Scott M. Rodgers

A Comprehensive Medical Student Wellness Program—Design and Implementation at Vanderbilt School of Medicine

Research suggests that student burnout and mental illness are increasing in U.S. medical schools. In response, students and administrators developed the Vanderbilt Medical Student (VMS) Wellness Program to promote student health and well-being through coordination of many new and existing resources. This program consists of three core components: The Advisory College Program, The Student Wellness Committee, and VMS LIVE. Each of the core components includes separate and unique individual programs, but each of these three components collaborates with the other two to accomplish the broad wellness goal of maximizing student health, happiness, and potential. The VMS Wellness Program has had early success with substantial growth and outstanding student buy-in since its inception in 2005. Preliminary data indicate that nearly every student has participated in at least two components of the VMS Wellness Program. In addition to participation, student response has been highly satisfactory, as evidenced by their positive feedback. The VMS Wellness Program is the first published model of a comprehensive medical student wellness initiative. The development and design of the program described in this article may serve as a framework for other institutions.

Assessing Student Mental Health at the Vanderbilt University School of Medicine

Purpose To determine the prevalence rates of four major categories of mental illness among medical students and to examine associations between these illnesses and a range of demographic variables. Method The authors invited all 330 first-, second-, and third-year medical students at Vanderbilt University School of Medicine to participate in a survey during winter 2008–2009. Students completed an anonymous written questionnaire assessing the prevalence of depression, anxiety, eating disorders, and alcohol and drug use disorders. Additionally, the authors obtained student demographic information to investigate variations in rates of illness based on interindividual differences. Results Most students (301; response rate: 91.2%) completed the survey. The authors found that depression and anxiety were more prevalent in the Vanderbilt medical student population than in their nonmedical peer group. The authors found that 37 (12%) of the students were borderline for possible alcohol abuse and 3 (1%) were problem drinkers, 1 (0.3%) had a possible drug abuse disorder, and 3 (1%) had possible eating disorders. Whereas exercising one to three times per week was associated with lower rates of both depression and anxiety, having a family history of mental illness was associated with higher eating disorder scores and anxiety. There was an association between gender and all disorders. Conclusions Insight into the prevalence of mental health disorders in the medical student population and the variables that may influence them provides important information for medical schools as they develop more robust and effective wellness programs to help students in these very stressful learning environments.

Improvements in medical school wellness and career counseling: A comparison of one-on-one advising to an Advisory College Program.

Background: Medical students have unmet needs in the areas of career and wellness advising. Aims: The goal of this study is to describe the development of an Advisory College Program (ACP) and assess its effectiveness compared to a traditional one-on-one faculty advisor system. Methods: The ACP, consisting of four colleges co-led by Advisory College Directors and supported by key Faculty, was developed to provide structured career and wellness advising. The authors compared the ACP to the former Faculty Advisory Program (FAP) using two parallel questionnaires. Results: Surveys were completed by 74% of first-year students, 60% of second-year students, and 88% of third-year students. Survey data demonstrated a significant increase in the number of students who could identify their advisor, the frequency of student–advisor contacts, and the perceived accessibility of advisors in the ACP compared to the FAP. While an ordinal logistic regression model did not demonstrate a significant effect of the new advising system on overall satisfaction, univariate analysis demonstrated a significant increase in student satisfaction with wellness and career counseling. Conclusions: The ACP was more effective in promoting student wellness and career counseling than the traditional one-on-one faculty advisor system. Similar college-based programs may be beneficial to students at other medical school programs.

Building learning communities: evolution of the colleges at Vanderbilt University School of Medicine.

Learning communities, which are an emerging trend in medical education, create a foundation for professional and academic development through the establishment of longitudinal relationships between students and faculty. In this article, the authors describe the robust learning community system at Vanderbilt University School of Medicine, which encompasses wellness, career planning, professional development, and academics. The Vanderbilt Advisory Colleges Program introduced in 2006 initially focused on two goals: promoting wellness and providing career advising. In the 2011–2012 academic year, the focus of the colleges expanded to incorporate an enhanced level of personal career advising and an academic component. In the four-year College Colloquium course, faculty selected as college mentors teach the medical humanities and lead sessions dedicated to student professional development in the areas of leadership, research, and service-learning. This academic and professional development program builds on the existing strengths of the colleges and has transformed the colleges into learning communities. The authors reflect on lessons learned and discuss future plans. They report that internal data and data from the Association of American Medical Colleges Medical School Graduation Questionnaire support consistently high and increasing satisfaction among Vanderbilt medical students, across the metrics of personal counseling, faculty mentoring, and career planning.

