Submitted: 25 February 2025
Accepted: 9 September 2025
Published online: 6 January, TAPS 2026, 11(1), 79-81
https://doi.org/10.29060/TAPS.2026-11-1/II3679

Gaik Kin Teoh¹ & Darlina Hani Fadil Azim²

¹Department of Psychology and Counselling, School of Psychology and Social Science, IMU University, Malaysia; ²Department of Psychology and Counselling, School of Psychology and Social Science, IMU University, Malaysia

I. WHERE THE STORY STARTED…

Climate change and health tractions have loudly cumulated at the recent Asian Pacific Medical Education Conference, APMEC 2025. This has alerted us, the mental health professionals in Malaysia, to reflect and to wonder what has been put in place to address the mental health issues while climate change is impending in our country. Thus, this paper aims to skim through the websites of global and Malaysian mental health governing organisations and advocates for climate change and mental health information. The keywords used for searching the official websites were “mental health” and “climate change.” The official websites selected were those that discuss and outline action plans for both mental health and climate change.

II. HIGHLIGHTS ON THE GLOBAL STATUS OF CLIMATE CHANGE

According to the Climate Change 2023 Synthesis Report: Summary for Policymakers,

1. About 3.3 to 3.6 billion people live in conditions that are highly vulnerable to climate change.
2. Increasing climate change events have caused millions of people to live with the threat of acute shortages of food and water security. These communities are found in Africa, Asia, Central and South America, Least Developed Countries, small islands and the Arctic. Meanwhile, in developing countries, the current global financial flows for adaptation are lacking.
3. Between 2010 and 2020, the death toll due to floods, droughts and storms was 15 times higher in highly vulnerable areas.
4. In the near term, every region of the world is predicted to face further escalation in climate hazards, increasing multiple risks to ecosystems and humans. The hazards and associated risks are – an increase in heat-related human mortality and morbidity, food-borne, water-borne, and vector-borne diseases and mental health challenges, floods, biodiversity loss in land, freshwater, and ocean ecosystems and a decrease in food production.
5. The choices and actions taken in this decade will influence the situation now and for thousands of years to come. Thus, deep, rapid, and sustained mitigation and accelerated implementation of changes in this decade would decrease future losses and damages. Delayed mitigation will further increase global warming and damage.

 

The threat of climate change to health has been highlighted by the World Health Organization (WHO) for many years. In 2008, WHO published a comprehensive report on the health impacts of climate change. In 2021, a survey conducted by WHO, among the 95 participating countries, only 9% included mental health and psychosocial support in national health and climate change plans. In 2022, a new WHO policy brief was put in place to underscore the serious risks of climate change to mental health. One of the most concerning mental health outcomes related to climate change is suicidal risk (Chen et al., 2025).

III. GLIMPSES OF CLIMATE CHANGE AND MENTAL HEALTH AMONG THE MENTAL HEALTH ORGANISATIONS IN THE WESTERN DEVELOPED COUNTRIES

On the other side of the coin, the American Psychological Association [APA] (2017) published Mental Health and Changing Climate: Impacts, Implications and Guidance. In 2020, the American Counseling Association’s task force disseminated a Climate Change Fact Sheet, to familiarise counselors to facts, actions and resources that help to address the needs of clients and communities based on climate change. In 2022, the American Psychological Association (APA) published Addressing Climate Crisis: An Action Plan for Psychologists. The British Psychological Society issued two Clinical Psychology Forum within a year and repeating the same theme – the climate and ecological emergency. This indicated the urgency to take actions and to come together to address the issues of climate change. The Australian Psychological Society [APS] (2024) spotlighted that 94% of its members are concerned about the upcoming impact of climate change on mental health. Particularly, psychological distress has risen from 18.4% in 2011 to 42.30% in 2021 among the 15-24 year old, due to climate change. The New Zealand government underscored climate change and well-being in New Zealand’s Environmental Reporting Series: Our Atmosphere and Climate 2020. In 2024, the Ministry of Health of New Zealand launched the Health National Adaptation Plan 2024-2027, where mental health is embedded to be part of the action plan. In Europe, Climate Change Impacts on Mental Health in Europe was published in 2022. This shows that information on mental health issues associated with climate change is apparent among mental health advocates, particularly, from most Western developed countries.

