Publication: Development, validation, and evaluation of the systematic assessment for resilience framework
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Date
2023-08
Authors
Wadi, Majed Mohammed Saleh
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Abstract
Mental health issues, such as stress, anxiety, burnout, and depression, continue
to rise among medical students, resulting in negative side effects that ultimately
jeopardize optimal medical care and patient health. Evidence indicates that assessment
is the primary cause of these mental issues. Although several interventions have been
initiated to improve the mental health of medical students, these have focused on
individual aspects, ignoring a comprehensive approach across multiple levels and the
assessment itself as the root cause. The emerging resilience intervention has an
advantage over other mental health interventions, which has led researchers begin to
implement it. The purpose of this study was to develop, validate, and evaluate a
systematic framework for promoting resilience through the assessment system. In the
first phase, four narrative reviews, a scoping review, and a focus group discussion were
conducted to lay a solid foundation for the framework’s development. The second
phase involved content validation and the response process (face validation). The new
framework was evaluated in the third and final phase using two tracks: first, by training
a group of international medical teachers and measuring their utilization of the
framework’s guidelines before and after training and, second, by implementing the
framework in a single medical institution and measuring certain mental health
parameters among medical students before and after the training of their medical
teachers to apply the framework. Furthermore, qualitative feedback was gathered for
both evaluation tracks. After synthesis and triangulation of the results gathered during
phase one, the systematic assessment for resilience (SAR) was developed. The SAR theoretically promotes four resilience constructs—self-control, management,
engagement, and growth—and does so through five phases of assessment—
assessment experience, assessment direction, assessment preparation, examiner focus,
and student reflection. In addition, each assessment phase contains several practical
guidelines to promote resilience. The SAR showed a high level of content and face
validity. During the first track’s evaluation, most of the SAR guidelines were adhered
to, and the teachers provided promising feedback. In the second track of evaluating the
SAR, the implementation of the SAR in a medical school significantly improved
students’ mental health paramters. Additionally, the medical teachers at the study site
shared their positive experiences and reported significant student changes after
implementing SAR. The current study presents a novel and holistic framework for
fostering student resilience through assessment practice. The novelty of the SAR
comes from its uniqueness as a resilience intervention that targets the leading cause of
medical students’ mental health problems, approaching this in a systematic way, in
turn providing a new horizon for the assessment process in medical education.
Nevertheless, additional research is required to provide more evidence on the
effectiveness of SAR guidelines addressing the wellbeing issues of tomorrow’s
doctors through assessment.
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Keywords
stress , anxiety