Online programs to strengthen mental health in medical students: a literature review (Preprint)

BACKGROUND Medical students are at an increasing risk of depression and burnout during their study period. This trend among future physicians is a cause for concern, given the great responsibility that the medical profession entails. Medical faculties therefore play a significant role in supporting medical students in maintaining their mental health. Especially in the context of the current COVID-19 pandemic, support services that allow greater flexibility in their use become particularly relevant. Online programs can be accessed from anywhere and any time and can be used individually in a safe or well-known setting. From a preventive perspective, individual characteristics that have been shown to be protective of mental health should be addressed in such programs. Before conceptualizing an online program, reviewing existing online programs for medical students is a first relevant step. OBJECTIVE This review provides an overview of the current online programs for medical students to strengthen their mental health by addressing individual characteristics believed to be protective of mental health and addressable in medical curricula. METHODS PubMed, ERIC, Cochrane, and Web of Science were used for a systematic literature search. The programs had to be offered digitally and address medical students. Preventive individual characteristics for mental health were included in the search to provide information on their role in the studies. Publications also should include information on the effectiveness of the respective programs. RESULTS The literature search yielded 592 articles; of them, only nine met the study criteria. The programs found included elements of cognitive-behavioral therapy, mindfulness training, or peer support. Regarding the mental health outcomes, two studies showed a significant reduction in perceived stress and one study indicated a reduced level of burnout. One program had significant immediate effects on mindfulness, empathy, and resilience; two studies indicated strengthening coping strategies. Two programs were qualitatively assessed as helpful. One study is still ongoing. CONCLUSIONS Only a few studies have assessed the effectiveness of online programs to strengthen medical students’ mental health. The programs found mostly addressed preventive individual characteristics but were not developed on the basis of a survey of medical students’ demands. Furthermore, they were provided as add-on programs; integration of such programs into the curriculum may highlight the relevance of mental health. For the development of future online programs, the concrete needs of the respective target group should be surveyed and taken into account. Based on this, suitable online programs can be developed in a targeted way to strengthen mental health by addressing preventive individual characteristics. This needs-based prevention approach can support health-promoting education of future physicians.