IV. GLIMPSES OF CLIMATE CHANGE AND MENTAL HEALTH IN SOME ASIAN COUNTRIES

In Asian countries, India has called for action plans for climate change and mental health. Japan and Taiwan have established initiatives focused on mental health and disaster management.  Many Asian countries are prioritising net-zero emissions and carbon neutrality. Information and discussions on mental health associated with climate change are not readily available on the official websites of most mental health organisations. Eliciting information from official websites among Asian countries proved challenging due to language differences.

V. CLIMATE CHANGE AND MENTAL HEALTH IN MALAYSIA

Skimming through the websites of the mental health associations in Malaysia, such as the Malaysian Society of Clinical Psychology, the Malaysian Board of Counsellors (Lembaga Kaunselor Malaysia), the International Counselling Association of Malaysia (PERKAMA International) and the Malaysian Psychiatric Association, no information was found pertaining to climate change and mental health.

Although climate change and health were highlighted in NEHAP Malaysia (National Environmental Health Action Plan) official website, mental health was only mentioned in the context of post-disaster recovery and Post-Traumatic Stress Disorder (PTSD). In reality, mental health issues caused by climate change can also manifest in daily activities. The Ministry of Natural Resources and Environmental Sustainability (NRES) published the National Climate Change Policy 2.0 in 2024, but addressing mental health concerns was not stated in the policy.

Mahmood and Guinto (2022) have highlighted the seriousness of the climate crisis in Malaysia, including how mental health associated with climate change can further complicate the nascent mental healthcare systems. Besides, Pandya-Wood et al. (2024) underscored that no study was conducted pertaining to mental health and climate change. Urgent attention and investment into climate change-related studies, particularly equitable initiatives, are urged. The readiness to curb the subtle and looming “2nd pandemic” seems to be dubious.

VI. POSSIBLE ACTIONABLE SOLUTIONS FOR MALAYSIA

Firstly, mental health challenges related to climate change should be integrated into the National Climate Change Policy. In addition to the existing stakeholders (such as the Ministry of Health, the Ministry of Natural Resources and Environmental Sustainability etc), forming new partnerships with the Ministry of Communications and Ministry of Women, Family and Community Development and NEHAP will play a crucial role in enhancing public awareness towards the issue, as well as implementing targeted health initiatives to uphold the safety, health and mental health of the high risk groups (i.e. pregnant, breastfeeding, postpartum and menopausal women, older people, children under 18, outdoor workers, indigenous communities, low-income populations, people with disabilities and chronic medical conditions). In addition to mass media, information on mental health and climate change should be widely disseminated across the websites and digital platforms of health and mental health-related organisations. In other words, mental health should be given equal prominence as physical health in policy planning.  Innovative technology research is crucial for sustainable development; however, there is a pressing need for more community-based research initiatives that actively seek to understand, involve, and empower the public to contribute to sustainable solutions. Nevertheless, more research grants should be offered to directly address the link between mental health and climate change.

VII. CONCLUSION

We acknowledge that the information retrieved is only limited to publicly available website content. We might also have a bias towards what we consider global mental health organisations. Meanwhile, we have observed that the priorities and initiatives to address mental health and climate change differ by country. Mental health concerns could be addressed by various ministries rather than solely mental health organisations. Achieving carbon neutrality is prioritised over solving mental health concerns in many Asian countries, including Malaysia. Rapid, explicit and organised concerted efforts among the governing bodies are pivotal to curb the subtle and approaching pandemic such as climate change. Forthcoming top-down and bottom-up initiatives are imperative, especially the choices and actions we make in this decade will bear enduring effects for years to come.

Notes on Contributors

GKT initiated, conceptualised, analysed the literature and wrote the paper.
DHFA echoed the significance of the issue, conceptualised, cross-checked the literature, and revised the paper.

Ethical Approval

There is no data presented in this paper, and thus ethical approval is not required.

Acknowledgement

We would like to thank the Dean of the School of Psychology and Social Sciences, in IMU University, Professor Haslee Sharil Lim Bin Abdullah, for supporting our participation in this conference. We also would like to thank Professor Nilesh Kumar Mitra for inviting us to participate in conducting the pre-conference workshop.

Funding

IMU University, Malaysia, funded our participation in this conference.

