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Psychological Distress in the Association between Medical Education Changes and Clinical Learning Worry among Students Receiving Clinical Education during the COVID-19 Pandemic in Taiwan

Shikha Kukreti1,#, Min-Chi Hsieh2,#, Musheer A. Aljaberi3, Ru-Yi Huang4,5,6, I-Ting Hwang7, Carol Strong2, Jung-Sheng Chen8, Ming-Ta Hsieh9,10,*, Mark D. Griffiths11, Chung-Ying Lin12,13,*, Nai-Ying Ko1
1 Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan
2 Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan
3 Department of Internal Medicine, Section Nursing Science, Erasmus University Medical Center (Erasmus MC), Rotterdam, 3015 GD, The Netherlands
4 Division of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, 231405, Taiwan
5 School of Medicine, Tzu Chi University, Hualien, 231036, Taiwan
6 Data Science Degree Program, National Taiwan University and Academia Sinica, Taipei, 106319, Taiwan
7 Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan
8 Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, 824005, Taiwan
9 Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 824005, Taiwan
10 School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 824005, Taiwan
11 International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, NG11 8NS, UK
12 Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan
13 Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 701401, Taiwan
* Corresponding Author: Ming-Ta Hsieh. Email: email; Chung-Ying Lin. Email: email
# These authors contributed equally to be the co-first authors

International Journal of Mental Health Promotion https://doi.org/10.32604/ijmhp.2024.057708

Received 26 August 2024; Accepted 15 November 2024; Published online 12 December 2024

Abstract

Background: The COVID-19 pandemic profoundly impacted medical education and caused psychological distress and worry about clinical learning for those who received clinical medical education during this period. Although the acute phase of COVID-19 has now ended, understanding its impact is essential for strengthening medical system preparedness. Therefore, the present study examined the association between changes in medical education and worry about clinical learning, considering the mediating role of psychological distress among participants who received clinical training. Methods: A cross-sectional online survey was conducted with 542 post-graduate year (PGY) doctors and allied health students from the 2020 and 2021 cohorts in Taiwan. The survey assessed changes in clinical training modes, direct patient care, learning stress, psychological distress, and worry about clinical learning. Results: Among the participants, 76.0% experienced changes in clinical training mode, and 84.3% had direct patient care experience. Direct patient care/contact was significantly correlated with lower levels of worry about clinical learning. Learning stress was positively correlated with increased psychological distress and worry about clinical learning. Psychological distress partially mediated the relationship between learning stress and worry about clinical learning. Conclusion: The findings highlight the importance of direct contact with patients because it was associated with lower levels of worry about clinical learning. Moreover, increased learning stress was associated with psychological distress and worry about clinical learning. Therefore, effective support systems are essential to mitigate these impacts and enhance clinical training during national health crises. The findings provide valuable insights for improving medical education and support systems in future health emergencies. However, the present study used a cross-sectional study design. Therefore, the mediation findings should be interpreted with caution (i.e., no causal relationships can be determined based on cross-sectional data).

Keywords

Psychological distress; allied health; patient care; worry about clinical learning
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