112 - Self-directed Learning Readiness, Mental Well-being, and Academic Performance in Preclinical Medical Education

Poster Board Number: 112
There are separate poster presentation times for odd and even posters.
Odd poster #s – first hour
Even poster #s – second hour

Co-authors:

Kenneth Thompson, PhD - Director, Institutional Research, Advanced Biomedical Education, University of Mississippi Medical Center; Ellen Robertson, PhD., OTR/L - Assistant Professor, Physician Assistant Program, Randolph Macon College; Andrew Notebaert - Associate Professor and Director, PhD in Health Sciences, College of Health and Human Sciences

Abstract Body :The environment and psychological demands of preclinical medical education (PCME) may create concerns for negative well-being (NWB) in first (M1) and second-year (M2) medical students. The triadic model of reciprocal determinism (Social Cognitive Theory) suggests an interplay between personal, behavioral, and environmental factors that may influence learning outcomes through the development of self-efficacy and agency. Self-directed learning readiness (SDLR) is an academic sense of agency where students take control of their learning. Students with better SDLR skills may manage these pressing demands better. This longitudinal and cross-sectional study investigated the relationship between SDLR, NWB, and academic performance (AP) in M1 and M2 students. A 55-item electronic questionnaire comprising the Depression, anxiety, and stress scale-21, and a Self-directed learning instrument, was distributed via REDCap twice per academic year to four preclinical classes over two years. Significant correlations were found in both M1 and M2 (SDLR and NWB: moderate negative; SDLR and AP: moderate positive (M1), weak positive (M2); NWB and AP: moderate negative (M1)). These variables significantly impacted each other, especially in the M1 year, where AP and NWB accounted for one-third of SDLR, and AP and SDLR, nearly 30% of NWB. In two successive M1 year groups, 73%, 76%, and 53% reported experiencing some stress, anxiety, and depression respectively, with 107 students (86.3%) reporting moderate to extremely severe anxiety in one year group. Similar rates were reported in successive M2 classes, despite lower overall NWB than in M1. NWB and SDLR scores were poorer in the M1 year, female students, and spring terms of both M1s and M2s. In M1s, significant differences were observed in SDLR and NWB among high- and low-performing students, but only in SDLR during the M2 year. Unlike SDLR, NWB differences were not significant between curriculum types (traditional or integrated). This study shows some negative emotional states of students to the rigors of PCME and highlights a critical relationship between SDLR, NWB, and AP that could influence well-being, learning motivation, planning, and metacognition. It shows curricular time points (spring term (M1, M2), M1-year) and persons (M1-females) at increased risk of NWB and poor SDLR. High levels of NWB may lead to program withdrawal, inappropriate coping methods, and suicidal ideation. Providing opportunities, training, and/or tools for SDL should be combined with targeted mental health campaigns and interventions at critical points of predicted heightened exposure to NWB stressors, and to persons at higher risk. This study necessitates further research into strategies and initiatives for improving SDLR and mental well-being in PCME.