Prepared by: Dr. Atef Al-Qasim / Educational Psychological Expert
President of the Psychological Sciences Association / Jordan
Introduction:
Modern educational literature confirms that the quality of learning is not only determined by the content of knowledge provided, but is fundamentally shaped through the characteristics of the educational environment in which this learning occurs. Multiple studies in the field of medical education have shown that the educational environment represents a decisive factor in determining the level of academic achievement, psychological well-being, and the shaping of professional identity among medical students.
In the context of medical education specifically, the importance 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 American Association of Medical Colleges (AAMC) indicate high rates of anxiety, depression, and psychological burnout among medical students globally, which negatively affects their academic performance and the quality of their future professional practice.
Therefore, developing 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 are academically competent, psychologically balanced, and capable of providing 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 impact it" (Genn, 2001). This environment includes multiple dimensions, among them the relationship between the student and the teacher, classroom interaction patterns, assessment methods, institutional culture, and the level of psychological support available.
Studies using the Dundee Ready Education Environment Measure (DREEM) have proven that a positive educational environment is directly linked to improved academic achievement, increased student satisfaction, and enhanced internal motivation for learning (Roff et al., 1997).
Amy Edmondson's theory of psychological safety suggests that an individual's sense of safety within the 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.
Reasons for Developing the Psychological Environment in Medical Colleges:
Research evidence indicates that medical students are among the groups most susceptible to psychological stress, with global depression rates ranging between 25%–30% (Rotenstein et al., 2016). These pressures are associated with phenomena such as psychological burnout, decreased empathy towards patients, and an increased likelihood of medical errors in the future.
In contrast, studies have shown that psychologically supportive educational environments contribute to improved academic performance (Henning et al., 2009), enhance psychological resilience and adaptability, reduce dropout and stress rates, develop professional and behavioral skills, and thus, investing in improving the psychological environment is not merely a welfare intervention, but a direct investment in the quality of the entire health system.
A safe and supportive learning environment in medical college has several positive effects on learning outcomes and the overall quality of graduates. Some specific benefits can be summarized as follows:
First: 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.
Second: Increased psychological resilience and adaptability: Studying at a medical college can be a challenging and demanding experience, so a safe and supportive learning environment can help students develop self-strength, character resilience, and the adaptability and coping skills needed to overcome these challenges and persevere in difficult times.
Third: Improved mental and psychological health: Students who feel safe and supported are more likely to enjoy better mental and psychological health and maintain high motivation for achievement. This can help them be more focused, motivated, and resilient, which can lead to improved self-concept and academic performance.
Fourth: Enhanced personal and professional development: A safe and supportive learning environment can provide students with the opportunity to develop their personal and professional skills and qualities. This may 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 for success in their professional lives and make a positive impact on the nation and the world.
Thus, investing in improving the psychological environment is not just a welfare intervention, but a direct investment in the quality of the entire health system. Based on this, we recommend the following measures to establish and maintain a positive and supportive educational environment for undergraduate medical students:
First: Faculty competence:
Faculty members are a 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 suggested 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 the mentorship system, where an academic mentor is assigned to each group of students to monitor their academic and psychological progress periodically, a model that has proven effective in many medical colleges globally (Sambunjak et al., 2006).
It is important for faculty members to be educationally knowledgeable and skilled, and supportive of students. This can help create a positive and engaging educational experience. Investing in a high-quality teaching staff requires the college dean to provide opportunities for ongoing professional training and development for faculty members in psychology. The most important aspect of their training could be a professional diploma in educational psychology lasting no less than 6 months, including the following:
- Learning and teaching theories from a cognitive psychology perspective.
- Achievement and learning motivation theories.
- Classroom management skills, learning environment, and teaching methods.
- Measurement methods and assessment, and the construction of achievement tests.
- Student mental health and social adjustment.
Second: Establish an integrated psychological support system for students and professors:
World Health Organization recommendations highlight the importance of integrating mental health services within educational institutions, especially in high-pressure specialties like medicine. It is also suggested to develop adjustment programs targeting new students, clinical year students, and international students, to facilitate their integration into the educational environment and reduce the transitional shock.