Declaration of Interest

All authors have no conflict of interest to declare.

References

Australian Psychological Society. (2024, April 24). 94% of psychologists are concerned about the impact of climate change on mental health. https://psychology.org.au/insights/94-of-psychologists-are-concerned-about-the-impact

Chen, D. D., Tu, J. H., Ling, K. N., Jin, X. H., & Huang, H. Y. (2025). Climate change and suicide epidemiology: A systematic review and meta-analysis of gender variations in global suicide rates. Frontiers in Public Health, 12, 1463676. https://doi.org/10.3389/fpubh.2024.1463676

IPCC, 2023: Climate change 2023: Synthesis report, summary for policymakers. Contribution of working groups I, II and III to the sixth assessment report of the Intergovernmental Panel on Climate Change [Core Writing Team, H. Lee and J. Romero (eds.)]. IPCC, Geneva, Switzerland. 1-34. https://doi.org/10.59327/IPCC/AR6-9789291691647.001

Mahmood, J., & Guinto, R. R. (2022). Lessons from climate reports for the Malaysian medical community. The Malaysian Journal of Medical Sciences: MJMS, 29(3), 1-4. https://doi.org/10.21315/mjms2022.29.3.1

Pandya-Wood, R., Azhari, A., Johar, H., Johns-Putra, A., Muhamad, N., & Su, T. T. (2024). Systematic review of climate change induced health impacts facing Malaysia: Gaps in research. Environmental Research: Health, 2(3), 032002. https://doi.org/10.1088/2752-5309/ad6208

*Teoh Gaik Kin
IMU University,
126, Jalan Jalil Perkasa 19, Bukit Jalil,
5700 Kuala Lumpur, Malaysia
60126714766
Email: GaikKinTeoh@imu.edu.my

Submitted: 19 September 2024
Accepted: 16 April 2025
Published online: 6 January, TAPS 2026, 11(1), 69-73
https://doi.org/10.29060/TAPS.2026-11-1/SC3524

Eng-Koon Ong^1-4,7, April Thant Aung^3,8, Min Chiam³, Lalit Kumar Radha Krishna^1,3,4, Yingxuan Chen¹⁰, Filomar Cortezano Tariao⁹, Faith Ng¹¹, Jamie Zhou^1,4 & Wen-Shan Sim^4-6

¹Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore; ²Office of Medical Humanities, SingHealth Medicine Academic Clinical Programme, Singapore; ³Division of Cancer Education, National Cancer Centre Singapore, Singapore; ⁴Duke-NUS Graduate Medical School, Singapore; ⁵Maternal Fetal Medicine, KK Women’s and Children’s Hospital, Singapore; ⁶PGY1 Programme, SingHealth, Singapore; ⁷Assisi Hospice, Singapore; ⁸School of Humanities, Nanyang Technological University, Singapore; ⁹School of Dance, Nanyang Academy of Fine Arts, Singapore; ¹⁰Shaw Heritage Arts and Wellbeing Studios, Singapore; ¹¹Checkpoint Theatre, Singapore

Abstract

Introduction: Through collaborative pedagogical initiatives, the medical humanities (MH) have the potential to support healthcare professionals in developing various competencies in medical education (ME). However, there is a lack of data on faculty development programmes specific to this field.

Methods: Based on our experience in designing a medical humanities workshop for medical students, we conducted two faculty development (FD) workshops that adopted an interdisciplinary approach towards faculty training. These FD workshops served to train fellow clinician educators in the integration of the MH in ME.

Results: A total of 17 participants completed two workshops over two years, with seven participants in 2023 and 6 in 2024 completing pre- and post-workshop surveys that evaluated their experience, knowledge and skills. The survey consisted of six self-rated questions based on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree) with an open-ended question embedded in the post-workshop survey. A paired t-test evaluation of the results suggests that there was an increase in awareness, knowledge, and confidence.

Conclusion: Our MH-based FD programme is limited by the lack of qualitative data and further studies are needed. Similar programmes should include an introduction to the medical humanities and its methodologies so that a train-the-trainers approach is adopted. Programmes should also look beyond teaching effectiveness to include developing systemic awareness and support, assess outcomes such as professional identity formation, and build communities of practice for faculty members.

