Draft Dec 30, 2012 Health and Wellness for Our Students Ã¢Â€Â“ The ...

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Academic / clinical• Perceived medical school stress• Lack of perceived diagnostic skills or competence• A sense of isolation and anonymity among students• Lack of sense of personal accomplishment• Burnout• Poor quality or insufficient supervision• Lack of administrative support• Lack of ‘debriefing’ measures after critical incidents• Unsympathetic administration / supervisors• Feelings of being an imposter (abilities do not match those of peers)• Rigidity of the academic program (lives are externally controlled)• Lack of clinical experience in early yearsCoping and time management strategies• Avoidance• Blamed self• Procrastination• Wishful thinking• Poor study and time management skillsNegative life events• Worries about finance and accommodation• Returning to school• Lack of time to take care of self and poor self care habits (including sleep, exercise)Addressing the problem: potential areas for considerationUnderstanding the impact and increasing awarenessWhat is the impact on patient care of depression at the different levels of our profession?Depression is generally easier to treat in earlier stages – how can we increase awareness?Prioritization of mental health education and awareness. An example would be the launch ofwebsite – vetlife.org.uk in response to high suicide rate among veterinarians. This site providesinformation, hotline support, and openly communicates around issues of mental health andwellness.Because of the lag between the onset of depression and initiation of treatment, it may be thatwe are missing the true impact by focusing on students. Similar to findings that have assessed4
physicians in the first year of their independent career, we may find that depression thatoriginates in veterinary school persists into the individuals career.Bridging the gap between student expectations and their experiences“Research in psychology has indicated that the expectations an individual brings to a situationsignificantly influence how he or she experiences and copes with that situation” (LA Pervin,reality and non-reality in student expectations of college. J Psych 61:41-48, 1966). Stress is aninevitable part of the veterinary student experience because of the intensity of the curriculumand minimal control of the workload. However, there are disconnects noted between studentand faculty expectations that may exacerbate the stress of veterinary school. First year studentsreport stress associated with the intensity of the program, the required time commitment, theamount of information to learn, the amount of material to memorize and the paucity ofclinically relevant experiences (7,19). Anxiety and depression were both associated with theperception of unclear faculty expectations by students across all 4 years (23). A studycomparing the expectations of 1 st year veterinary students and faculty found that (8):• Students expected their veterinary education to provide basic competence in veterinarymedicine and also train them in specific skills and knowledge that would enable them tofunction competently. Training in technical skills was rated very high. Students wantedexaminations that integrated facts and skills.• Faculty saw a general education that emphasized theoretical basic knowledge where theprimary focus was learning basic facts. They felt that training in technical skills wouldoccur primarily after graduation. Faculty wanted examinations to ensure students hadmastered the information.Students studied in a surgical education environment noted that anxiety was counterproductiveto learning while excitement appeared to increase their engagement (21). Being able to preparewell was associated with a positive experience while lack of self-confidence accentuated anegative response (21). Are there mechanisms we can improve upon to provide ongoingfeedback that reinforces student perceptions of skills and knowledge gained? Can we provideincreased practice periods, ability to gain and test skills in different formats?Availability of counseling and psychologic services for veterinary studentsIn 2001, only 48% of veterinary schools had exclusive counseling services for veterinarystudents, and most of this was available through part time counselors with an average of 9hours / week (10). In 2012, the rates for in-house counseling support were similar with availabletime varying from 5-40 hours per week (24). Types of services included individual counseling(100%), group counseling (82%), family counseling (69%), stress management (94%),biofeedback (33%), and test anxiety reduction (94%). Financial support for these came from thecollege (50%), university (19%), or were shared between the college and the university (31%).Despite the funding concerns there was a perceived need by colleges: 63% answered that theysometimes needed these services, 27% reported that they needed these services fairly often,and 7% reported very often.5
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