Publication: Coping in medical professionalism and mental wellbeing among Universiti Sains Malaysia medical students
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Date
2024-05
Authors
Sattar, Kamran
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Abstract
The main aim of medical education is to cultivate students with good mental wellbeing and professional competence, equipping them to serve the community effectively. However, the journey of medical students is not without psychological challenges. Concerns about the mental wellbeing (MWB) of students and its impact on medical professionalism (MP) are widespread. Research indicates that adopting effective coping strategies (CSs) can help students navigate through adversity and maintain their professionalism. This study explores how CSs influence both MWB and MP among undergraduate medical students, employing an exploratory sequential mixed-method approach. In the phase one, qualitative data was gathered through scoping reviews (ScRs) and focus group discussions (FGDs), focusing on three key components - CSs, MWB, and MP. Phase two involved constructing a hypothetical model illustrating the interplay between CSs, MWB, and MP, guided by insights from phase one. Six medical education experts validated the model's core concepts, theories, and framework. In the subsequent phase, quantitative data from a cross-sectional survey involving 234 students were collected using five inventories - Dundee inventory, DASS-9, Brief COPE, CBI, and TEQ. Structural equation modelling (SEM) was performed to assess the causal relationships between CSs, MWB, and MP. The findings from phase one underscored the significance of 'respect' in nurturing MP, while attributes like altruism, accountability, duty excellence, honour, integrity, and respect for others were central in assessing MP. Psychological distress, including stress, anxiety, and depression, along with burnout, emerged as common manifestations of MWB issues. Notably, students experiencing MWB issues identified support as a primary coping strategy. Additionally, burnout was found to be inversely associated with empathy. During phase two, the hypothetical model revealed how CSs, MWB, and MP are interconnected, drawing upon evidence synthesis from ScRs, FGDs and the expert panel. Subsequent SEM analysis revealed that professional behaviour showed an inverse correlation with burnout, with negative coping worsening the situation, while positive coping strategies protected empathy. The study highlighted the importance of self-compassion and empathy in alleviating burnout and enhancing professional satisfaction. Moreover, it highlighted the detrimental impact of MWB issues on MP. Although creating a comprehensive program for medical professionalism is a challenging task, it is important for medical faculties to start with foundational activities that emphasize teaching the fundamental aspects of professionalism, including defining relevant definitions and attribute