Efficacy of a brief screening tool to identify medical students in distress

Acad Med. 2011 Jul;86(7):907-14. doi: 10.1097/ACM.0b013e31821da615.


Purpose: To determine whether the Medical Student Well-Being Index (MSWBI) can serve as a brief assessment tool to identify medical students in severe psychological distress.

Method: The authors used data from 2,248 medical students at seven U.S. medical schools who responded to a 2007 survey to explore the accuracy of the MSWBI in identifying medical students with three outcomes: low mental quality of life (QOL; defined by having a Medical Outcomes Study Short-Form Health Survey mental component summary score ≥1/2 standard deviation below that of the age- and gender-matched population norm), suicidal ideation, or serious thoughts of dropping out. The authors confirmed their analyses using data from a separate sample of 2,682 students evaluated in 2009.

Results: Students with low mental QOL, suicidal ideation, or serious thoughts of dropping out were more likely to endorse each individual MSWBI item and a greater number of total items than were students without such distress (all P < .001). The likelihood ratio for low mental QOL among students with MSWBI scores <4 was 0.47 as compared with 4.79 for those with scores ≥4. At an MSWBI threshold score of ≥4, the MSWBI's sensitivity and specificity for identifying students with low mental QOL or recent suicidal ideation/serious thoughts of dropping out were both ≥90%. On multivariable logistic regression, all MSWBI items were independently associated with at least one outcome.

Conclusions: The MSWBI is a useful brief screening tool to help identify students with severe distress.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Cohort Studies
  • Depression / diagnosis
  • Depression / epidemiology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Self-Assessment*
  • Sensitivity and Specificity
  • Stress, Psychological / diagnosis*
  • Stress, Psychological / epidemiology
  • Students, Medical / psychology*
  • Suicidal Ideation
  • Surveys and Questionnaires / standards*
  • United States / epidemiology