensing Examination (USMLE), Step 1 scores and clerkship performance were also collected. Analysis included Pearson correlations and linear regression.

Results: Of the 204 students completing the clerkships, 146 students completed the survey (72%). Well-being correlated positively with learning environment (r = 0.43) and resilience (r = 0.35, p < 0.01). Stress was negatively correlated with learning environment (r = -0.34) and resilience (r = -0.53, p < 0.01). Well-being was not significantly correlated with performance measures. However, stress demonstrated a weak positive correlation with clerkship performance (r = 0.17, p < 0.05). The overall regression models for well-being and stress were statistically significant (p < 0.001) and explained 23% and 26% of the variance, respectively.

Conclusions: Our study found that well-being and stress are associated with students' resilience and perception of the learning environment in the clinical phase of medical school. However, we found no relationship between well-being and performance and a modest positive relationship between stress and performance. This data helps to illustrate the complex relationship between these factors.