Introduction:
Modern educational literature confirms that the quality of learning is not only determined by the content of the knowledge presented, but also essentially shaped through the characteristics of the educational environment in which this learning occurs. Multiple studies in medical education have shown that the educational environment is a crucial factor in determining the level of academic achievement, psychological well-being, and the formation of professional identity among medical students.
In the context of medical education specifically, the significance of the educational environment is magnified due to the nature of the specialty that combines cognitive complexity, psychological stress, and ethical responsibility. Recent reports from the World Health Organization (WHO) and the Association of American Medical Colleges (AAMC) indicate high rates of anxiety, depression, and burnout among medical students globally, negatively impacting their academic performance and the quality of their future professional practice.
Therefore, the development of the psychological environment in medical colleges in Jordan represents a strategic necessity, not only to improve the quality of education but also to ensure the preparation of doctors who possess scientific competence, psychological balance, and the ability to provide humane and safe healthcare (Dunn & Burnett, 1995؛ Genn, 2001).
Conceptual Framework for the Psychological Environment in Medical Education:
The medical educational environment is defined as "the set of physical, psychological, and social conditions that surround the learning process and affect it" (Genn, 2001). This environment includes multiple dimensions, among them the relationship between the student and the professor, classroom interaction patterns, assessment methods, institutional culture, and the level of psychological support available.
Studies using the Dundee Ready Education Environment Measure (DREEM) have demonstrated that a positive educational environment is directly linked to improved academic achievement, increased student satisfaction, and enhanced intrinsic motivation for learning (Roff et al., 1997).
The theory of Psychological Safety, presented by Amy Edmondson, suggests that an individual's sense of security within a learning environment enhances their ability to participate, ask questions, and learn from mistakes without fear of negative evaluation, which is a crucial element in practice-based medical education.
Justifications for Developing the Psychological Environment in Medical Colleges:
Research evidence shows that medical students are among the groups most susceptible to psychological stress, with rates of depression ranging between 25%–30% globally (Rotenstein et al., 2016). These stresses are associated with phenomena such as burnout, decreased empathy towards patients, and an increased likelihood of medical errors in the future.
Conversely, studies have shown that psychologically supportive educational environments contribute to improved academic performance, enhanced psychological resilience, reduced attrition and stress rates, and the development of professional and behavioral skills. Thus, investing in improving the psychological environment is not merely a welfare intervention, but a direct investment in the quality of the healthcare system as a whole.
A safe and supportive learning environment in a medical college has several positive impacts on learning outcomes and the overall quality of graduates. Some of the specific benefits can be summarized as follows:
Firstly, improved academic performance: Students who feel safe and supported in their learning environment are likely to be enthusiastic and engaged in their studies. This can lead to improved grades and overall academic performance.
Secondly, increased psychological resilience and flexibility: Studying in a medical college can be a challenging experience with many complex demands, so a safe and supportive learning environment can help students develop self-strength, personal resilience, increased flexibility, and coping skills they need to overcome these challenges and persist in difficult times.
Thirdly, improved mental and psychological health: Students who feel safe and supported are more likely to enjoy mental and psychological health and maintain a high motivation for achievement. This can help them be more focused, motivated, and resilient which can lead to improved self-concept and academic performance.
Fourthly, enhanced personal and professional development: A safe and supportive learning environment provides students with the opportunity to develop their personal and professional skills. This can include skills such as teamwork, leadership, communication, and problem-solving, which are essential for success in the medical profession.
Overall, a safe and supportive learning environment can help produce high-quality graduates who are well-prepared to succeed in their careers and make a positive impact on the nation and the world.
Therefore, investing in improving the psychological environment is not a welfare intervention, but a direct investment in the quality of the healthcare system as a whole. Accordingly, we recommend the following actions to create and maintain a positive and supportive educational environment for undergraduate medical students:
First: Faculty Competence:
Faculty members are the cornerstone in shaping the psychological environment within the medical college. Literature confirms that supportive teaching methods, constructive feedback, and positive human relationships with students are linked to improved learning outcomes and reduced academic anxiety.
Therefore, it is proposed to introduce a mandatory training program for faculty members in the fields of medical education and educational psychology, which includes practical training on active teaching strategies, classroom management, fair assessment, and empathetic communication skills.
It is also recommended to adopt a mentorship system, whereby each group of students is assigned an academic mentor who monitors their academic and psychological progress periodically, a model proven effective in many medical colleges globally (Sambunjak et al., 2006).
