Impact of Small Group Reflection Sessions in Junior and Senior Medical Students
Grace Oei, MD, MA, Center for Christian Bioethics, Loma Linda University Health
Amy Hayton, MD, Internal Medicine Clerkship Director, Loma Linda University Health
Carolyn Pearce, BS, Loma Linda University School of Medicine
The journey from first year medical student to physician is emotionally taxing and research shows that medical students can lose empathy during this process. Loma Linda University School of Medicine (LLUSOM) is the only medical school in the country which specifically incorporates concepts of Christianity into its curriculum through its teaching of wholeness and whole person care. LLUSOM defines wholeness as loved by God, growing in health, and living in community with purpose. LLUSOM students are encouraged and taught throughout medical school to give attention to their patient’s as well as their own personal wholeness. Reflective writing techniques are taught throughout the four years to help students process their experiences contributing to wholeness. Interactive small group reflection sessions are added in the junior and senior year in the Internal Medicine (IM)and intensive care unit (ICU) rotations, respectively. Students are required to write about a patient experience before coming to the small group reflection sessions. A one time survey was sent to students in March 2016 to evaluate the effectiveness of the reflection curriculum. The survey asked students to self-report symptoms of burnout, if the reflection session helped students feel supported by LLUSOM faculty and their peers, and if the reflection session helped them feel less alone in their experience.
Survey data showed that junior medical students report significantly higher rates of burnout (40%) compared to senior medical students (14%) (p = 0.0006) and significantly lower rates of enjoyment in their clinical work (3% vs 15% respectively, p = 0.0069). Junior medical students who reported symptoms of burnout were compared to their peers who did not report symptoms of burnout. Both groups reported similar levels of support by LLUOSM faculty (p = 0.8) and their peers (p = 0.6). However, junior medical students who reported symptoms of burnout were significantly less likely to report feeling less alone in their experience as compared to the students who do not report burnout (p = 0.01). Analysis between groups of senior medical students who did (17%) or did not (83%) report symptoms of burnout showed no significant statistical difference in their reactions after the reflection session.
Our data shows that junior medical students report significantly higher rates of burnout and lower rates of enjoyment in their clinical work compared to senior medical students. Senior medical students who reported symptoms of burnout feel a similar amount of support from the LLUSOM faculty and their peers after the reflection session as compared to their peers who did not report symptoms of burnout. Junior medical students who reported symptoms of burnout also feel a similar amount of support from the LLUSOM faculty and their peers, however, junior medical students were significantly less likely to feel less alone in their experience as compared to their peers who did not report symptoms of burnout. This may mean that students reporting symptoms of burnout may require additional interventions to help process emotionally difficult experiences during medical school. Additional research is needed to determine the significance of these findings.
Amy Hayton, MD, Internal Medicine Clerkship Director, Loma Linda University Health
Carolyn Pearce, BS, Loma Linda University School of Medicine
The journey from first year medical student to physician is emotionally taxing and research shows that medical students can lose empathy during this process. Loma Linda University School of Medicine (LLUSOM) is the only medical school in the country which specifically incorporates concepts of Christianity into its curriculum through its teaching of wholeness and whole person care. LLUSOM defines wholeness as loved by God, growing in health, and living in community with purpose. LLUSOM students are encouraged and taught throughout medical school to give attention to their patient’s as well as their own personal wholeness. Reflective writing techniques are taught throughout the four years to help students process their experiences contributing to wholeness. Interactive small group reflection sessions are added in the junior and senior year in the Internal Medicine (IM)and intensive care unit (ICU) rotations, respectively. Students are required to write about a patient experience before coming to the small group reflection sessions. A one time survey was sent to students in March 2016 to evaluate the effectiveness of the reflection curriculum. The survey asked students to self-report symptoms of burnout, if the reflection session helped students feel supported by LLUSOM faculty and their peers, and if the reflection session helped them feel less alone in their experience.
Survey data showed that junior medical students report significantly higher rates of burnout (40%) compared to senior medical students (14%) (p = 0.0006) and significantly lower rates of enjoyment in their clinical work (3% vs 15% respectively, p = 0.0069). Junior medical students who reported symptoms of burnout were compared to their peers who did not report symptoms of burnout. Both groups reported similar levels of support by LLUOSM faculty (p = 0.8) and their peers (p = 0.6). However, junior medical students who reported symptoms of burnout were significantly less likely to report feeling less alone in their experience as compared to the students who do not report burnout (p = 0.01). Analysis between groups of senior medical students who did (17%) or did not (83%) report symptoms of burnout showed no significant statistical difference in their reactions after the reflection session.
Our data shows that junior medical students report significantly higher rates of burnout and lower rates of enjoyment in their clinical work compared to senior medical students. Senior medical students who reported symptoms of burnout feel a similar amount of support from the LLUSOM faculty and their peers after the reflection session as compared to their peers who did not report symptoms of burnout. Junior medical students who reported symptoms of burnout also feel a similar amount of support from the LLUSOM faculty and their peers, however, junior medical students were significantly less likely to feel less alone in their experience as compared to their peers who did not report symptoms of burnout. This may mean that students reporting symptoms of burnout may require additional interventions to help process emotionally difficult experiences during medical school. Additional research is needed to determine the significance of these findings.