Keywords:           Faculty Development, Medical Humanities, Medical Education, Health Professions Education

I. INTRODUCTION

The role of the medical humanities (MH) in healthcare is multifaceted, supported by its methodologies from the arts and humanities in promoting perspective-taking, reflective practice, and professional identity formation. Specifically, its relevance in aspects of medical education (ME) such as professionalism, communications, and humanistic care has rallied healthcare educators exploring the field to achieve educational goals in developing empathy, improving patient experience, and preventing burnout (Ong et al. 2024).

A vision to integrate MH within ME has gained prominence over the past decade, with articles describing its epistemological functions, guidelines on programme development, and emerging evidence of acceptability and effectiveness of pilot programmes. Despite this, there is a disproportionate lack of data on faculty development (FD) to support this vision. A white paper by Howley et al. (2020) advocates for interdisciplinary collaboration between clinician educators, humanities scholars and creative arts practitioners. However, little guidance was provided on the type of effort, support, and considerations needed to nurture an interdisciplinary team of faculty members to design, implement, and sustain MH programmes.

II. CONTEXT AND PROGRAMME

Since 2022, a one-day theatre-based MH workshop has been conducted for all medical students from Duke-NUS Graduate Medical School (Singapore) rotating through the Division of Supportive and Palliative Care at the National Cancer Centre Singapore. During the workshop held on the final day of their one-week clinical rotation, students watch a full recording of a local theatre play, A Good Death by the playwright Faith Ng, and participate in small group discussions on scenarios that depict pain crises experienced by oncology and hospice patients, difficult conversations about end-of-life care, and moral distress faced by palliative care practitioners and its impact on their mental wellbeing. Students also participate in a “hot-seating” activity where they embody the different characters of the play, and respond to questions from the class while in character. Prior to this core clinical rotation, most students had little prior exposure to end-of-life care and the activities were intended to promote perspective-taking, self-awareness, and professional identity formation through the use of theatre. The workshop is co-facilitated by a specialist palliative care physician with a master’s degree in medical education, a medical humanities doctorate fellow, a medical social worker trained in counselling and narrative therapy, and the director of the play. This interdisciplinary faculty team facilitated dynamic discussions and generated new insights for the students.

Based on our positive experience in developing this programme, we decided to conduct a yearly faculty development (FD) workshop for other educators who were keen on designing arts and humanities programmes within their specialities and settings. The workshop consisted of three segments. Firstly, an introduction to conceptual frameworks and principles within both MH and ME was presented by EKO and YC, listing frameworks such as adult learning, community of practice, and reflective practice. Principles such as the need to create a sense of agency, establish common goals, validate values of faculty members, and promote reflective processes were also identified. Secondly, YC described and explained theatre-based facilitation methods such as improvisation and applied theatre techniques. This provided refreshing insight on how MH programmes could be designed and conducted by arts practitioners like herself. The choice of teaching materials that considered learners’ receptivity, appropriateness to achieve learning objectives, and ease of access were also explored. Lastly, the team demonstrated how learning objectives and lesson plans could be written based on Bloom’s taxonomy and Gagne’s model of instruction respectively. The educators were then asked to practice doing the same in groups of three for an existing or potential MH-based ME programme.

We applied the conceptual framework of adult learning in the design of the FD workshop and the relevance of medical humanities in medical education was regularly alluded to in all three segments. This promoted a sense of agency towards self-directed learning. All staff from the SingHealth Academic Medicine Centre, the largest healthcare cluster in Singapore, were invited to participate in the FD workshops in 2023 and 2024. The same team of faculty members from the original medical students’ workshops conducted the FD workshops.

III. METHODS / RESULTS

A total of 17 participants completed the FD workshops over two years. We found a lack of validated evaluation methods for MH-based ME programmes and thus designed a questionnaire guided by Bloom’s taxonomy for our programme. This was similarly done by Kumagai et al. (2007) who investigated the effects of a forum theatre-based workshop for 29 medical school faculty members that facilitated discussions on race and gender through a self-designed survey pre- and post-workshop that assessed self-awareness and “critical consciousness”.

All 17 participants were invited to complete an online survey within one week before and after the FD workshops. The survey consisted of six self-rated questions based on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree) that alluded to the participants’ experience, knowledge, and skills gained from the workshop.

In total, 7 participants in 2023 and 6 in 2024 consented to and completed the surveys (Ong et al., 2024). The group consisted of seven doctors, a clinical psychologist, a clinical pastoral counsellor, a healthcare education executive, two pharmacists, and an assistant director of community outreach and philanthropy. Table 1 lists the questions and the outcomes of the survey. A paired t-test evaluation of the results suggests that there was an increase in awareness, knowledge, and confidence.

	Questions	Mean score (n=13)		t-score difference	p-value
		Pre-workshop	Post-workshop
1.	I would recommend this workshop to my fellow colleagues.	3.62	4.23	2.309	0.04
2.	I am keen to attend similar workshops again in the future.	3.85	4.62	2.993	0.011
3.	I agree that the arts and humanities have valuable knowledge to offer to medical education.	4.38	4.62	0.478	0.641
4.	I can identify potential content, materials and facilitation needed for medical education programs involving the arts and humanities.	2.54	3.92	4.454	<0.001
5.	I am able to pursue the design and implementation of a medical education program involving the arts and humanities confidently as part of a team.	2.46	3.69	6.121	<0.001
6.	I am able to pursue the design and implementation of a medical education program involving the arts and humanities confidently as an education lead, alongside arts practitioners.	1.92	2.77	4.430	<0.001

Table 1. Survey questions and results

IV. LIMITATIONS

Programme evaluation is limited by the small number of participants and lack of a validated measure. While there may be apparent statistical significance to the improvement of the scores collected, a solely quantitative outcome measure may not be adequate to provide insight on the success of the programme. Future programme evaluations with bigger cohorts coupled with qualitative data are needed.

V. DISCUSSION

Existing publications in FD focus on broader teaching competencies such as facilitation and communication skills, curriculum development, education leadership, and scholarship (Steinert et al. 2016), suggesting that faculty members could translate what they have learnt into individual fields of interest. Based on our experience, we posit that further considerations are needed for FD programmes in the field of the medical humanities.

Firstly, a low awareness of the relevance of the MH in ME (Ong, 2021), the need for faculty members to achieve basic understanding of content from diverse theoretical and practical frameworks from both fields, distinct but complementary roles of co-faculty members from medicine and the arts and humanities (Ong et al. 2024), and a lack of agreement on how teaching effectiveness is defined can affect faculty members’ decision to enrol in FD workshops and subsequently how they experience FD in MH. Thus, equipping faculty members with teaching skills may not be adequate. A “train-the-trainers” approach where teaching competencies are complemented with knowledge about MH’s content, methodologies, theoretical frameworks, and assessment tools may be preferable. This approach ensures that faculty members not only develop the skills required to co-facilitate MH programmes, but also reinforces the value of MH when employed within ME.

Secondly, Steinert et al.’s (2016) Best Evidence Medical Education (BEME) guide on faculty development in ME concludes that the outcomes of FD programmes should include the development of a community of practice that can affect organisational and cultural change towards education. In countries such as Singapore where the field of MH within ME is still in its nascent stage, building a community of practice (COP) is essential. A COP can increase awareness and promote endorsement by both senior leadership and peer educators, ensuring programme sustainability beyond initial “pilot” programmes. We hope that this study can inspire like-minded educators to develop FD programmes in tandem to the novel MH programmes that they implement.

Finally, we would also like to remind readers that with its unique methodologies like narrative inquiry, close reading, and experiential learning frameworks, the FD programmes for MH for medical educators have the potential to contribute to professional identity formation and foster wellbeing (Ong et al., 2024). These outcomes though not listed as the learning objectives of our study, have been consistently expressed by the participants during our workshops.

VI. CONCLUSION

In summary, we have described and presented the quantitative outcomes of a faculty development (FD) workshop specific to the field of medical humanities. Qualitative data is still needed for programme evaluation. Addressing gaps in the current literature, we recommend that all MH FD programmes incorporate an introduction to MH and its methodologies, look beyond teaching effectiveness to include systemic awareness and support, assess outcomes such as professional identity formation, and build communities of practice. Future research into these aspects and the development of validated learning outcome measures that include qualitative data will enhance current insight on FD and support the call for integrating MH within the medical education landscape.

Notes on Contributors

OEK conceptualised the outline of the paper and focused mainly on the perspectives from clinicians and clinician educators. He also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

LKRK conceptualised the outline of the paper and focused mainly on the perspectives from clinicians and clinician educators. He also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

JZ conceptualised the outline of the paper and focused mainly on the perspectives from clinicians and clinician educators. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

SWS conceptualised the outline of the paper and focused mainly on the perspectives from clinicians and clinician educators. She also reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

ATA contributed to the layout of the paper and focused on perspectives as medical humanities scholars and teachers. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

CM contributed to the layout of the paper and focused on perspectives as medical humanities scholars and teachers. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

FCT contributed to the layout of the paper and focused on perspectives as performing arts practitioners and tutors. He also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

CYX contributed to the layout of the paper and focused on perspectives as performing arts practitioners and tutors. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

NF contributed to the layout of the paper and focused on perspectives as performing arts practitioners and tutors. She also designed and taught at the faculty development workshops, reviewed and approved the final draft of the manuscript, and agree to be accountable for all aspects of the paper.

Ethical Approval

The project was submitted to the SingHealth centralised institutional review board (IRB) but exempted from review due to its nature as a medical education programme evaluation (CIRB number 2023/2036).

Data Availability

The data that support the findings of this study are openly available in the Figshare repository https://doi.org/10.6084/m9.figshare.27038086 (Ong et al. 2024).

Acknowledgement

We would like to thank Ms Eve Seraphina Low for setting up the online survey form and correspondence with the participants, and logistical support of the conduct of the workshop.

Funding

The faculty development workshop was supported by the SingHealth Oncology Academic Clinical Programme Education Support Grant (project number 08/FY2022/P2/09-A75).

Declaration of Interest

All of the authors state no conflicts of interest.

References

Howley, L., Gaufberg, E., & King, B. (2020). The fundamental role of the arts and humanities in medical education. Washington, DC: AAMC.

Kumagai, A. K., White, C. B., Ross, P., Purkiss, J. A., O’Neal, C. M., & Steiger, J. A. (2007). Use of interactive theater for faculty development in multicultural medical education. Medical Teacher, 29(4), 335-340. https://doi.org/10.1080/01421590701378662

Ong, E. K. (2021). HAPPE – A pilot programme using humanities to teach junior doctors empathy in a palliative medicine posting. The Asia Pacific Scholar, 6(1), 83-92. https://doi.org/10.29060/TAPS.2021-6-1/OA2251

Ong, E. K., Tan, E. U., Min, C., & Sim, W. S. (2024). The employment of art therapy to develop empathy and foster wellbeing for junior doctors in a palliative medicine rotation – A qualitative exploratory study on acceptability. BMC Palliative Care, 23(1), 84. https://doi.org/10.1186/s12904-024-01414-6

Ong, E. K., Aung, A. T., Min, C., Krishna, L. K. R., Chen, Y., Tariao, F. C., Ng, F., Zhou, J., & Sim, W. S. (2024). Data from pre- and post-surveys of participants [Dataset]. Figshare. https://doi.org/10.6084/m9.figshare.27038086

Steinert, Y., Mann, K., Anderson, B., Barnett, B.M., Angel., C., Naismith, L., Prideaux, D., Spencer, J., Tullo, E., Viggiano, T., Ward, H., & Dolmans, D. (2016). A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40. Medical Teacher, 38(8), 769-786. https://doi.org/10.1080/0142159X.2016.1181851

*Ong Eng Koon
National Cancer Centre Singapore
30 Hospital Blvd, Singapore 168583
Email: ong.eng.koon@assisihospice.org.sg

Submitted: 3 January 2025
Accepted: 14 May 2025
Published online: 6 January, TAPS 2026, 11(1), 82-85
https://doi.org/10.29060/TAPS.2026-11-1/II3600

Sulthan Al Rashid¹ & Pubalan Rajagopalan²

¹Department of Pharmacology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), India; ²Medical Surgical Department, Farrer Park Hospital, Singapore

I. INTRODUCTION

Medical education is transforming to nurture not just clinical expertise and theoretical understanding but also the holistic development of healthcare clinicians. In an era where sustainability in healthcare demands adaptable, resilient, and empathetic professionals, Personal Development Programs (PDPs) have emerged as vital tools. These programs aim to equip healthcare clinicians —doctors, nurses, and allied professionals—with essential skills like communication, empathy, and resilience while fostering lifelong learning and personal well-being. This personal view explores the critical role of PDPs in shaping healthcare clinicians who are prepared to meet the physical, psychological, and social challenges of their roles, thereby contributing to a sustainable future in healthcare. We highlight the benefits, current frameworks, challenges, and strategies necessary for effectively integrating PDPs into medical education to cultivate a holistic, future-ready workforce.

