ABSTRACT
BACKGROUND: On March 11, 2020 the World Health Organization declared the novel coronavirus SARS-CoV-2 disease (COVID-19) a global pandemic. We sought to understand impact of COVID-19 on learner wellness at a large tertiary care academic institution to inform the future development of learner wellness interventions during the COVID-19 pandemic. METHODS: A cross-sectional, internet-based survey collected quantitative and qualitative data from learners April-June 2020. Descriptive statistics and univariate analyses were reported for quantitative data. Open-ended, qualitative responses were analyzed deductively using thematic analysis. RESULTS: Twenty percent of enrolled learners in that faculty of medicine (540/2741) participated including undergraduate [Bachelor's] students (25.7%), graduate [science] students (27.5%), undergraduate medical students (22.8%), and postgraduate resident physicians (23.5%). We found that learner wellness across all stages of training was negatively impacted and the ways in which learners were impacted varied as a result of their program's response to the COVID-19 pandemic. CONCLUSIONS: Learners in health sciences and medical education report worsening well-being because of the programs and the systems in which they function with the added burden of the COVID-19 pandemic. Future interventions would benefit from a holistic framework of learner wellness while engaging in systems thinking to understand how individuals, programs and respective systems intersect. The importance of acknowledging equity, diversity and inclusion, fostering psychological safety and engaging learners as active participants in their journey during a pandemic and beyond are key elements in developing wellness interventions.
CONTEXTE: Le 11 mars 2020, l'Organisation mondiale de la santé a déclaré que le nouveau coronavirus SRAS-CoV-2 (COVID-19) était pandémique. Nous avons tenté de cerner l'impact de la COVID-19 sur le bien-être des apprenants dans un grand centre universitaire de soins tertiaires afin d'étayer le développement futur d'interventions en faveur du bien-être des apprenants en contexte de pandémie. MÉTHODES: Une enquête transversale par sondage en ligne, menée entre les mois d'avril et juin 2020, a permis de recueillir des données quantitatives et qualitatives auprès des apprenants. Des statistiques descriptives et des analyses univariées ont été présentées comme données quantitatives. Les réponses ouvertes, qualitatives, ont été analysées de manière déductive par le biais d'une analyse thématique. RÉSULTATS: Vingt pour cent des étudiants de la faculté de médecine (540/2741) ont participé, dont 25,7 % étaient inscrits au premier cycle (baccalauréat), 27,5 % au deuxième cycle (sciences), 22,8 % au premier cycle en médecine et 23,5 % étaient résidents. Nous avons constaté que la pandémie a négativement affecté le bien-être des apprenants à tous les niveaux de formation et que les effets précis sur les étudiants pouvaient varier en fonction de la réponse de leur programme à la situation sanitaire. CONCLUSIONS: Les étudiants en médecine et en sciences de la santé signalent une détérioration de leur bien-être liée aux programmes et aux systèmes dans lesquels ils évoluent, auxquels s'ajoute le fardeau supplémentaire de la pandémie de la COVID-19. Il conviendrait de définir les interventions futures sur la base d'un cadre holistique du bien-être des apprenants tout en adoptant une réflexion systémique pour appréhender l'entrecroisement entre individus, programmes et systèmes. Reconnaître l'importance de l'équité, de la diversité et de l'inclusion, favoriser la sécurité psychologique et assurer la participation active des apprenants dans leur parcours pendant la pandémie et au-delà, constituent des éléments clés dans l'élaboration d'interventions au profit de leur bien-être.
ABSTRACT
Problem: The novel coronavirus SARS-CoV-2 disease (COVID-19) impacted medical learner well-being and serves as a unique opportunity to understand medical learner wellness. The authors designed a formal needs assessment to assess medical learners' perspectives regarding distress related to disrupted training environments. This Rapid Communication describes findings from a qualitative study which defined medical learner wellness and validated five wellness domains.Approach: We conducted follow-up telephone interviews to an online needs assessment survey to identify a learner definition for wellness and to validate five wellness domains, including social, mental, physical, intellectual, and occupational wellness. Using purposive and maximal variation sampling, 27 students were interviewed from July-August 2020. Thematic analysis was performed using a deductive thematic approach to qualitative analysis.Outcomes: Medical learners defined wellness as a general [holistic] sense of personal well-being - the opportunity to be and to do what they most need and value. Learners validated all five wellness domains for medical education. Learners acknowledged the need for an adoptable and adaptable holistic framework for wellness in medical education.Next steps: We recommend academic medical institutions consider learner wellness a key component of medical education to cultivate learners as a competent collective of self-reliant, scholarly experts. We encourage evaluation of wellness domains in diverse medical learner populations to identify feasible interventions potentially associated with improvements in medical learner wellness.