Enhancing self-care education amongst medical students: a systematic scoping review

Author: Darius Wei Jun Wan1,2, Laura Shih Hui Goh1,2, Mac Yu Kai Teo1,2, Celestine Jia Ling Loh3,4, Gerald Hng Kai Yak1,2, Joanna Jing Hui Lee1,2, Nila Ravindran1,2, Nur Diana Abdul Rahman5, Min Chiam5, Eng Koon Ong1,4,5,6, Nagavalli Somasundaram4,7, Ying Yin Lim8, Gillian Li Gek Phua1,4,9, Lalit Kumar Radha Krishna10,11,12,13,14,15,16
Affiliation:
1 Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
2 Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore.
3 Obstetrics and Gynaecology, KK Women's and Children's Hospital (KKH), 100 Bukit Timah Road, Singapore, 229899, Singapore.
4 Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
5 Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
6 Assisi Hospice, 823 Thomson Road, Singapore, 574627, Singapore.
7 Division of Medical Oncology, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore.
8 Division of Palliative Care, Alexandra Hospital, 378 Alexandra Rd, Singapore, 159964, Singapore.
9 Lien Centre for Palliative Care, Duke-NUS Medical School, National University of Singapore, 8 College Rd, Singapore, 169857, Singapore.
10 Division of Palliative and Supportive Care, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore. lalit.radha-krishna@liverpool.ac.uk.
11 Yong Loo Lin School of Medicine, National University Singapore, Singapore, 1E Kent Ridge Road NUHS Tower Block Level 11, Singapore, 119228, Singapore. lalit.radha-krishna@liverpool.ac.uk.
12 Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore. lalit.radha-krishna@liverpool.ac.uk.
13 Division of Cancer Education, National Cancer Centre Singapore, 30 Hospital Boulevard, Singapore, 168583, Singapore. lalit.radha-krishna@liverpool.ac.uk.
14 Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, University of Liverpool, 200 London Road L3 9TA, Liverpool, UK. lalit.radha-krishna@liverpool.ac.uk.
15 Centre for Biomedical Ethics, National University of Singapore, Blk MD11, 10 Medical Drive, #02-03, Singapore, 117597, Singapore. lalit.radha-krishna@liverpool.ac.uk.
16 PalC, The Palliative Care Centre for Excellence in Research and Education, Singapore, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore. lalit.radha-krishna@liverpool.ac.uk.
Conference/Journal: BMC Med Educ
Date published: 2024 Jan 8
Other: Volume ID: 24 , Issue ID: 1 , Pages: 37 , Special Notes: doi: 10.1186/s12909-023-04965-z. , Word Count: 293

Background:
Reports of emotional, existential and moral distress amongst medical students witnessing death and suffering of patients during their clinical postings have raised awareness on the need for better psycho-emotional support during medical school. Furthermore, the stress experienced by medical students stemming from the rigours of their academic curriculum underlines the need for greater awareness on mental health issues and better self-care practices across medical training. With such programmes lacking in most medical schools, we propose a systematic scoping review (SSR) to map and address our research question, "what is known about self-care education interventions amongst medical students?".

Methods:
We adopted the Systematic Evidence-Based Approach to guide a systematic scoping review (SSR in SEBA) of relevant articles published between 1st January 2000 and 30th June 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles were independently and concurrently thematically and content analysed, with complementary categories and themes combined using the Jigsaw Approach. The domains created from the Funnelling Process framed the discussion.

Results:
A total of 6128 abstracts were identified, 429 full-text articles evaluated, and 147 articles included. The 6 domains identified were definition, topics, pedagogy, influences, outcomes and assessment. Most interventions were promising, though peer-led mindfulness-based interventions showed most promise in enhancing engagement, positively impacting personal wellbeing, and improving patient care. Overall, however, self-care education was poorly recognized, adopted and integrated into curricula.

Conclusion:
Greater dedicated time and conducive practice environments within medical school curricula is required to enhance medical student wellbeing. Host organizations must ensure faculty are appropriately selected to instil the importance of self-care, be trained to assess and personalize self-care interventions and provide longitudinal assessment and support. Further study into assessing self-care capabilities is required.

Keywords: Medical education; Medical students; Medicine; Palliative care; Self-care.

PMID: 38191374 DOI: 10.1186/s12909-023-04965-z

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