Student Perceptions of a Reflective Writing-based Wellness Course: "Good in Theory, But..."

To offset disconcerting trends showing alarming rates of burnout and other types of psychological distress among medical students, many medical schools have implemented wellness initiatives for first year students as they are first adjusting to the rigors of medical school. This study examines students' attitudes toward a reflective writing-based wellness course. We conducted a thematic analysis of 97 writings that students wrote in response to a prompt asking them what they thought of the wellness course at an American Midwestern medical school. The most consistent perception that students expressed was that while they were deeply appreciative of the effort to integrate wellness into the curriculum (what we call Good in Theory…), they did not think it was implemented efficaciously and even, in some cases, felt that the wellness course contributed to their distress rather than alleviated it (what we call …But…). Specifically, while the wellness course helped them prioritize wellness and fostered connection between fellow medical students, it also conflicted with their individualized notions of health and was a burden on their limited time. We discuss the findings in the context of their implications for medical education and argue that the implicit messages students internalized from the mere existence of a wellness program-that the university/faculty cares about them, they do not need to feel guilt when taking a break from medicine, they are not alone, and it is acceptable to express emotions-are all important for their professional socialization and personal well-being.