Determinants of authentic responses to medical student wellbeing surveys: An interpretive description study

Medical students develop higher rates of depression and burnout relative to similarly aged university graduates, suggesting that the medical school journey contributes to adverse mental health. Medical students prefer self-report surveys to characterize their wellbeing; however, enlisting authentic responses can be challenging. Our study sought to identify factors that impact medical student engagement and honesty when completing wellbeing surveys.

From June 2023 to September 2023, we conducted semi-structured interviews with 20 medical students at the University of Alberta, Canada. Using an interpretive descriptive approach, transcripts were coded by two independent researchers who met with a third to create and refine the codebook. Data collection and analysis occurred concurrently in an iterative fashion, guided by theoretical sampling until thematic saturation was reached.

We identified that psychological safety of the learning environment underpins student engagement with wellbeing surveys, irrespective of other factors. Perceived agency, connection, and impact are other key factors that promote students' willingness to complete a wellbeing survey. Furthermore, mitigating administrative burden and fear of repercussions is critical to ensure authentic engagement.

Creating psychologically safe environments and engaging student partners is key to promoting authentic engagement with wellbeing surveys. Ongoing stigma in the culture of medicine creates fear of repercussions among students. National organizations are often seen as too distanced to have an impact. Empowering trusted partners such as wellbeing offices can therefore help ensure a sense of safety, connection, and impact.