Learning mindset may be key to addressing alarming medical student burnout

Overall, Matthew Barnett’s medical school experience has been great, but the fourth-year medical student at A.T. Still University Kirksville School of Osteopathic Medicine knows his experience may not be the same for all medical students.

“We recognize that this can be extremely challenging for classmates with different learning styles, support systems and backgrounds,” Burnett said, “and this is true regardless of their desire to help others, career interests or ability to succeed in medicine.”

Barnett is part of a larger study aimed at improving medical student happiness, led by Yoi Tibbets, a research assistant professor in the University of Virginia School of Education and Human Development and director of research at the Motivate Lab.

Tibbetts, who studies motivation and achievement in higher education, shifted his research focus to medical students after a colleague at the American Association of Osteopathic Medical Colleges shared the plight of medical students and physicians.

“I was seeing disturbing trends that burnout and other mental health conditions were far more prevalent among physicians than the general population,” Tibbetts said, “so my colleagues and I put our heads together to think about how we could support the physician workforce.”

Data collected and reviewed by Tibbetts’ team found that 29% of students reported moderate to severe burnout during their first semester of their first year of osteopathic medical school. By the time they graduated, that number had risen to nearly two-thirds.

Of the students who reported burnout, 68% also said they had moderate to severe psychological symptoms related to a mental illness. These students were studying to become osteopaths or DOs, but Tibbetts believes the trend is similar for students pursuing allopathic or MD degrees.

“What’s going on when medical school burnout rates more than double from admission to graduation? That’s the problem we’re trying to solve.”

Measuring learning mindset

Through their work with undergraduate students, Tibbetts and her colleagues at the Motivate Lab have shown that elements of a learning mindset, such as a growth mindset, a sense of purpose and relatedness, and a sense of belonging, are related to academic achievement and students’ sense of well-being.

“We know that through interventions and changes to the educational environment, we can improve mindsets about learning,” Tibbetts says. “We can help students feel more included or better understand the purpose and relevance of what they’re studying.”

Tibbetts and her colleagues wanted to know whether what was true for undergraduates also applied to medical students, so they surveyed 6,622 students from across the country.

The results, published in JAMA Network Open in June, were clear.

Students with a growth mindset showed greater growth: greater resilience, purpose, and connectedness reduced burnout and psychological symptoms.

“The less certain students are about their belonging, the more exhausted they are and the more psychological symptoms they report,” Tibbetts says. “So the question about belonging is more like, ‘Hey, have you ever wondered if you don’t belong?'”

Tibbetts looked at research on students from historically marginalized communities, such as first-generation students and students of color, and the data showed their experiences in medical school were different.

“Our data show that students from historically marginalized communities report higher growth mindsets, greater sense of purpose and relatedness, less uncertainty about their sense of belonging, somewhat greater feelings of thriving and resilience, and lower levels of burnout and psychological symptoms,” Tibbetts said. “Furthermore, our research shows that while supporting learning mindsets is beneficial for all students on average, it is particularly effective in supporting the well-being of (osteopathic medicine) students from historically underserved backgrounds.”

Research has shown that students from historically marginalized environments outperform their peers in non-cognitive skills.

“They’re clearly not coming into these areas with a deficit, as is often the case,” Tibbetts said. “They’re coming in with a lot of assets that we can further develop.”

Increased sense of well-being

Researchers are now testing ways to make educational environments more supportive.

“We think that by changing the learning environment to be more motivating and supportive, we can help move student well-being and unwell-being outcomes in the right direction,” Tibbetts said.

The team is currently implementing an intervention program to train 150 faculty members at the School of Osteopathic Medicine, who will serve approximately 17,400 students this year, on how to create learning environments that support students’ growth mindsets and a sense of purpose, relatedness, and belonging.

“We’re certainly not going to solve this problem by targeting individual students,” Tibbetts said. “We need to target the whole system.”