Are We Supporting the Well-Being of Medical Students?: A Systematic Review
Sasha Monteiro MSc, Shakila Mohmand BSc, Imane Squalli Houssaini MD, Leslie Solomonian ND
BACKGROUND Medical students experience significant stress and mood impacts due to multiple reasons including excessive workload, uncertain career choices, and financial stressors.
OBJECTIVES The authors aim to review the literature on strategies shown to improve the well-being of medical students. This will guide the design of a prospective matched cohort study to evaluate the impact of a longitudinal wellness program on mood and perceived stress of naturopathic medical students.
METHODS An English systematic review was performed using the PubMed database with keywords: "medical students", "well-being", "strategies", "tools", "coping", "support", and "stress management". The search targeted studies focused on well-being strategies implemented by medical schools between the date of database inception to July 3rd, 2020.
RESULTS Interventions included stress management workshops, resilience training, mindfulness meditation, and reflective practice. Studies collected data via interviews, small group meetings, essays, questionnaires, and surveys. Students in intervention groups experienced lower overall levels of psychological distress and perceived stress, along with an improvement in general well-being, mindfulness, resilience, development of better coping strategies, and improved academic/clinical performance. Results were sustained when studies included follow-up, and when asked, students recommended well-being focused programs.
CONCLUSION There is clear evidence, based on the studies which have been analyzed, of the effectiveness of incorporating wellness-focused programs and strategies into medical school curricula. Although intervention and outcome measures varied, a common theme of students benefiting from wellness strategies was prevalent. Further studies are warranted to develop curriculum changes allowing for similar programs to be accessible to all medical students.
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Project COPE: Chronicling Healthcare Providers Pandemic Experiences: A Descriptive Study of Essential and Non-Essential Health Care Workers During an Active Pandemic
Ann Blair Kennedy, Rebecca Russ-Sellers, Smith Heavner-Sullivan, Chloe Wilson, Hannah Metwally, Kendall Dean, Kemi Balogun, Niki Munk, Marissa Shuffler, Shannon Stark Taylor, Sarah Griffin, Thomas Britt
BACKGROUND Researchers have documented the experiences of a variety of healthcare workers following major catastrophic events; however, data is often collected after the fact, rather than obtaining the emotional and physical experiences individuals are actively experiencing. Additionally, perspectives of complementary and integrative health (CIH) practitioners are rarely captured during these events. Systematic and inter-professional data collection from all types of healthcare workers, including CIH practitioners, during the COVID-19 pandemic will provide an understanding into providers' experiences from two perspectives: 1) those healthcare providers who are locked in the healthcare system without any real ability to make changes, such as MD/DOs, RN, etc. 2) and those locked out of the same system and not being allowed to help (massage therapists, other CIH providers, etc.).
OBJECTIVES The study objective is to understand the experiences and impact of the COVID-19 pandemic on wellness, moral distress, and experiences of providers in real time. Here we report the impetus of the study, the early data collection, and lessons learned.
METHODS Within three weeks, we developed, received ethical oversight, and launched an international, longitudinal, mixed-methods study, recruiting through social media and networking. Recruitment, participant participation and pandemic evolution are monitored weekly.
RESULTS Study idea formation began in the last week of March 2020 and data collection began mid-April. By mid-July we had 703 participants, representing 10 countries and 20 healthcare fields; the majority are CIH providers. Early publicity within the massage therapy community provided an additional avenue for recruitment which is being duplicated for other fields. Monitoring of participation and data allowed for targeted recruitment materials and protocol/survey amendments.
CONCLUSION The findings will allow for the development of a longitudinal database for future evaluation of changes in wellbeing (e.g. emotional, physical, financial) and willingness to stay in a chosen health profession as the COVID-19 pandemic continues.
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Honeybee Products for the Prevention, Treatment and/or Recovery of COVID-19 and Other Coronavirus-Related Respiratory Tract Infections: A Living Rapid Review
Susan Arentz, Baljit Khamba, Michelle Mravunac, Romy Lauche, Zemirah Lee, Kristen Alexander, Joshua Goldenberg, Stephen Myers, Jennifer Hunter
BACKGROUND The global COVID-19 pandemic has prompted an urgent search for interventions to prevent, treat, and support recovery from SARS-CoV-2. Honeybee products (honey, bee-pollen, royal-jelly propolis and bee-venom) are widely used in traditional and modern medicine. They contain bioactive compounds shown to illicit anti-viral effects, including reduced virulence of human coronaviruses and also produce immune-modulating, anti-inflammatory, and tissue-healing effects that may lessen the severity of symptoms. Honey has demonstrated equivalence and superiority against controls for acute cough in children, without adverse effects and is recommended in WHO and NICE clinical-practice guidelines. A systematic review and meta-analyses for honeybee products in treatment of adults is yet to be undertaken.
OBJECTIVES To systematically appraise the quality of evidence and efficacy of honeybee products for use in SARS-CoV-2.
METHODS A protocol for the rapid systematic review of honeybee products was registered with PROSPERO on 20 July 2020. Included were randomized and quasi-randomized controlled trials that compare single or adjunct honeybee products to placebo or active controls for prevention, treatment, or recovery from the SARS-CoV-2 virus, for other coronavirus or related viral respiratory infections. Important outcomes include the incidence of infections, reduced duration and severity of symptoms, and recovery from post-viral illness (incidence, duration and severity). Indirect evidence from coronavirus species other than SARS-CoV2, and related respiratory virus infections will be graded down.
RESULTS From 519 studies, 9 RCTs investigating honey were included in this review. Estimated effects of honey on eligible outcomes were found to be at high risk of bias. Honey reduced acute cough severity in children more than cough medicines. The addition of honey to usual care did not significantly reduce hospitalization due to complications from RTI compared to usual care alone. The addition of honey to instant coffee compared to coffee alone significantly reduced persistent post-infectious cough associated with viral RTI. Honey and instant coffee were taken for 7 days in participants with persistent post-infectious cough of at least 30 days duration.
CONCLUSION This systematic review provides evidence for honey the reduced severity of cough and sore throat and for recovery from post-infectious cough due to viral respiratory infections.
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