Medical students in distress: a mixed methods approach to understanding the impact of debt on well-being

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Publicado en:BMC Medical Education vol. 24 (2024), p. 1
Autor principal: Yang, Adrienne
Otros Autores: Langness, Simone, Chehab, Lara, Rajapuram, Nikhil, Zhang, Li, Sammann, Amanda
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Springer Nature B.V.
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022 |a 1472-6920 
024 7 |a 10.1186/s12909-024-05927-9  |2 doi 
035 |a 3102481444 
045 2 |b d20240101  |b d20241231 
084 |a 58506  |2 nlm 
100 1 |a Yang, Adrienne 
245 1 |a Medical students in distress: a mixed methods approach to understanding the impact of debt on well-being 
260 |b Springer Nature B.V.  |c 2024 
513 |a Journal Article 
520 3 |a BackgroundNearly three in four U.S. medical students graduate with debt in six-figure dollar amounts which impairs students emotionally and academically and impacts their career choices and lives long after graduation. Schools have yet to develop systems-level solutions to address the impact of debt on students’ well-being. The objectives of this study were to identify students at highest risk for debt-related stress, define the impact on medical students’ well-being, and to identify opportunities for intervention.MethodsThis was a mixed methods, cross-sectional study that used quantitative survey analysis and human-centered design (HCD). We performed a secondary analysis on a national multi-institutional survey on medical student wellbeing, including univariate and multivariate logistic regression, a comparison of logistic regression models with interaction terms, and analysis of free text responses. We also conducted semi-structured interviews with a sample of medical student respondents and non-student stakeholders to develop insights and design opportunities.ResultsIndependent risk factors for high debt-related stress included pre-clinical year (OR 1.75), underrepresented minority (OR 1.40), debt $20–100 K (OR 4.85), debt >$100K (OR 13.22), private school (OR 1.45), West Coast region (OR 1.57), and consideration of a leave of absence for wellbeing (OR 1.48). Mental health resource utilization (p = 0.968) and counselors (p = 0.640) were not protective factors against debt-related stress. HCD analysis produced 6 key insights providing additional context to the quantitative findings, and associated opportunities for intervention.ConclusionsWe used an innovative combination of quantitative survey analysis and in-depth HCD exploration to develop a multi-dimensional understanding of debt-related stress among medical students. This approach allowed us to identify significant risk factors impacting medical students experiencing debt-related stress, while providing context through stakeholder voices to identify opportunities for system-level solutions. 
651 4 |a United States--US 
653 |a Mixed methods research 
653 |a Medical education 
653 |a Mindfulness 
653 |a Tuition 
653 |a Likert scale 
653 |a Medical students 
653 |a Medical schools 
653 |a Student loans 
653 |a Stress 
653 |a Debt restructuring 
653 |a Variables 
653 |a Mental health 
653 |a Well being 
653 |a Physicians 
653 |a Economic Factors 
653 |a Self Efficacy 
653 |a Likert Scales 
653 |a Academic Achievement 
653 |a Meetings 
653 |a Interviews 
653 |a Debt (Financial) 
653 |a Licensing Examinations (Professions) 
653 |a Competition 
653 |a Feedback (Response) 
653 |a Student Surveys 
653 |a Alaska Natives 
653 |a Data Analysis 
653 |a Private Schools 
653 |a Validated Programs 
700 1 |a Langness, Simone 
700 1 |a Chehab, Lara 
700 1 |a Rajapuram, Nikhil 
700 1 |a Zhang, Li 
700 1 |a Sammann, Amanda 
773 0 |t BMC Medical Education  |g vol. 24 (2024), p. 1 
786 0 |d ProQuest  |t Healthcare Administration Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3102481444/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3102481444/fulltext/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3102481444/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch