AAVMC sessions highlight student anxiety, the overvaluing of resiliency

Veterinary college leadership is looking deeper into student anxiety and how promoting resiliency may not be the right strategy.

Attendees at the American Association of Veterinary Medical Colleges Annual Conference and Iverson Bell Symposium, March 3-5, met virtually to listen to a range of lectures, some of which touched on how to promote well-being in veterinary academia.

Makenzie Peterson, director for well-being at the AAVMC, updated attendees on the AAVMC Wellbeing Initiative and discussed related projects.

In the veterinary profession, “We want veterinarians here as long as they want to be, not as long as they can endure,” Peterson said, during the session “AAVMC Wellbeing Operations Plan 2021-22” at the conference.

Resiliency

Jeremiah Grissett, counselor and wellness coordinator at Oklahoma State University College of Veterinary Medicine, discussed how resiliency may negatively impact short- and long-term health.

Grissett said during his talk at the AAVMC conference, “The High Cost of Resilience: A Discussion of the Overarching Impacts of Veterinary Student Stress,” that as a society we are impressed by heroic bravery, marvel at triumph, and value resiliency. And veterinary education isn’t immune to those tendencies.

“There is a huge reliance on overvaluing resiliency, hardiness, and grit,” Grissett said. “Veterinarians view themselves as strong people who can get through anything, and I believe that, but when we only highlight the resilience, then we don’t ask for help. We don’t want to admit weakness.”

Grissett said just getting into veterinary school shows resiliency.

“I don’t know anyone with a DVM who hasn’t experienced resiliency, and there is a pride in that. However, I think people forget that resiliency comes with a cost, and there is an impact from that.”

Grissett added that overvaluing resiliency also invalidates previous difficult experiences, can cause burnout, and places the responsibility for success entirely on students.

“Yes, they’re working toward a DVM, and they’re responsible for their work,” Grissett said. “They receive that success, but if we tell them the only way to succeed is to be more resilient, we put the blame on them and absolve ourselves of our part in that failure. There are too many people who think the only way to succeed is to work harder.”

Anxiety

Pauline Prince, PhD, staff psychologist and coordinator of clinical psychological services at Mississippi State University College of Veterinary Medicine, said anxiety influences learning, and that experience exists across veterinary medicine. She spoke during the session “Anxiety and the Brain: Strategies for Learning, Memory, and Emotional Regulation” at the AAVMC conference.

Dr. Prince said students feel overwhelmed, suffer from panic attacks, experience hypervigilance, are fearful of not being successful, and endure impostor syndrome, meaning they doubt their skills.

“Some stress is good for improving performance, but only some,” Dr. Prince said. “It is not good for thinking and creativity or abstract thinking like reaching conclusions or making a diagnosis or finding a treatment plan. Anxiety can be a killer for that kind of thinking.”

Grissett and Dr. Prince offered the following suggestions for helping students manage anxiety and improve well-being:

• Normalize the struggle and asking for help.
• Create routines and predictability for students who are suffering from anxiety.
• Use “do” statements rather than “don’t” to show a clear path of what needs to be done. For example, say, “Take a deep breath, and this is what I need you to do.”
• Remember the goal of teaching is for students to learn, so trick questions won’t teach anything.
• Discuss sensory triggers, and build a comfortable environment.
• Suggest students engage in yoga, mindfulness practices, and movement.

Well-being

Makenzie Peterson said most well-being work focuses on the personal level or microlevel, and while that is important work, so is work at the medium and macro levels that results in structural or cultural change. Peterson added that well-being has also historically been a very white space, and the AAVMC initiative will be inclusive of diverse competencies when focusing on larger, industry-level change.

“Having a mental health professional in a clinic does not solve the problems long term,” Peterson said. “We need to meet the immediate mental health needs of individuals but also eliminate the root causes of distress that impact our communities.”

Peterson presented data collected on intern and resident well-being during the session “Clinician Wellbeing Initiative, Phase 1: Interns & Residents.”

Almost 30% of respondents reported having experienced suicidal thoughts or suicidal ideation. About 60% of respondents felt emotionally drained by their work a few times a week or every day.

Respondents who were not satisfied with their programs experienced common themes, including no limit to working hours, understaffed clinics, no protected time off, and little to no mentorship or didactic learning in their program. Mentorship seems to have a major impact on whether an intern or a resident has a positive experience, according to the data.

“The profession is not short on committed, dedicated individuals,” Peterson said. “We are swimming in good folks. But we put them in environments of huge stress that hinder and in some cases make it impossible to adequately tend to their well-being.”

The survey is a part of a collaboration with the American Association of Veterinary Clinicians. Survey results will likely be published in the summer.

Peterson said it’s important to move away from solutions that center only on personal well-being and instead move into a space of making systemic changes that positively impact the professional community.

“This is an amazing but unwell profession,” Peterson said. “We need an industry-level culture change.”