Burnout and psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study

BACKGROUND: Mental distress among medical students is often reported. Burnout has not been studied frequently and studies using interviewer-rated diagnoses as outcomes are rarely employed. The objective of this prospective study of medical students was to examine clinically significant psychiatric morbidity and burnout at 3(rd )year of medical school, considering personality and study conditions measured at 1(st )year. METHODS: Questionnaires were sent to 127 first year medical students who were then followed-up at 3(rd )year of medical school. Eighty-one of 3(rd )year respondents participated in a diagnostic interview. Personality (HP5-i) and Performance-based self-esteem (PBSE-scale) were assessed at first year, Study conditions (HESI), Burnout (OLBI), Depression (MDI) at 1(st )and 3(rd )years. Diagnostic interviews (MINI) were used at 3(rd )year to assess psychiatric morbidity. High and low burnout at 3(rd )year was defined by cluster analysis. Logistic regressions were used to identify predictors of high burnout and psychiatric morbidity, controlling for gender. RESULTS: 98 (77%) responded on both occasions, 80 (63%) of these were interviewed. High burnout was predicted by Impulsivity trait, Depressive symptoms at 1(st )year and Financial concerns at 1(st )year. When controlling for 3(rd )year study conditions, Impulsivity and concurrent Workload remained. Of the interviewed sample 21 (27%) had a psychiatric diagnosis, 6 of whom had sought help. Unadjusted analyses showed that psychiatric morbidity was predicted by high Performance-based self-esteem, Disengagement and Depression at 1(st )year, only the later remained significant in the adjusted analysis. CONCLUSION: Psychiatric morbidity is common in medical students but few seek help. Burnout has individual as well as environmental explanations and to avoid it, organisational as well as individual interventions may be needed. Early signs of depressive symptoms in medical students may be important to address. Students should be encouraged to seek help and adequate facilities should be available

Applying the SRL vs. ERL Theory to the Knowledge of Achievement Emotions in Undergraduate University Students

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpsyg. 2019.02070/full#supplementary-materialThe SRL vs.ERL Theory predicts that a student's own self-regulation and the regulatory nature of the context are factors that jointly determine the student's level of motivational-affective variables. However, this principle has not yet been verified in the case of achievement emotions. The aim of this research was to test this prediction, with the hypothesis that students' level of self-regulation (low-medium-high), in interaction with the regulatory nature of the teaching (low-medium-high), would determine positive or negative emotions as well as the degree of burnout/engagement. A total of 440 university students completed validated questionnaires on self-regulation; regulatory teaching; achievement emotions in class, in study and in testing situations; and on burnout/engagement. Using a quasi-experimental design by selection, ANOVAs and MANOVAs (3 × 3; 5 × 1) were carried out. The results confirmed that the level of self-regulation and the level of external regulation jointly determined university students' level of achievement emotions, as well as their level of burnout/engagement. Based on these results, a five-level progressive scale was configured. We conclude that this scale may be useful and adequate as a heuristic technique or model for understanding and analyzing the type of student-teacher interaction that is taking place in the university classroom, and thereby learn the probability of stressful effects and the students' level of emotional health.R&D Project PGC2018-094672-B-I00 (Ministry of Science and Education, Spain), and UAL18-SEJ-DO31-A-FEDER (University of Almería, Spain), and the European Social Fund

Combined Effect of Levels in Personal Self-Regulation and Regulatory Teaching on Meta-Cognitive, on Meta-Motivational, and on Academic Achievement Variables in Undergraduate Students

The Theory of Self- vs. Externally-Regulated Learning™ (SRL vs. ERL) proposed different types of relationships among levels of variables in Personal Self-Regulation (PSR) and Regulatory Teaching (RT) to predict the meta-cognitive, meta-motivational and -emotional variables of learning, and of Academic Achievement in Higher Education. The aim of this investigation was empirical in order to validate the model of the combined effect of low-medium-high levels in PSR and RT on the dependent variables. For the analysis of combinations, a selected sample of 544 undergraduate students from two Spanish universities was used. Data collection was obtained from validated instruments, in Spanish versions. Using an ex-post-facto design, different Univariate and Multivariate Analyses (3 × 1, 3 × 3, and 4 × 1) were conducted. Results provide evidence for a consistent effect of low-medium-high levels of PSR and of RT, thus giving significant partial confirmation of the proposed rational model. As predicted, (1) the levels of PSR and positively and significantly effected the levels of learning approaches, resilience, engagement, academic confidence, test anxiety, and procedural and attitudinal academic achievement; (2) the most favorable type of interaction was a high level of PSR with a high level RT process. The limitations and implications of these results in the design of effective teaching are analyzed, to improve university teaching-learning processes.This research was funded through an R & D Project, ref. EDU2011-24805 (2012–2015) of the Ministry of Science and Innovation (Spain), and with Federal Funds (European Union)

Satisfaction With the Self-Assessment of University Students Through e-Coping With Academic Stress UtilityTM

The general purpose of this report is: (1) research was to check whether the degree of satisfaction with the self-assessment activity of university students was related to the scores obtained and the degree of different variables, associated with level of Self-Regulation; (2) to present the online utility, e-Coping with Academic StressTM, as a technological development in Educational Psychology; (3) analyze the possibilities of transfer of this technological innovation. A total of 929 university students, coming from a public university, participated in the use of this online utility. University students can use the tool’s online inventories to make self-assessments in the different variables of Studying, Learning and Performing under Stress (SLPS Competency Model). Descriptives, correlational and inferential analyzes (ANOVAs and MANOVAs) were carried out. The results allowed to know the profile of competences of the analyzed university students, in addition to the degree of satisfaction with the self-evaluation. Finally, we communicate possible actions and options available for transfer of this resulting technology, through RD transfer contracts arranged directly or with other universities

Why risk professional fulfilment: a grounded theory of physician engagement in healthcare development

The need for trans-professional collaboration when developing healthcare has been stressed by practitioners and researchers. Because physicians have considerable impact on this process, their willingness to become involved is central to this issue. OBJECTIVE: This study aims to gain a deeper understanding of how physicians view their engagement in healthcare development. METHOD: Using a grounded theory approach, the study developed a conceptual model based on empirical data from qualitative interviews with physicians working at a hospital (n = 25). RESULTS: A continual striving for experiences of usefulness and progress, conceptualized as 'striving for professional fulfilment' (the core category), emerged as a central motivational drive for physician engagement in healthcare development. Such experiences were gained when achieving meaningful results, having impact, learning to see the greater context and fulfilling the perceived doctor role. Reinforcing organizational preconditions that facilitated physician engagement in healthcare development were workplace continuity, effective strategies and procedures, role clarity regarding participation in development and opportunities to gain knowledge about organization and development. Two opposite role-taking tendencies emerged: upholding a traditional doctor role with high autonomy in relation to organization and management, clinical work serving as the main source of fulfilment, or approaching a more complete 'employeeship' role in which organizational engagement also provides a sense of fulfilment. CONCLUSION: Experiencing professional fulfilment from participation in healthcare development is crucial for sustainable physician engagement in such activities.</p