Mattering (and Not Mattering) in the Clinical Learning Environment: The Medical Student Perspective

Background Mattering, defined as making a difference in the world and being significant to others, fosters well-being in higher education students and workplaces globally. Medical students experience depression, burnout, and stress injury during their education, yet creating cultures of mattering in academic healthcare could have a positive impact on student well-being. Little is known, however, about how medical students perceive mattering in the clinical learning environment. Objective This study aims to gain an understanding of what specifically contributes to a sense of mattering and not mattering among medical students in the clinical learning environment (CLE). Methods This was a qualitative study involving thirty-three U.S. medical students at two geographically distinct institutions. Data was collected from semi-structured interviews to explore students’ sense of mattering and not mattering in their clinical training. Prilleltensky’s mattering and Flett’s anti-mattering conceptual frameworks provided the theoretical foundation for the study and initial themes for analysis. Thematic analysis continued until no new themes emerged. Results Eight themes were identified that described contributing factors to student mattering, not mattering, and anti-mattering. In the CLE, students feel they add value when they are contributing to the medical team and serving a meaningful role with patients and families. They feel valued when they are verbally validated, seen as a unique individual, treated with respect, and cared for by others. They also feel they matter when they are learning and when others are invested in their learning. Students sense they do not matter when they are unable to meaningfully contribute to the medical team and when they are ignored or hindered in their learning. Conclusions Mattering provides a new lens to examine the CLE while generating potential actionable solutions for improving student well-being. Educators and clinical supervisors can attend to medical student mattering in a variety of straightforward and easy to implement strategies. Trial Registration Not applicable.