Individual values, the social determinants of health, and flourishing among medical, physician assistant, and nurse practitioner students

PLoS One. 2024 Sep 27;19(9):e0308884. doi: 10.1371/journal.pone.0308884. eCollection 2024.

Abstract

The purpose of this study is to explore how demographics and individual values, qualities, and personality traits are associated with perceptions of flourishing among medical (MD), physician assistant (PA), and nurse practitioner (NP) students. Current MD, PA, and NP students from two academic medical centers were recruited to participate in this cross-sectional study between August 6 and October 9, 2023. Participants completed the Secure Flourish Index (traditional SFI) and then applied a percentage weight to each of the six flourishing domains based on perceived relative importance to their overall flourishing. Additional survey questions included demographics and multiple validated instruments: WellRx, 2 Question Maslach Burnout Inventory, Brief COPE Inventory, the Short Grit Scale, and Duke University Religion Index. Descriptive statistics, ANOVA, correlation, and regression analyses were performed with an alpha of 0.05. A total of 393 of 1820 eligible students began the survey (21.6%) while 280, (15.4%) were included in the analysis. Traditional SFI scores were higher with higher grit (r = .368, p < .001). Traditional SFI scores were lower with higher WellRx (r = -.336, p < .001), burnout (r = -.466, p < .001), or avoidant (r = -.453, p < .001) coping style. Scores were about 10 points lower for students who had considered leaving training in the past 6 months (M = 75.3, SD = 16.2) than those who had not (M = 85.6, SD = 14.4; p < .001). The SFI domain of physical and mental health had the highest relative percentage weight (20.2% (SD 8.4)) but was second to lowest in mean domain flourishing score (mean 6.5, SD 1.7). While participants placed high value on physical and mental health, they reported relatively low flourishing in this area. Targeted interventions to improve the ability for students to cope with the hardships of training and life, as well as supports structured to address the social and structural determinants of health may improve flourishing among students with similar values.

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Nurse Practitioners* / education
  • Nurse Practitioners* / psychology
  • Physician Assistants* / education
  • Physician Assistants* / psychology
  • Social Determinants of Health*
  • Students, Medical / psychology
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

SN: This project was funded in part by a grant award from the Physician Assistant Education Association, Washington, DC. Funding of this project does not necessarily constitute an endorsement of the findings of this research report by the PA Education Association. https://paeaonline.org/our-work/research-data-and-support/don-pedersen-research-grants-program SN: Additional funding was provided in part by the Yale University General Internal Medicine Educational Research Grant. https://medicine.yale.edu/internal-medicine/ SN: Additional funding was provided by the PA Foundation Breitman-Dorn Research Fellowship. https://pa-foundation.org/scholarships-fellowships/breitman-dorn-fellowship/ Medical University of South Carolina technology support: This project was also supported, in part, by the National Center for Advancing Translational Sciences of the National Institutes of Health under Grant Number UL1 TR001450. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. No funders were involved in the study design data collection or analysis, decision to publish, or the preparation of the manuscript.