Impact of the COVID-19 Pandemic on the Psychological Distress of Medical Students in Japan: Cross-sectional Survey Study

  1. Yoshito Nishimura
  2. Kanako Ochi
  3. Kazuki Tokumasu
  4. Mikako Obika
  5. Hideharu Hagiya
  6. Hitomi Kataoka
  7. Fumio Otsuka

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Abstract

The COVID-19 pandemic has negatively affected medical education. However, little data are available about medical students’ distress during the pandemic.

Objective

This study aimed to provide details on how medical students have been affected by the pandemic.

Methods

A cross-sectional study was conducted. A total of 717 medical students participated in the web-based survey. The survey included questions about how the participants’ mental status had changed from before to after the Japanese nationwide state of emergency (SOE).

Results

Out of 717 medical students, 473 (66.0%) participated in the study. In total, 29.8% (141/473) of the students reported concerns about the shift toward online education, mostly because they thought online education would be ineffective compared with in-person learning. The participants’ subjective mental health status significantly worsened after the SOE was lifted (P<.001). Those who had concerns about a shift toward online education had higher odds of having generalized anxiety and being depressed (odds ratio [OR] 1.97, 95% CI 1.19-3.28) as did those who said they would request food aid (OR 1.99, 95% CI 1.16-3.44) and mental health care resources (OR 3.56, 95% CI 2.07-6.15).

Conclusions

Given our findings, the sudden shift to online education might have overwhelmed medical students. Thus, we recommend that educators inform learners that online learning is not inferior to in-person learning, which could attenuate potential depression and anxiety.

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  1. ScreenIT

    SciScore for 10.1101/2020.10.22.20216572: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: The participants’ consent was implied by their completion of the survey.
    IRB: Ethical approval: This study protocol was approved by the institutional review board of Okayama University Hospital (reference number 2006-029, approved on June 5, 2020).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Measurements: Statistical analysis: We analyzed the data using JMP version 13.1.0 (SAS Institute Inc.
    SAS Institute
    suggested: (Statistical Analysis System, RRID:SCR_008567)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Several limitations to this study should be noted. First, due to the single-center cross-sectional survey design, we may not conclude causal relationships. Second, the cross-sectional research contains a limitation in terms of addressing changes over time. While we illustrated the changes in students’ average time spent on self-learning related activities before and after the SOE in Table 3, a longitudinal study design would be more appropriate to examine the differences in the study cohort. Third, we asked participants to provide their mental health status and time spent on self-learning related activities before the SOE (approximately six weeks before the survey implementation), both of which are subject to recall bias. Also, PHQ-9 and GAD-7 scores were obtained only after the SOE. Thus, it is possible that they might have not changed during the period. Lastly, due to the nature of the survey topic, those who were interested in the public health emergency or mental health may have been more likely to respond, which would lead to self-selection bias. Despite these limitations, a total population sampling strategy coupled with higher-than-usual response rates(25) contributed to high internal validity. In conclusion, through the study, we have provided graphical data and evidence regarding the socio-educational impacts of the COVID-19 pandemic on medical students. In circumstances of considerable uncertainty, both educators and medical students need to be flexible, patient, an...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  2. Version published to 10.2196/25232
  3. Version published to 10.2196/preprints.25232
  4. Version published to 10.1101/2020.10.22.20216572v1 on medRxiv