ACT for Patient Care: Effects of Psychological Flexibility and Implicit Bias on Medical Student Clinical Engagement and Academic Performance

Medical schools are required to teach burnout management, implicit bias management, and patient-centered care (PCC). Acceptance and Commitment Training (ACT) is an empirical approach to increase psychological flexibility (PF). Increases in PF have been correlated with reductions in burnout, improvements in managing biases, and improvements in academic performance. However, less is known about relationships between ACT, PF, implicit bias, PCC, and academic performance. The purpose of this study was to examine relationships between these variables with two cohorts of medical students. Cohort One (n = 43) were exposed to ACT one time and Cohort Two (n = 48) were exposed to ACT twice. All participated in an Objective Structured Clinical Exam (OSCE) with a Standardized Patient (SP) during their third-year OB/GYN clerkship rotation and completed standardized medical knowledge competency exams. Independent samples t-tests between cohorts were conducted as well as multiple linear regressions. Results found Cohort Two (those with more ACT exposure) significantly cut-off the SP at a lower frequency than Cohort One. Participants with more clinical experience had higher performance scores for clinical engagement, asked less questions, and had less echoics. Positive implicit weight bias predicted a higher rate of echoics while implicit biases related to less burnout predicted a lower rate of echoics. Less PF was correlated with lower standardized exam scores. ACT and objective behavioral measurement may be promising technologies for medical educators to incorporate for teaching burnout management, implicit bias management, PCC skills, and ways to improve academic performance.

Level thesis:degree_level

Doctorate Degree

Year dc:date.issued

2023

Author dc:creator

• Szarko, Alison J.

Advisor dc:contributor.advisor

• Houmanfar, Ramona A.

Committee members dc:contributor.committeemember

• Hayes, Steven C.
• Lewon, Matthew
• Piasecki, Melissa
• Etezadi-Amoli, Neda
• Baker, Timothy K.

• Acceptance and Commitment Training
• Clinical Engagement
• Implicit Bias
• Medical Education
• Patient-Centered Care
• Psychological Flexibility

Handle dc:identifier.uri

http://hdl.handle.net/11714/10830

OAI identifier oai:identifier

oai:scholarwolf.unr.edu:11714/10830