背景:医学学位是一个漫长而具有挑战性的课程,不仅仅是学术上,而是关于医学教育文化中根深蒂固的期望。最近关于学生心理健康状况不佳的文献激增,这表明了一种困境,通常使学生有责任改善自己的健康状况。人格与心理困扰的脆弱性之间的联系得到了承认。这项纵向研究着眼于第一年的人格和某些心理特征水平的变化,作为幸福的代理指标,在第四年。我们旨在确定心理特征随时间的变化在多大程度上可以归因于人格。
方法:医学生在其医学学位的开始(第一年:基线)和结束(第四年:随访)时完成了调查(N=154)。气质和性格个性,完美主义-对错误的关注(CoM),歧义容忍度,复原力,打电话给医学,并测量了人口统计学变量。配对t检验比较了从基线到随访的心理特征变化。线性回归检查了基线人格是否可以预测随访中的心理特征水平。
结果:样本的气质和性格轮廓符合预期,与以前的研究一致,描述一个成熟的人格。四年多,完美主义-CoM水平显著提高,而弹性,模棱两可的容忍度和对医学的呼吁降低。避免伤害,坚持不懈,基线的自我导向和合作显着预测了随访中这些特征的水平,但是效果大小很弱。相关性在预期的方向和弱。
结论:大多数开始的医学生,包括这个队列,有成熟的性格,勤奋的气质和适应能力。然而,在四年的医学生涯中,歧义容忍度,弹性和呼叫下降,而完美主义-CoM,在基线时已经升高,继续增加到最后一年。令人担忧的是完美主义的增加与不良的心理健康和心理困扰密切相关。研究结果表明,我们可以仔细研究整个教育环境及其文化,包括中学和医学院的招生过程可能会影响学生的这些趋势。作为医学教育工作者,我们应该质疑为什么医学途径会给渴望成为医生的学生带来如此不健康的压力。
BACKGROUND: The medical degree is a long and challenging program, not just academically, but regarding the expectations engrained in the culture of medical education. The recent proliferation of literature on the poor mental well-being among students suggests a dilemma that often lays the onus on students to improve their health. The link between personality and vulnerability to psychological distress is acknowledged. This longitudinal study looked at personality in 1st-year and changes in levels of certain psychological traits, as proxy indicators of well-being, in 4th-year. We aimed to determine to what extent changes in psychological traits over time may be attributed to personality.
METHODS: Medical students completed surveys at the start (1st-year: baseline) and finish (4th-year: follow-up) of their medical degree (N = 154). Temperament and character personality, Perfectionism-Concern over mistakes (CoM), Ambiguity Tolerance, Resilience, Calling to medicine, and demographic variables were measured. Paired t-tests compared changes in psychological traits from baseline to follow-up. Linear regression examined whether personality at baseline would predict levels of psychological traits at follow-up.
RESULTS: The temperament and character profile of the sample was as expected, and congruent with previous studies, which describe a mature personality. Over four years, levels of Perfectionism-CoM significantly increased, while Resilience, Ambiguity Tolerance and Calling to medicine decreased. Harm Avoidance, Persistence, Self-Directedness and Cooperativeness at baseline significantly predicted levels of these traits at follow-up, but effect sizes were weak. Correlations were in the expected direction and weak.
CONCLUSIONS: Most commencing medical students, including this cohort, have mature personalities with an industrious temperament and an adaptable character. Yet over four years of medicine, Ambiguity Tolerance, Resilience and Calling declined while Perfectionism-CoM, already elevated at baseline, continued to increase to the final year. Of concern is the increased perfectionism that is strongly associated with poor mental health and psychological distress. The findings suggest a closer look at the entirety of the education environment and how its culture, including secondary school and the medical school admissions processes may influence these trends in students. As medical educators we should question why the pathway to medicine places such unhealthy pressure on students who aspire to be doctors.