Analysis of Anonymous Student Narratives About Experiences with Emergency Medicine Residency Programs.

Background: Academic emergency medicine (EM) communities have viewed anonymous online communities (AOC) such as Reddit or specialty-specific "applicant spreadsheets" as poor advising resources. Despite this, robust EM AOCs exist, with large user bases and heavy readership. Insights about applicants' authentic experiences can be critical for applicants and program leadership decision-making. To date, there are no EM studies to qualitatively assess EM AOC narratives during the application cycle. Our goal was to perform a qualitative analysis of students' EM program experiences through a publicly available AOC. Methods: This was a qualitative analysis of a publicly available, time-stamped, user-locked AOC dataset: "Official 2020-2021 Emergency Medicine Applicant Spreadsheet." We extracted and then de-identified all data from selected sub-sheets entitled "Virtual Interview Impressions" and "Rotation Impressions." Four investigators used constant comparative method to analyze the data inductively, and they subsequently met to generate common themes discussed by students. Preliminary thematic analysis was conducted on a random sample of 37/183 (20%) independent narratives to create the initial codebook. This was used and updated iteratively to analyze the entire narrative set consisting of 841 discrete statements. Finally, two unique codes were created to distinguish whether the identified sub-themes, or program attributes, were likely "modifiable" or "non-modifiable." Results: We identified six major themes: living and working conditions; interpersonal relationships; learning experiences, postgraduate readiness, and online/virtual supplements. Common sub-themes included patient population (13%); resident personality (7%); program leadership personality (7%); relationship with faculty/leadership (6%); geography (4%); practice setting (4%); program reputation (4%), and postgraduate year-3 experiences (4%). Modifiable sub-themes outnumbered non-modifiable sub-themes, 60.7% to 39.3%. Conclusion: In this analysis of selected medical students' narratives in an AOC, the majority of identified themes represented topics that may serve as external feedback for EM residency programs and their clerkships. Selective use of AOCs may set a precedent for future program assessments by applicants and inform program leadership of important programmatic elements in the eyes of applicants. It elucidates important themes in their interactions or learning experiences with programs and creates opportunities for learner-centric program improvement.

Personal value orientations as mediated predictors of mental health: A three-culture study of Chinese, Russian, and German university students.

Previous studies of traditional and modern value orientations in individuals found mediated predictive relationships of these values on particular mental disorders. The aim of this study with samples from three countries (Germany, Russia, and China) is to extend findings on mental health (MH) and value orientations to broader MH indicators and two types of mediators, i.e. social support and resilience in accordance to a theory of values and modernization/postmodernization. The multisite study was conducted in the three countries. A path-model with traditional values predicting MH mediated by social support, and modern values predicting MH mediated by resilience was tested in all three countries. As expected, value orientations were for the most part strongest in China, followed by Russia and Germany. Structural equation modeling supported the assumption of mediated prediction of MH by value orientations by and large. The traditional value benevolence predicts social support whereas the modern value self-direction predicts resilience. Value orientations are a sensitive tool to empirically describe cross-cultural differences. The findings indicate that personal value orientations are meaningful predictors of MH. The analysis of personal values shows promise in linking public health, cross-cultural and modernization issues.

Estudios previos sobre orientaciones de valores tradicionales y modernos encontraron relaciones predictivas mediadas con trastornos mentales particulares. El objetivo de este estudio con muestras procedentes de tres países (Alemania, Rusia y China) es ampliar los resultados indicadores más amplios de salud mental (SM) y dos tipos de mediadores (apoyo social y resiliencia), de acuerdo a la teoría de los valores y la modernización/postmodernización. Se probó en los tres países un path-model con valores tradicionales prediciendo la SM mediada por el apoyo social y valores modernos prediciendo la SM mediada por la resiliencia. Como era de esperar, las orientaciones de valores eran en su mayor parte más fuertes en China, seguido por Rusia y Alemania. Modelos de ecuaciones estructurales apoyaron la hipótesis de la predicción de la SM mediada por las orientaciones de valores en general. La benevolencia de valores tradicionales predice el apoyo social, mientras que el valor autodirección moderna predice la resiliencia. Las orientaciones de valores constituyen una herramienta sensible para describir empíricamente las diferencias interculturales. Los resultados indican que las orientaciones de valores personales son predictores significativos de la SM. El análisis de los valores personales se muestra prometedor en la salud pública transcultural y cuestiones de modernización.