Increasing Medical Student Well-being Through Gratitude Journaling

Randomised Controlled Trial of Gratitude Reporting vs no Intervention on Well-being of Medical Students During Clerkship

Clerkship causes significant stress to medical students. Some interventions to increase well-being have been described but none have been studied prospectively in this context. The primary objective of this study is to examine the effects of gratitude journaling on medical clerks' perceived well-being. Students will be randomised to one of two groups: gratitude journaling or no intervention. The participants of the experimental group will be asked to complete an online gratitude journal 3 times per week and will be compared to the participants in the control group. The students in both groups will answer a standardised questionnaire evaluating well-being before and after their surgical rotation. Those randomised to the intervention group will perform gratitude journaling three times a week during their surgical rotation. This activity consists of writing something that made them feel happy during their day. Those randomised in the control group (no intervention) will proceed with their normal rotation, without additional gratitude journaling. The main outcome will be evaluated by comparing the well-being at the end of the surgical rotation as evaluated by a composite well-being assessment scale between both groups.

Medical education involves 2 years of rotations in different medical and surgical specialties. These cause significant stress to clerks, in particular during the surgery rotation. In other professional fields, mindfulness techniques have shown only small to moderate effect on mental health compared to the control group. An alternative approach to increasing well-being is gratitude journaling. A study examining this approach in student populations demonstrated enhanced well-being and life satisfaction. The primary objective of this study is to examine the effects of gratitude journaling on medical clerks' perceived well-being. Students will be randomised to one of two groups: gratitude journaling or no intervention. The participants of the experimental group will be asked to complete an online gratitude journal 3 times per week and will be compared to the participants in the control group. The students in both groups will answer a standardised questionnaire evaluating well-being before and after their surgical rotation. Those randomised to the intervention group will perform gratitude journaling three times a week during their surgical rotation. This activity consists of writing something that made them feel happy during their day. Those randomised in the control group (no intervention) will proceed with their normal rotation, without additional gratitude journaling. The main outcome will be evaluated by comparing the well-being at the end of the surgical rotation as evaluated by a composite well-being assessment scale between both groups.

Students perform gratitude journaling 3 times per week on a form. This activity consists of writing elements of their day that brought happiness to them. Can be in keyword form or in sentences.

Medical student well-being at the end of their surgical rotation. Measured by Perceived Stress Scale (Cohen, 1983)

Medical student well-being at the end of their surgical rotation. Measured by Satisfaction with Life Scale (Diener, 1985)

Before and after comparison of well-being by comparing initial and post-intervention questionnaires (Perceived Stress Scale (Cohen, 1983))

Inclusion Criteria: Medical students at the University of Montreal about to begin their surgical clerkship rotation. Exclusion Criteria: -

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Pettitt BJ. Medical student concerns and fears before their third-year surgical clerkship. Am J Surg. 2005 Apr;189(4):492-6. doi: 10.1016/j.amjsurg.2004.09.017.

Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96. No abstract available.

Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. J Pers Assess. 1985 Feb;49(1):71-5. doi: 10.1207/s15327752jpa4901_13.