DOI: 10.5061/dryad.2jm63xskj
title: Worried, weary and worn out: a mixed methods study of stress and wellbeing in final year medical students

description: Objectives: Although there is much focus on burnout and psychological
 distress amongst doctors, studies about stress and wellbeing in medical
 students are limited but could inform early intervention and prevention
 strategies. Design: The primary aim of this mixed methods, cross-sectional
 survey was to compare objective and subjective levels of stress in Final
 Year Medical students (2017) and to explore their perspectives on the
 factors they considered relevant to their wellbeing. Setting: University
 College Dublin, the largest University in Ireland. Participants: 161 of
 235 medical students participated in this study (response rate 69%).
 Results: 65.2% of students scored over accepted norms for the Perceived
 Stress Scale (34.8% low; 55.9% moderate; 9.3% high). 35% scored low; 28.7%
 moderate and 36.3% high on the Subjective Stress Scale. Thematic Analysis
 identified worry about exams, relationships, concern about future,
 work-life balance and finance; 1 in 3 students reported worry,
 irritability and hostility; many felt worn out. Cognitive impacts included
 over-thinking, poor concentration, sense of failure, hopelessness and
 procrastination. Almost a third reported sleep and appetite disturbance,
 fatigue and weariness. A quarter  reported a “positive
 reaction” to stress. Positive strategies to manage stress included
 connection and talking, exercise, non-study activity  and
 meditation. Unhelpful strategies included isolation and substance use. No
 student reported using the college support services or sought professional
 help. Conclusions: Medical students experience high levels of
 psychological distress, similar to their more senior doctor colleagues.
 They are disinclined to avail of traditional college help services. Toxic
 effects of stress may impact their cognition, learning, engagement and
 empathy and increase patient risk and adverse outcomes. The focus of
 wellbeing in doctors should be extended upstream and embedded in the
 curriculum where it could prevent future burnout, improve retention to the
 profession and deliver better outcomes for patients.
description: The participants in this study were Final Year Medical Students
 from Ireland’s largest University, University College Dublin (UCD). A
 typical final medical year is made up of around 240 students who are
 divided into four groups and then rotate through the different
 specialities of Paediatrics, Obstetrics and Gynaecology, Public Health,
 Medicine of the Elderly, General Practice and Psychiatry. 
 The class included both Graduate Entry (GEM) and undergraduate
 (non-GEM) students. In UCD GEM and undergraduate students come together at
 year 4. Students were informed of the study and invited to participate in
 week five of their six-week Psychiatry Module. Data was
 collected as part of a larger project that examines the impact of an
 eLearning module on Stress and Self-care. We embedded a new problem based
 small group teaching module on stress and self-care within the curriculum
 at pre-clinical and clinical teaching. We further developed an interactive
 eLearning module on Stress and Self-care and made this available to the
 same groups. The present study is descriptive and mixed-methods in nature
 and focuses on baseline stress levels in medical students prior to
 exposure to any educational intervention, embedded or
 electronic. Students were assured that all data was
 anonymised and confidential. Ethical approval for the study was obtained
 from the Head of School in accordance with University College Dublin
 Regulations. Due to the sensitive nature of the questions, students were
 informed of the student support services available to them and encouraged
 to seek help if needed.
description: Data presented in Excel format. See also Questionnaire relating
 to the dataset.