It is important that faculty members are educationally knowledgeable and skilled, and supportive of students. This can help create a positive and engaging educational experience. The investment in high-quality teaching staff requires the college administration to provide continuous training and professional development opportunities for faculty members in the psychological aspect, and the most important thing that can be trained on them is a professional diploma specialized in educational psychology, not less than 6 months, including the following:
- Theories of learning and education according to the perspective of cognitive psychology.
- Theories of achievement motivation and learning.
- Classroom management skills, learning environment, and teaching methods.
- Methods of measurement and assessment and building achievement tests.
- Student mental health and social adjustment.
Second: Establishing a Comprehensive Psychological Support System for Students and Teachers:
The World Health Organization's recommendations emphasize the importance of integrating mental health services within educational institutions, especially in high-pressure specialties like medicine. It is also suggested to develop adaptive programs targeting new students, clinical year students, and international students, to facilitate their integration into the educational environment and reduce transitional shock.
In addition, technology can be leveraged by creating digital platforms that allow students to access psychological support services confidentially and easily, which has proven effective in improving access to services and reducing social stigma, through the following:
- First: Establishing a specialized psychological center that offers counseling, educational and psychological therapy services, and burnout prevention programs, in addition to group support sessions, including a qualified team from educational psychology, guidance, mental health, and clinical psychology professionals according to global scientific and professional standards, serving both students and teachers.
- Second: Introducing a special adaptation program that helps students engage in the new learning environment at the beginning of the academic program and also at the end of each academic semester, where one of its goals is to create a kind of emotional release for students, create a warm and empathetic social atmosphere, humanize the classroom and the learning process through parties, meetings, and trips between terms to achieve this goal, providing a welcome service for foreign students at the beginnings through a program lasting a week that includes introducing them to habits and traditions and integrating them into the Jordanian social and historical environment.
Third: Enhancing Supportive Institutional Culture and Standard Operating Procedures (SOPs) for All Professors:
Institutional culture plays a pivotal role in shaping the general psychological climate within the college. Studies indicate that environments characterized by fairness, transparency, and mutual respect enhance students' feelings of belonging and security. Therefore, it is recommended to establish clear policies that regulate the relationship among all parties in the educational process, including a professional code of conduct, Standard Operating Procedures (SOPs), and transparent assessment mechanisms. It is also suggested to create an independent and confidential complaint system that ensures students' protection from any unprofessional practices, such as academic bullying or bias, with the responsible entity being outside the scope of the college and directly under the university's presidency.
The culture and general atmosphere of the institution can significantly affect students' learning experience, and to develop this, clear working procedures must be established that all professors working in the college must adhere to, including a precise and systematic description of the teaching process. It also includes a code of conduct that regulates the ethics and quality of professional work for professors, staff, and students. It also includes a precise description of work models and a unified timeframe for procedures. To achieve this mechanism, the following must be done:
- Conducting in-depth interviews with a group of faculty members.
- Conducting focus group discussions for professors (at least 3 groups).
- Conducting focus group discussions for students (at least 3 groups).
- Reviewing global instructions and literature in this framework.
- Preparing an SOP manual and discussing it with a select group of professors to approve it in its final form, to serve as a work constitution that regulates the relationship between professors and students.
Reforming the Academic Assessment System:
Literature confirms that traditional assessment systems based only on final exams contribute to increased anxiety and limit deep learning. Therefore, it is recommended to transition to continuous assessment, using diverse tools such as OSCE and Portfolio, which reflect the student's overall competence and reduce the psychological stress associated with tests. In addition, training professors on building assessment tools and finding their psychometric properties such as validity and reliability is recommended.
Integrating Life Skills and Psychological Well-Being into the Learning Climate within Colleges:
Recommendations from the Association of American Medical Colleges and the World Health Organization emphasize the necessity of including skills such as stress management, emotional intelligence, and work-life balance within medical curricula. This can be achieved through courses or interactive workshops that contribute to preparing the student not just as a doctor, but as a balanced individual capable of handling the pressures of the profession, and introducing an emotional release program for students whereby a recreational program is held at the end of each month for at least two hours inside the college building.
Implementation and Evaluation Mechanisms:
To ensure the effectiveness of this proposal, the following is recommended:
- Forming a national committee to oversee the implementation of the program.
- Implementing the project on a pilot basis in a number of medical colleges.
- Using a standardized scientific tool to measure the quality of the educational environment from students' perspectives, Dundee Ready Education Environment Measure
