Personal view or opinion piece
Open Access

Positive medical education: Are we focusing on the right things while teaching?

Alvaro Tala[1]

Institution: 1. Universidad de Chile
Corresponding Author: Dr Alvaro Tala ([email protected])
Categories: Educational Strategies, Teaching and Learning, Undergraduate/Graduate
Published Date: 26/07/2018

Abstract

Neuropsychiatric disorders are a global problem and medical students are a population with high vulnerability to mental disorders, with medical education currently in crisis considering the alarming rates of mental health problems reported in medical students, which in addition to compromising the health of students, influence their learning processes and patient care. In this context, it is necessary to move towards a medical education that considers, in addition to the academic performance, the well-being of its students as a central focus, without compromising the former. Positive psychology, with interventions at individual level, and positive education, with interventions at institutional level, could provide a response based on the evidence to this problem, in the form of a positive medical education. This article address a personal view of how this approach can benefit medical students

Keywords: Positive Psychology; Positive Education; Medical Education; Well-being

Perspective

From my point of view, medical education and well-being have a close relationship in at least two points: on one hand, how the teaching and learning processes are developed can influence the well-being of the students, with studies that have showed that formative processes in general tend to generate stress in the students, associating this to greater rates of adverse outcomes in mental health, being medical students a population with greater vulnerability to mental disorders compared to populations of similar age range, due to factors such as role transition, sleep deprivation, poor support systems, among others, with studies that have shown rates of depressive symptoms up to almost 30% and suicidal ideation of up to 11% in this population (Rotenstein et al., 2016), and given how the learning environments are structured nowadays, medical students tend to neglect their well-being in order to prioritize their academic performance, this despite the efforts of multiple universities around the world. Although universities have implemented various strategies to promote the well-being of their students from different approaches, they have not been able to find a definitive answer to this problem, and even many times are being confronted with the fact that students do not value these strategies as useful for their well-being. 

 

On the other hand, there is compelling evidence that associates elements of well-being not only with better results in physical health, but also mental health, not explained only by the absence of disease, and that these elements of well-being could also be associated with better learning outcomes, higher achievement, and greater labor productivity, possibly through mechanisms such as increased creativity, cognitive flexibility, holistic thinking,resilience, intrinsic motivation among others(Seligman et al., 2009; Diener et al., 2017; Myers and Diener, 2018).

 

In this context, I think the work done by positive psychology in the topic of well-bieng and education stands out. Under the umbrela of positive psychology exists positive education, which is an approach to education that blends academic learning with well-being. Within this approach, many great scientists in fields like psychology and neurosciences, like Martin Seligman, have managed to carry out initiatives worldwide, in countries like United Kingdom, Australia, Mexico and United States of America, both in schools and universities, in order to generate concrete educational programs, with measurable results, on the basis that well-being would have aspects that could be intervened and strengthened. To the moment, interventions have shown that they could prevent adverse results in mental health like depression, at least in young people, and that they can increase good relationships, engagement in learning, cooperation, assertiveness, and self-control, among other qualities that I think can benefit medical students to meet the needs of the modern healthcare, but in spite of that, maybe due to the need of gather more data before include this in medical education to avoid potential harms to students and patients, there is a lack of data related to positive education in medical curriculums across the world. In my opinion, more important than the specific interventions, which still require further studies to ensure their effectiveness, is the contribution that the paradigm of positive psychology offers to medical education in the question: “what is the purpose of the teaching/learning?”. From my point of view, the ultimate answer to this question could be that we learn and teach in order to maximize the happiness or well-being of individuals and eventually of society, being the educational institutions a fundamental place from which this subject can be worked, since they are environments that frequently affect the well-being of students, and since they are the place where students spend most of their time. Although the World Health Organization (WHO) defines health not only as the absence of disease, but as a state of complete physical, mental and social well-being, in my experience from medical education, and particularly in mental health, the time students spend in medical education tends to focuses particularly on disorders and pathologies over well-being. How do we expect that future physicians focus on health when they treat their patients, not only in their ill-being, if we do not teach them about well-being?.

 

Based on all of the above, I believe that incorporating aspects of positive psychology into medical education would not only bring us closer to teaching about health as conceived by the WHO, but it could also be a great opportunity to reduce alarming rates of mental health problems that affects medical students worldwide, improve their well-being, and that could even improve learning outcomes. I believe that more attention should be paid to the advances in this field and the possible contributions that can be delivered to medical education, as they could help us to refocus our teaching practices to the ultimate goal of life, happiness.

Take Home Messages

  • Medical students are a population with high vulnerability to mental disorders
  • Mental disorders can compromise the health of students, influence their learning processes and patient care
  • Not only medical students, but also institutions have a role in student well-being
  • Positive psychology and positive education can improve well-being and learning outcomes in medical students
  • Positive medical education could be an educational approach that improves medical education

Notes On Contributors

Alvaro Tala,  MD, is a Psychiatrist and Assistant Professor in the Psychiatric University Clinic, Faculty of Medicine, University of Chile, Santiago, Chile.

