METHOD

• Conducted from April 2009 – September 2009

• 24 allopathic, osteopathic and naturopathic medical students and 1 premedical

student accepted on rolling basis. All students who applied were accepted.

• The program was loosely based on the concept of the Mastermind as described in

the book Think and Grow Rich by the author Napoleon Hill.

• Program

• Skills sessions (recorded webinars) (Fig. 1)

• Led by physician and non-physician experts in various student and

resident wellness, counseling and group facilitation

• Primarily knowledge-based

• Group sessions (moderated support group meetings over conference calls)

• Measures taken to improve communication and group cohesiveness (Fig

2)

• 3 groups (Monday, Tuesday and Wednesday) led by medical students or

assigned moderator, whichever was available.

• Format followed the moderator guide, which was developed with the help

of the NJ Self Help Group Clearing-house guidelines for communication. 5

• Each session started with discussion of one hurdle encountered and

one good thing that happened during the previous week.

• Students took turns speaking about thoughts they may have had

regarding roses and thorns or previous skills session

• Some groups had students present regarding a wellness topic

• Students took on wellness related goals to work toward till the next call.

• Extensive measures were taken to ensure confidentiality (Fig. 3)

• Technology used (Table 1)

Describe the piloting of an online, long-distance support program for medical students

that aimed to fill the gaps of accessibility and confidentiality that may exist within medical

school support services, with the additional aim of providing community and education in

counseling and group facilitation skills.

OBJECTIVE

BACKGROUND

CHALLENGES

AMSA Mastermind Program:

A Confidential, Long-Distance Approach to Student Wellness Deepa Sannidhi MSIII (UMDNJ – New Jersey Medical School), Katherine Ellington MS II (St. Georges University, St. Georges Grenada) ,Rebecca Sadun MD (PGY1) (Duke University –

Residency in Medicine and Pediatrics) , Joanne McMullen MBA, Wheaton Wood, MD, JD, Daniel Williams, MD

CONCLUSIONS & FUTURE STEPS

ACKNOWLEDGEMENTS

• Rates of burn-out and suicidal ideation amongst physicians and physicians in

training are as high as 30%.1 Medical school can be a lonely experience for many

students. 4

• It is known that physicians who take care of themselves are more able to counsel

their patients on life-style change. 2

• While LCME requires medical schools to provide timely access to medical and

mental health services at reasonable proximity to their home institution, these may

still vary in quality, accessibility and confidentiality. 3

• Counseling skills are a required skill-set for competent physicians engaging in direct

patient care. While these are taught at medical schools, the quality of teaching

varies.

• AMSA Mastermind Program was created in 2008-09 to fill gaps in accessibility and

confidentiality of student support services for future physicians, provide education in

counseling and group facilitation, and provide community for participants.

REFERENCES

Figure 1: Topics Covered in Skills Sessions

• Group Facilitation – Barbara White

• Preventing Suicide and Preventing Addiction –

Joanne McMullen and Wheaton Wood

• How to get the most out of a Mastermind – Jane

Pollak

• Active Listening – Barbara White

• Mindfulness-based stress-reduction and burn-out

prevention – John Schorling MD,

• Financial Management – Leon Johnson

• Writing to Heal – James Pennebaker MD

• The Mindful Medical Student – Jeremy Spiegel MD

• Emotional Intelligence – Katherine Chretien MD

• Time-management – Juggling the circus of medicine

and life – Linda Hawes Clever, MD, MACP

• Center for Mind-Body Medicine – James Gordon MD

• The major challenge the program faced was attrition from participants and

facilitators.

• Changes in facilitators, problems with technology, and time commitment were the

major reasons why some students did not attend sessions. One student left the

program due to a disagreement related to confidentiality issues.

• Implementing a program with multiple medical students in time intensive

leadership positions proved to be difficult. One student facilitator and skills session

facilitator left due to personal health issues.

• Despite the conference call format, participants experienced the power of

connection and community, making meaning of their experiences and finding

empowering solutions to the complexity of challenges faced during medical school

in preclinical and clinical training.

• In particular, second year students studying for USMLE Step 1 as well as students

who were taking a year off of medical school for introspection professed gaining

the most benefit. Coming back to the group allowed time for reflection and

introspection. Students professed feeling less alone in their struggle when other

students divulged their vulnerabilities.