Career Guidance and the Web: Bridging the Gap Between the AAMC Careers in Medicine Web Site and Local Career Guidance Programs

Background : Medical students face a difficult challenge choosing a specialty. The Web offers several advantages in guiding students in the decision-making process. Description: The Vanderbilt University School of Medicine created a school-specific Web site to complement the Association of American Medical Colleges Careers in Medicine program. The goals were: connecting students with institution-specific resources, providing students with information on specialty choices and residency preparation, and promoting an interactive Web-based tool. A student team developed the Web site over several months. The site incorporates tracking tools to assess usage. During the first 240 days of use, the Web site has had 3,782 sessions viewing 29,864 Web pages. Monthly usage has trended upward. Conclusions : Using the Web to provide school-specific career information can guide students in the difficult process of specialty selection. Future studies are required to assess the Web sites overall effectiveness and overall student satisfaction.

Medical student involvement in website development.

Background: The digital management of educational resources and information is becoming an important part of medical education. Aims: At Vanderbilt University School of Medicine, two medical students sought to create a website for all medical students to act as each students individual homepage. Method: Using widely available software and database technology, a highly customized Web portal, known as the VMS Portal, was created for medical students. Access to course material, evaluations, academic information, and community assets were customized for individual users. Modular features were added over the course of a year in response to student requests, monitoring of usage habits, and solicitation of direct student feedback. Results: During the first 742 days of the VMS Portals release, there were 209,460 student login sessions (282 average daily). Of 348 medical students surveyed (71% response rate), 84% agreed or strongly agreed that ‘consolidated student resources made their lives easier’ and 82% agreed or strongly agreed that their needs were represented by having medical students design and create the VMS Portal. Conclusion: In the VMS Portal project, medical students were uniquely positioned to help consolidate, integrate, and develop Web resources for peers. As other medical schools create and expand digital resources, the valuable input and perspective of medical students should be solicited.

Transitional Age Lesbian, Gay, Bisexual, Transgender, and Questioning Youth: Issues of Diversity, Integrated Identities, and Mental Health

Although most LGBTQ youth become healthy young adults, they often face considerable stress over the course of their lives because of bullying, victimization, and overt/covert discrimination. Families, educational and religious institutions, health care professionals, and communities help shape the experience of LGBTQ transitional age youth. LGBTQ youth have higher rates of depression, suicide, anxiety, posttraumatic stress disorder, alcohol and drug use, and preventable sexually transmitted diseases. When best practice guidelines are followed and key stakeholders take action to support LGBTQ youth, health disparities begin to disappear. Much can be done to change the trajectory for LGBTQ youth through advocacy, education, culturally competent health care, and policy-making.

Easing specialty selection with a web‐based shadowing programme

agencies. An important element of the simulations included the notion of interprofessional education (IPE), in order that students might gain a better understanding and appreciation of other health care professions. Why the idea was necessary This was necessary for 3 reasons. First, there is an ongoing shortage of clinical placement opportunities. This places extra pressure on clinical sites to take students on placement. Second, several new health sciences programmes at Monash University were being developed and this was viewed as an opportunity to develop an alternative way of delivering IPE content in hospital-based clinical placements. Finally, educational quality would potentially be reduced if learning opportunities were not utilised to their fullest potential in clinical education environments and if there were a lack of consistency in the linking of classroom theory to practical application whilst on clinical placements. What was done A contemporary model of flexible IPE was developed to capture clinical simulated scenarios relevant to allied health professions that might be expected during specific hospital-based clinical placements. Eleven DVD simulations were produced, of 10)60 minutes in length. Undergraduate paramedic (n 1⁄4 35), occupational therapy (n 1⁄4 9), physiotherapy (n 1⁄4 39) and nursing (n 1⁄4 97) students at Monash University were asked to complete a paper-based questionnaire (25 questions) using a 7-point Likert scale (1 1⁄4 strongly disagree, 7 1⁄4 strongly agree) that aimed to assess the clinical relevance and students’ general perceptions of and attitudes towards viewing clinical simulations via DVD. Thematic analysis was also undertaken following a focus group that included paramedic (n 1⁄4 3), occupational therapy (n 1⁄4 3), physiotherapy (n 1⁄4 2) and nursing (n 1⁄4 3) students. Evaluation of results and impact Overall, the DVD simulations produced positive results. Quantitative data were analysed from the Likert scale items under the following headings: Sustained Attention, mean 3.8, 95% confidence interval (CI) 3.6–3.9 (range 1–7); Learner Satisfaction, mean 4.9, 95% CI 4.8–5.1 (range 1.5–7), and Clinical Relevance, mean 4.3, 95% CI 4.2–4.4 (range 2.1–6). The qualitative data analysis focused on clinical placements and the issue of whether DVD simulations could replace or supplement clinical placement learning. The focus group produced a number of salient themes, which included: the engendering of greater respect between health care disciplines; the promotion of teamwork among health professionals, and the recognition that efficient and effective learning does not take place consistently in clinical placements. Some health disciplines emphasised that certain hospitalbased clinical placements could be replaced with DVD simulations.