Acknowledgements

The autor alone is responsible for all the content and writing of this article.

Other disclosures: This paper is not under consideration by other journals.

Bibliography/References

Diener, E., Pressman, S.D., Hunter, J., Delgadillo-Chase, D. (2017) ‘If, Why, and When Subjective Well-Being Influences Health, and Future Needed Research’, Applied Psychology: Health and Well-Being. https://doi.org/10.1111/aphw.12090

 

Myers, D. G. and Diener, E. (2018) ‘The Scientific Pursuit of Happiness’, Perspectives on Psychological Science. https://doi.org/10.1177/1745691618765171

 

Rotenstein, L.S., Ramos, M.A., Torre, M., Segal, J.B.,et al.(2016) ‘Prevalence of Depression, Depressive Symptoms, and Suicidal Ideation Among Medical Students’, JAMA. https://doi.org/10.1001/jama.2016.17324

 

Seligman, M. E. P., Ernst, R.M., Gillham. J., Reivich, K.,et al.(2009) ‘Positive education: Positive psychology and classroom interventions’, Oxford Review of Education. https://doi.org/10.1080/03054980902934563

Appendices

None.

Declarations

There are no conflicts of interest.
This has been published under Creative Commons "CC BY-SA 4.0" (https://creativecommons.org/licenses/by-sa/4.0/)

Ethics Statement

An ethics statement is not required as this is a personal view.

External Funding

This paper has not had any External Funding

Reviews

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Meghana Sudhir - (08/08/2018) Panel Member Icon
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I do acknowledge the global issue of stress and burn out and its impact on mental health among medical students. I am unable to relate the title and personal view of the author. Personal view or opinion can be more effectively emphasized with more supportive evidence which is lacking in this paper.
The lengthy sentences and lack of punctuation takes away the essence of the article. I would suggest the importance of proof reading before submitting.

The terms Positive medical education & positive psychology needs more clarity.
Susan Van Schalkwyk - (06/08/2018) Panel Member Icon
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There can be no doubt that the mental health well-being of students in the health professions is a growing source of concern and requires our attention. The author raises a number of important issues in this regard and the recommendation that a more positive and focused approach to teaching would have value is an interesting one. Further exploration of what is meant by this and how it could manifest in a practical way, would enhance understanding. The title is possibly a little too cryptic. The lengthy sentences also detract from the readability of the piece. In addition, providing some indication of the author's own credentials would provide a context within which the recommendations can be considered.
P Ravi Shankar - (03/08/2018) Panel Member Icon
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The title of the paper is interesting. However, I am not sure that the paper fully justifies the title. The author briefly mentions about the importance of positive education in medical schools. One of the challenges for readers like me is that positive education and the topics which should be addressed are not described. I must admit that I am not aware of what exactly is meant by positive education. I would be grateful if the author can explain this in the manuscript. The article can benefit by being more specific and focused on what areas should be covered under positive education. I can sympathize with the author whose first language is not English but the standard of written English could be improved. There are also a few spelling and punctuation errors which can be corrected.
Neslihan Onder-Ozdemir - (28/07/2018) Panel Member Icon
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Dear Alvaro Tala,
Thank you very much for highlighting the ‘significance of neuropsychiatric disorders’ as mental health problems with potentially harmful effects on medical students’ education and patients’ care. Unfortunately, in every stage of education mobbing and bullying are at an alarming stage that are highly likely to bring about devastating effects, including neuropsychiatric disorders. Indeed, fulfilling lives should be on the agenda for the enhancement of medical students’ years in medical education. Indeed, one of your key messages “Positive medical education could be an educational approach that improves medical education” is a concise message.

Below are my basic comments about punctuation you may consider:
In the Abstract, a “dot” is needed for the last sentence: This article addresses a personal view of how this approach can benefit medical students [.]
Please delete the comma after “medical students” in the following sentence:
Not only medical students[,] but also institutions have a role in student well-being
Please delete the “dot” after the question mark in the following sentence:
How do we expect that future physicians focus on health when they treat their patients, not only in their ill-being, if we do not teach them about well-being?[.]

Sateesh Babu Arja - (27/07/2018) Panel Member Icon
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I enjoyed while reading this paper.This is such an interesting topic in the current medical education. Physical and mental well-being of medical students and burnout issues among medical students and residents became hot topics in the medical fraternity. Even recently when I attend the conference of International Association of Medical Sciences Educators (IAMSE), there was a lot of discussion regarding well-being of medical students. It emphasizes the importance of having effective learners support system in all universities. This leaners support systems should be able to provide support in academic and professional development and provide personal support in coping up with the physical and emotional demands of the school. It is good to see authors picked up an important topic. Most of us may like their suggestion to incorporate positive psychology into medical education and curriculum. But I would like to see how this can be incorporated into curriculum. Authors might would like to elaborate on this.