• Future Plans

• Pre- and post- evaluations of participants’ knowledge, skill-set and burn-out.

• To remedy attrition, suggest making program of shorter time interval to

accommodate medical students’ changing schedule. To allow for better

attendance, finalize and disclose schedule of webinars and group meetings

earlier.

• Finalize faculty moderators who will be experienced, and better able to tolerate

time demands placed upon them by group facilitation.

• Make clear before each meeting that presenters and participants are not to

ask participants where they are from as an ice-breaker. Make clear that

participants are under no obligation to disclose where they are from.

1. Thompson, D., D. Goebert, and J. Takeshita, A program for reducing depressive symptoms and suicidal

ideation in medical students. Acad Med, 2010. 85(10): p. 1635-9.

2. Abramson, S., et al., Personal exercise habits and counseling practices of primary care physicians: a

national survey. Clin J Sport Med, 2000. 10(1): p. 40-8.

3. Liaison Committee on Medical Education, Functions and Structure of a Medical School: Standards for

Accreditation of Medical Education Programs Leading to the M.D. Degree. Washington DC. 2010.

4. Hoferek, M., Feelings of loneliness in women medical students. Journal of Medical Education, 1981

56(5): p. 397-403.

5. Roe, G., Suggested Guidelines for Communication During Meetings, NJ Self Help Group Clearinghouse:

Cedar Knolls.

6. Self-Help Resource Centre, Resources on Confidentiality for Self-Help/Mutual Aid Support Groups .

Toronto. 2003.

• American Medical Student Association leadership and staff

• Alison Hwong for her suggestion of “Roses and Thorns” as well as her role in

reviewing the numerous documents created for the project.

• Barbara White and the NJ Support Group Clearing house for providing free training

and resources to the Mastermind program moderators and participants.

• Mastermind Program participants for their enthusiasm and encouragement

Figure 2: Measures taken to increase fluency of

communication during conference calls

• Moderator guide – specified a format for

students leading groups

• Roses and Thorns – Each participant states one

good thing and one hurdle they faced each week

at the beginning of each session

• Introductory meeting – students were invited to

send a picture of themselves or of an object that

they felt represented them. This ice-breaker

helped students to bond.

• Institution of phone protocol:

• All participants state name before speaking

• Leader of conference call specifies a

sequence of people to speak in order to

eliminate cross-talk

Purpose Program Cost Pros Cons

Course website Amsa.org Free Good recruitment tool

Gave thorough explanation of the program.

No forum or other communication

medium available.

No method of storing documents.

Web-conferencing platform

(webinar)

webex.com $$ Hosted all large groups

Chat and video available

Some technical difficulties

Difficulty recording webinars, lack of

familiarity with format for

participants and presenters

Small groups cannot run simultaneously

Web-conferencing platform

(desktop sharing software)

Mikogo.com Free Hosted small groups

Very good for introductory meeting as presenter

was able to use pictures.

Unable to record audio.

Learning curve made it less appealing to

participants leading small groups.

Phone-conferencing platform Calliflower.com Free Used for small groups

Easy to use

Able to record

Automated reminders

No video or chat

E-mail Gmail.com Free Primary mode of communicating reminders,

schedule and preparatory materials

Privacy was not an issue when sending e-mail

via bcc option.

•No central file-storage available

Web-conferencing platform

(desktop sharing software)

GoToMeeting.com $$ Experienced moderator overcame learning

curve for group

Hosted one small group

Chat, video, and recording available

Saves recording locally

•Small groups cannot run simultaneously

Table 1: Technology use in AMSA Mastermind Program

Figure 3: Measures Taken To Ensure Confidentiality

•Confidentiality agreement and informed consent:

•Created with assistance of NJSelf Help clearing house and Ontario Self Help Resource Centre materials. 6

•Signed before beginning the program.

• Discussed during the introductory meeting with each individual group.

• Exceptions to confidentiality were discussed (if a child is/may be in need of protection, or if someone

declares a plan to harm himself or another adult.

• Students were advised not to divulge identifying information about other students.

•Students participated in a “confidentiality exercise” from confidentiality resource kit by the Ontario Self Help

Resource Centre.