II. THE RATIONALE FOR PERSONAL DEVELOPMENT

The healthcare profession is synonymous with high-pressure work environments that challenge even the most seasoned professionals. As such, equipping healthcare clinicians with resources for self-improvement and mental well-being is not just desirable—it is crucial. Healthcare clinicians regularly contend with issues like burnout, compassion fatigue, and work-life imbalance. The ripple effects of these challenges extend beyond the individual to affect the quality of patient care. Hence, incorporating personal development into medical education is more than a value-added option; it is a foundational component that addresses the holistic training needs of healthcare clinicians.

III. EMOTIONAL INTELLIGENCE AND COMMUNICATION SKILLS

Emotional intelligence (EI) and strong communication skills are essential for effective patient interaction and care. According to research, healthcare clinicians with high EI are more adept at understanding patient concerns, managing personal emotions and potential biases (Webster et al., 2022), and handling complex interpersonal dynamics (Giménez-Espert et al., 2023). Programs focused on EI employ hands-on exercises, role-playing, and workshops that allow healthcare clinicians to develop these skills in real-world scenarios. For instance, simulation labs can recreate patient encounters that test and improve healthcare clinicians’ emotional responses, making them better communicators and more empathetic caregivers.

Moreover, EI training is associated with tangible benefits like higher patient satisfaction and lower medical error rates. In a clinical setting, the ability to manage stress and maintain clear, empathetic communication can significantly affect patient outcomes. Thus, by integrating EI training into the medical curriculum, educators are nurturing a new generation of healthcare clinicians who prioritise both technical precision and human connection.

IV. BUILDING RESILIENCE AND MANAGING STRESS

The healthcare profession is notorious for its physical and emotional demands, making resilience a crucial attribute for survival and success. PDPs that focus on resilience-building often include mindfulness practices, stress management techniques, and guided self-reflection. For example, mindfulness training has been shown to lower levels of burnout among healthcare workers. Programs like these teach healthcare clinicians to manage stress, recover from setbacks, and foster a supportive work culture. This approach benefits both individual well-being and professional performance, ultimately enhancing patient care.

Additionally, stress management workshops can be designed to simulate high-pressure scenarios, helping healthcare clinicians develop coping mechanisms they can use in real clinical environments. Practical training sessions, such as mock emergency simulations, prepare healthcare clinicians to think critically and remain composed under pressure. By equipping future healthcare clinicians with these skills, educational institutions are ensuring that healthcare clinicians can thrive in the demanding healthcare fields.

V. CURRENT MODELS OF PERSONAL DEVELOPMENT IN MEDICAL EDUCATION

A. Reflective Learning and Mentorship

Reflective practices are key components of many personal development programs, allowing healthcare clinicians to analyse their experiences, learn from them, and adjust their behaviour or thinking accordingly. Journaling, in particular, is a powerful tool for self-reflection. By regularly documenting their experiences, thoughts, and emotions, healthcare clinicians can gain a deeper understanding of their learning processes and emotional responses. This habit helps them identify patterns, recognise areas for improvement, and appreciate personal growth over time. Journaling also serves as a therapeutic outlet, reducing stress and fostering self-awareness.

Techniques like case-based discussions and guided reflections complement journaling by encouraging active engagement and peer learning. For instance, healthcare clinicians may write about a challenging patient encounter and later discuss it in a group setting, exploring different perspectives and potential strategies for improvement. These reflective exercises promote a culture of continuous self-improvement and emotional resilience (Hagrass et al., 2023).

