A primer of an in-depth resilience status for German medical graduates: results of a cross-sectional survey on the status quo of resilience among graduates of human medicine in Bavaria, Germany - a necessary step in building an emotionally equipped healthcare work-force

Encouraging medical students to become surgeons? Impact of psychological and surgical factors on career choice at medical school

Aim

Training decisions are viewed as a problem by the majority of medical students.In the present study we compared sociodemographic and psychological characteristics of students who are interested in surgical training to those who preferred a non-surgical specialty. Furthermore, we examined whether students who wish to be trained as surgeons performed better than their non-surgical counterparts in a course designed to acquire skills in minimally invasive surgery.

Method

From October 2020 to January 2021 we performed a cross-sectional survey among 116 medical students prior to their year of practical training at Christian-Albrechts University in Kiel. Based on their intended field of specialization, the students were divided into a non-surgical and a surgical group. Sociodemographic and psychological characteristics such as self-efficacy expectations, resilience and stress perception were evaluated and compared between groups. Simultaneously, we compared their surgical performance in two laparoscopic exercises and their self-assessment as surgeons. Statistical differences between the training groups were determined by the Mann-Whitney U test or Pearson's Chi square test.

Results

Ninety-two students participated in the study, of whom 64.1% intended to train in a non-surgical specialty and 35.9% in a surgical specialty. Students who wished to be trained as surgeons had higher general self-efficacy expectations (p<0.001) and greater resilience (p=0.009). However, on comparison they had a lower stress level (p=0.047). The inter-group comparison of training results and self-assessment as surgeons revealed no unequivocal differences in surgical performance.

Conclusion

Interest in surgical specialties is correlated, among other factors, with the strength of psychological skills such as general self-efficacy expectations, resilience and stress perception. Early attention to these psychological resources in academic training might assist medical students in future career choices.

German first-year medical students' expectations of their professional life - concerns and hopes: A project report

Aim

Expectations among medical students towards their future professional life are affected by intrinsic and extrinsic factors which may change during years of medical school. The aim of this study is to gain further insight into students' expectations of their professional life at the beginning of medical school. Findings regarding contextual influences can be used to improve curricula and student guidance.

Methods

The project report based on an online survey among three cohorts of first year medical students at the LMU. The questionnaire consisted of six open-ended questions which addressed the student's motivation, expectations, anticipations and concerns of their professional life. Questions were also asked about presumed personal development and influence on private life. An inductive coding was used in this qualitative content analysis.

Results

Written responses from 591 participants were coded, categorized and summarized into four main themes: personal life, work, science, personal issue. Despite coming from different cohorts, the occurrence of the main themes showed the same trend in all student groups. Students are worried most about the work-life-balance, and they expect it to be a difficult issue. But many of our first-year students are optimistic that they will be able to establish a good work-life-balance or that the working conditions will have changed to a manageable workload at the time they will enter their first jobs. The majority of our students expect to become more self-confident with enhanced empathy and team-working ability and more patient and stress-resistant in daily challenges.

Conclusion

The medical students emphasize the gender-neutral desire for work-life balance. So, they expect improved working conditions for the future - an ongoing challenge for the health care system.

Resilience status of dental students and derived training needs and interventions to promote resilience

Background

The concept of resilience is defined differently in the literature, with the definition depending on the criteria under consideration. Currently, the most commonly used definition is: resilience as "psychological resistance to biological, psychological, and psychosocial developmental risks". In order to systematically enhance resilience, it is necessary to first determine specific training needs. This study examines the resilience status of dental students in Germany from different academic years and derives interventions for resilience enhancement, as the field of dentistry is considered one of the "most stressful professions".

Methods

To determine the resilience status, a questionnaire was developed, consisting of the 10-Item Connor-Davidson Resilience Scale (10-Item CD-RISC), the Maslach Burnout Inventory Scale (MBI), the Negative Self-Image Scale (NSBS), and five self-formulated closed-ended questions. A total of 320 questionnaires were distributed, with 184 responses (43.7% female) received, including partially completed forms.

Results

The resilience status shows an average moderate level of resilience (M=28.43; SD=5.57). The subcomponents of emotional exhaustion (M=23.66; SD=8.32) and reduced personal performance (M=33.69; SD=8.47) indicate an increased risk of burnout, but not depersonalization (M=5.04; SD=5.50). Overall, the participants have a positive self-image (M=1.72; SD=0.69).

Conclusion

The study reveals that dental students have a moderate level of resilience. Dental students are not inherently prone to burnout, but they show reduced levels of emotional exhaustion and personal performance, suggesting a need for interventions in these areas. Possible interventions tailored to these training needs are discussed in the article. Further research is needed to determine the effectiveness of these interventions.

Measuring informal workplace learning outcomes in residency training: a validation study

BACKGROUND

Informal workplace learning (WPL) has no concrete learning objective and takes place without a responsible supervisor, which makes it difficult to assess its learning outcomes. Formal learning situations, as they are known from universities or schools, do not exist in this context and make a conventional assessment of learning goals and achievements impossible. Informal learning in the workplace is of central importance, and the assessment of informal learning outcomes in medical education is an under-researched area. The aim of our study was to adapt and validate an informal WPL questionnaire (originally developed for social workers) to assess learning outcomes due to informal WPL in residency training.

METHODS

A total of 528 residents (n = 339 female; age: M = 29.79; SD = 3.37 years) completed an adapted questionnaire on informal WPL outcomes and the Freiburg Questionnaire to Assess Competencies in Medicine (i.e. medical knowledge, communication, and scholarship). Exploratory factor analysis was used to determine the underlying factor structure. The reliability of the factors was tested using McDonald's omega, and the correlation between the factors and the three subscales of the Freiburg questionnaire was tested using Spearman's rho correlation coefficient. To investigate construct validity, a structural equation model was calculated to examine the relationships between medical competencies and informal learning outcomes.

RESULTS

The exploratory factor analysis yielded a four-factor solution that best fit the data. The scores of all four factors (GLO-CD: generic learning outcomes-competence development, GLO-R: generic learning outcomes-reflection, JSLO: job-specific learning outcomes, and OLLO: organisational learning outcomes) showed good internal consistency (Ω ≥ .69). The structural equation model showed that "medical expertise" had an impact on all four factors of informal learning at work. "Scholarship" seemed to predict GLO-CD and GLO-R.

CONCLUSIONS

Our four-factor model reveals meaningful determinants of informal WPL in relation to residency training. The instrument is therefore the first promising attempt to assess informal WPL in the broader context of medical education during residency, thus supporting its construct validity.