Medical Student Research Forum Posters

Background: Stressors, both inherent to training and stemming from the learning environment, have left many health professions students (HPS) struggling with high rates of burnout, depression, and academic difficulties. Besides being problematic for HPS themselves, these problems have also been shown to affect patient outcomes. In light of these findings, psychological resilience is gaining traction as a promising area of intervention to counter those problems in health professional schools. To address gaps in the literature, the authors propose a multidimensional model of the social determinants of resilience in HPS that includes drivers and their relationship to adverse mental health and academic outcomes.

Methods: The authors assessed the current literature for theories, interventions, and empirical evidence related to resilience and its associated variables in health professional students, distilling key drivers into a model inspired by the social determinants of health.

Results: The drivers of resilience were conceptualized into two main categories. Upstream drivers represent distal social determinants such as socioeconomic background, race/ethnicity, and adverse childhood experiences (ACEs). Downstream drivers represent modifiable postmatriculation variables that may be associated with resilience. Downstream drivers can be further grouped into structural, interpersonal, and intrapersonal. Upstream drivers impact resilience, mental health, and academic outcomes directly, with some of these effects mediated by intrapersonal downstream drivers, such as self-compassion and physical activity. Other upstream effects may be moderated by structural and interpersonal drivers, such as learning environment and sense of belonging.

Conclusion: Resilience in HPS is a complex construct influenced by determinants at all levels of the psychosocial spectrum. However, most resilience-based interventions have focused only on augmenting intrapersonal drivers (e.g., mindfulness). The current model offers a more extensive interpretation of resilience in HPS, taking student background and social environment into consideration. The authors plan to test this model, creating a guide for future interventional and empirical resilience investigations.