Effects of Voluntary Attendance Patterns on First Year Medical Students’ Wellness During COVID‐19

Salzman, Joshua; Williamson, Macy; Epsina‐Rey, Andrea; Kibble, Jonathan; Kauffman, Christine

The COVID‐19 pandemic interrupted all in person activities at the UCF College of Medicine (CoM) M.D. program in March 2020. For the remainder of the academic year, all students were required to adopt to a new learning environment where all aspects of the M.D. program were delivered in an online platform. An ongoing study was taking place to evaluate how voluntary attendance at non‐mandatory sessions affected performance and wellness. The students in this study who had been attending non mandatory in‐person sessions were now only given the option of watching pre‐recorded sessions online. The study investigators hypothesized that this change would affect the wellness of the students who were attenders prior to the pandemic more so than then non‐attenders. This was an observational cohort study in which prospectively collected attendance at non‐mandatory sessions during the first year of the MD program was correlated with responses to a wellness survey deployed pre‐ and post‐ the onset of the pandemic. The 69‐item survey was adapted from published and validated instruments: Graduate Stress Inventory – Revised (GSI‐R), Modified School Burnout Inventory, “Healthy Days Measure” (CDC HRQOL‐4), Pearlin Mastery Scale (Mastery), Multidimensional Scale of Perceived Social Support (MSPSS), De Jong Gierveld 6‐Item Loneliness Scale and Lubben Social Network Scale – 6 item (LSNS‐6). Multiple regression and Poisson regression analysis was performed as appropriate to predict participants wellness based upon attendance while controlling for collected demographics. Eighty‐two students participated in the larger study and of those, 44 responded to the pre‐pandemic survey. Attendance was associated with lower stress overall as measured by the GSI (β= ‐0.331, p= 0.048, R(2)= 0.217) including lower scores in the Family Stress subscale (B= ‐0.01, p= <0.001). Loneliness also decreased with increasing attendance (B= ‐0.015, p= 0.008). Increase in attendance was associated with fewer days unable to do normal activities due to poor physical or mental health, as measured by the CDC HRQOL‐4 (β= ‐0.339, p= 0.043, R(2)= 0.216). Thirty‐nine students participated in the post‐pandemic survey, where again attendance was associated with lower stress according to the GSI (β= ‐0.482, p= 0.029, R(2)= 0.203). Thirty‐one students completed both surveys for paired analysis. Increase in attendance before COVID‐19 was associated with a decrease in poor mental health afterwards as measured by the CDC HRQOL‐4 (B= ‐0.007, p= 0.004). The rest of the regressions did not demonstrate an association between attendance and other aspects of wellness pre‐ or post‐ the pandemic. Attending non‐mandatory sessions was associated with a decrease in graduate stress both pre and post COVID‐19 lockdown. Most other results were not statistically significant, elucidating that there may be no major differences between attender's and non‐attender's experience of burnout or social isolation.