In addition, technology can be leveraged by creating digital platforms that allow students to access psychological support services confidentially and easily, a method that has proven effective in improving access to services and reducing social stigma. This can be achieved through the following:
First: Establish a specialized psychological center that provides psychological counseling, educational therapy, and mental health prevention programs, in addition to group support sessions. It should include a team of educational psychology, counseling, and clinical psychology specialists according to global scientific and professional standards to serve both students and professors.
Second: Introduce a special adjustment program to help students engage with the new learning environment at the start of the academic program and at the end of each semester. One of its objectives should be to provide emotional relief for students, and create a warm, empathetic social atmosphere by humanizing classrooms and the learning process through parties, meetings, and trips between terms to achieve this aim. It should also include a service to welcome international students at the start of their program through a week-long program that introduces them to local customs and traditions and integrates them into the Jordanian social and historical environment.
Third: Enhance supportive institutional culture and standard operating procedures (SOPs) for all professors:
The institutional culture plays a pivotal role in shaping the overall psychological climate within the college. Studies indicate that environments characterized by fairness, transparency, and mutual respect enhance students' feelings of belonging and safety. Therefore, it is recommended to establish clear policies that regulate relationships between all parties involved in the educational process, including a professional code of conduct, standard operating procedures (SOPs), and transparent evaluation mechanisms. It is also suggested to establish an independent and confidential complaint system, ensuring the protection of students from any unprofessional practices such as academic bullying or bias. This body should be responsible for it outside the college framework and directly report to the university presidency.
The culture and overall atmosphere of the institution can significantly affect the students' learning experience. To develop it, it is necessary to establish clear operating procedures that all professors working in the college must adhere to, which include detailed and systematic descriptions of the teaching process. This also includes a code of conduct that regulates the ethics and quality of professional work for professors, staff, and students. It also includes detailed descriptions of work models and the uniform duration of procedures. To achieve this mechanism, it is necessary to:
• Conduct in-depth interviews with a group of faculty members.
• Conduct focus group discussions for professors (at least 3 groups).
• Conduct focus group discussions for students (at least 3 groups).
• Review relevant international instructions and literature.
• Develop an SOPs manual and discuss it with a select group of professors to approve the final version, which will serve as a working constitution regulating the relationship between professors and students.
Reform the academic assessment system:
Education literature confirms that traditional assessment systems based solely on final exams contribute to increased anxiety and limit deep learning. Therefore, it is recommended to shift towards continuous assessment, and use diverse tools such as OSCE and Portfolio, which reflect the student's competence comprehensively and reduce the psychological stress associated with exams. In addition, it includes training professors on skills for constructing exams and identifying their psychometric properties such as validity and reliability.
Integrate life skills and psychological well-being into the learning environment within the colleges:
Recommendations from the Association of American Medical Colleges and World Health Organization emphasize the importance of including skills such as stress management, emotional intelligence, and work-life balance within medical curricula. This can be achieved through interactive courses or workshops, contributing to preparing the student not just as a doctor, but as a balanced individual capable of handling the pressures of the profession. Establish a program for emotional discharge for students, where a recreational program is held at the end of each month for two hours inside the college building.
Implementation and Evaluation Mechanisms:
To ensure the effectiveness of this proposal, it is recommended as follows:
• Form a national committee to supervise the implementation of the program.
• Implement the project on a pilot basis in several medical colleges.
• Use a standardized scientific tool to measure the quality of the educational environment from the students' perspective, Dundee Ready Education Environment Measure
• Identify key performance indicators (KPIs) such as: reduced psychological burnout rates, improved academic performance, increased student satisfaction, and reduced anxiety and depression rates.
Conclusion:
Developing the psychological environment in medical colleges represents a strategic investment in the future of the health sector in Jordan. Preparing a competent doctor involves not only equipping them with knowledge and skills but also building a psychologically balanced human being, capable of empathy, decision-making, and working under pressure.
Therefore, adopting this proposal by the relevant authorities will contribute to a qualitative shift in medical education and enhance Jordan's regional position as a distinguished center for training medical personnel.
To contact the author of the article: Dr. Atef Al-Qasim, phone 0792009376, [email protected]
