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Levels of Resilience & Coping of Osteopathic Medical Students during COVID-19: Implications for Mental Health Innovations for Physicians in Training
Lanspa, M. E. [1]
Jacobs, R. J. [7]
Patel, K. C. [2]

Journal: The Journal of the American Osteopathic Association Date: 2020/12, 120(12):Pages: e14-e16. doi: Subito , type of study: cross sectional study

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2020.157/html)

Keywords:

covid-19 [117]
cross sectional study [842]
medical students [647]
mental health [35]
osteopathic medicine [2025]
USA [1656]

Abstract:

Statement of Significance: In addition to fears about one's own health, which consequentially precipitate changes in health and coping behaviors, medical students have added concerns regarding the interruption of their studies. While both allopathic and osteopathic students must complete a minimum number of hours of in-person training before clinical rotations, osteopathic medical education also requires 300 hours of training in Osteopathic Manipulation Therapy (OMT). Given the restrictions imposed by COVID-19, concerns of keeping one's skills practiced for board examinations, professional competence in OMT, and uncertainty regarding education timelines are significant sources of stress and raise concerns regarding the emotional wellbeing of osteopathic medical students. Research Methods: Data were collected from 202 medical students via an online questionnaire developed by the researchers titled Emotional Wellbeing in Medical Students Questionnaire (EWB-Q). Anecdotal evidence and published reports guided the development of the major study variables and the creation of the EWB-Q, which included validated measures to assess the levels of coping strategies, personal resilience (the ability to “bounce back” after a setback), and certain health behaviors (i.e., healthy eating and exercise patterns) among osteopathic medical students and how these variables may contribute to their emotional wellbeing. Data on participants' sociodemographic characteristics were also collected. The study was approved by the researchers’ university Institutional Review Board. The survey took approximately 10 minutes to complete. Data Analysis: Resilience. The 6-item Brief Resilience Scale (BRS) assesses the ability to bounce back or recover from stress and is negatively related to anxiety, depression, negative affect, and physical symptoms when other resilience measures and optimism, social support, and Type D personality are controlled. Responses are scored on a five-category ordinal scale, with higher scores indicating higher levels of resilience. Coping. The Brief COPE is a 28-item scale with scores ranging from 1 to 4, with higher scores indicating greater use of coping strategies. Responses ranged from 1 = I haven't been doing this at all, and 4 = I've been doing this a lot. Categories under which items are reflected include, but are not limited to, self-distraction, active coping, denial, use of emotional support, positive reframing, acceptance, and religion. Emotional wellbeing. Higher Mental Health Continuum (MHC-SF) is a 14-item scale with scores ranging for 1 to 6. People can be classified as flourishing (higher scores) or languishing (lower scores) in regard to emotional wellbeing. Responses are scored on a six category ordinal scale ranging from 1 = never, to 6 = every day. Health behaviors. These items were scored using a 4-point ordinal scale where 1 = haven't been doing this at all, 2 = I've been doing this a little bit, 3 = I've been doing this a medium amount, and 4 = I've been doing this a lot. Results: The mean age of the participants was 26.7 years (range 21-57 years; SD=4.05); 59.1% (n=110) were women. About half (n=110; 54.5%) of participants were in preclinical training (years 1 and 2) and the remainder (n=92; 45.5%) were currently in clinical rotations in outpatient settings/hospitals (years 3 and 4). Multiple linear regression analysis indicated that the level of coping, personal resilience, and certain health behaviors (i.e., eating and sleeping well) explain a significant amount of the variance in emotional wellbeing scores in U.S. osteopathic medical students during the first months of the COVID-19 pandemic in the United States. A significant regression equation was found, F(4,171) = 17.481, p < .000, R2 = .290, R2 adjusted = .274). Higher levels of resilience, greater use of coping strategies, getting enough sleep, and eating well made significant contributions to emotional wellbeing. Conclusion: This initial study will help guide efforts to develop mental health interventions for osteopathic medical students. The findings can also help to identify and address any novel or changing mental health needs of U.S. osteopathic medical students due to COVID-19, and to evaluate any suggested changes their educational environments and career progression planning. As the importance of supporting mental health among health care providers continues to be an area of professional concern, it is especially relevant during crises and pandemic to consider the mental health of medical students. Cultivating emotional wellbeing should continue to be a goal for educators and administrators of medical schools now more than ever as they design curriculum and campus-based initiatives to help students bolster their skills in personal resilience and encourage healthy coping behaviors. While this is particularly evident during times of crises and education and professional uncertainty, better mental health training as a proactive stance to promote personal resilience is critical for medical students who will soon be providing front-line patient care and influencing health care policy. Osteopathic medical schools and educators should be providing a model for comprehensive care through compassionate and holistic evaluations of students’ physical and mental therapy health needs in order to produce providers capable of dealing with an increasingly uncertain and unstable health care environment.

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