Mentorship is another cornerstone of personal development in medical education. Structured mentorship programs provide a platform for healthcare clinicians to discuss both professional and personal challenges. A mentor can offer guidance, emotional support, and career advice, fostering a nurturing relationship that promotes growth and emotional well-being. Through regular discussions, mentees can share insights from their journaling or reflect on professional challenges, receiving valuable feedback and support from experienced practitioners. These mentorship relationships not only guide healthcare clinicians in their academic and clinical journeys but also offer a supportive network that contributes to their overall well-being.

B. Wellness and Achieving Work-Life Balance

Maintaining a healthy work-life balance is vital for healthcare clinicians, who often face long hours and emotionally taxing work (Mitra et al., 2024). Medical education programs that emphasise wellness strategies—such as exercise, nutrition, and self-care—can equip healthcare clinicians with tools to manage stress and sustain their energy levels. Some schools offer wellness electives or modules focusing on self-care and practical life skills, such as time and financial management; for instance, Hackensack Meridian School of Medicine provides a financial wellness elective titled ‘Dollars and Sense for Medical Students,’ which focuses on practical budgeting and saving strategies (Schiavone et al., n.d.).

Practical courses can also prepare healthcare clinicians for the unique challenges of a medical career. Time management workshops, for example, can help healthcare clinicians learn to prioritise tasks and maintain productivity without sacrificing their well-being. Financial literacy courses could teach them how to manage their finances, easing the stress associated with economic pressures during residency and early practice. A holistic curriculum addresses physical, mental, and emotional health, ensuring that healthcare clinicians are well-rounded and resilient.

VI. OVERCOMING CHALLENGES IN IMPLEMENTATION

Despite the numerous advantages of PDPs, integrating them into an already rigorous medical curriculum is fraught with challenges. Heavy academic schedules leave little room for additional content, and there is often scepticism among both faculty and students about the value of PDPs compared to traditional clinical training. However, these hurdles can be surmounted with thoughtful strategies.

VII. EFFECTIVE STRATEGIES FOR INTEGRATION

A. Embedding PDPs into Existing Courses

Instead of introducing separate modules, personal development content can be seamlessly integrated into clinical courses. For instance, stress management techniques can be taught as part of clinical skills training, making it easier for healthcare clinicians to apply these lessons in practical settings.

B. Offering Flexible Learning Options

Workshops or online modules provide flexibility, accommodating diverse schedules and learning preferences. This approach ensures that healthcare clinicians can benefit from PDPs, regardless of their time constraints.

C. Leveraging E-Learning Platforms

Online resources can make personal development topics more engaging and accessible. Interactive e-learning modules on resilience, time management, and communication can be tailored to fit into the existing curriculum without overloading healthcare clinicians.

D. Evidence-Based Customisation

Programs should be tailored to the specific needs of healthcare clinicians and backed by research. Continuous evaluation and feedback loops can refine these programs, ensuring they remain effective and relevant. Institutions should commit to ongoing research to evaluate the long-term impact of PDPs on healthcare clinicians’ professional success and personal well-being.

VIII. THE INFLUENCE ON PATIENT CARE

The ultimate goal of medical education is to produce healthcare clinicians who are not only clinically skilled but also compassionate, resilient, and emotionally intelligent. PDPs that focus on active listening, empathy, and teamwork have a direct, positive impact on patient care. Healthcare providers who are emotionally healthy and well-rounded offer more patient-centered care, communicate better, and work more effectively within teams. For example, a healthcare clinician who can manage their own stress is less likely to make hasty decisions, reducing the risk of medical errors.

Emotionally intelligent practitioners are also better equipped to handle complex clinical scenarios, contributing to lower malpractice claims and improved patient safety. Furthermore, a workforce trained in empathy and effective communication fosters a more compassionate healthcare environment, benefiting patients and professionals alike.

IX. LOOKING TO THE FUTURE

As the healthcare landscape evolves, so too must the training of future professionals. Medical educators, healthcare leaders, and policymakers must collaborate to create curricula that prepare healthcare clinicians for the multifaceted realities of medical practice. The future of effective healthcare delivery depends on the well-being of its providers, making personal development programs a vital component of medical education. Research should continue to explore innovative methods to embed personal growth into medical training, measuring the outcomes on both a personal and professional level.

X. CONCLUSION

Integrating personal development programs into medical education is essential for cultivating healthcare practitioners who are not only clinically proficient but also emotionally intelligent and resilient. These programs empower healthcare clinicians to navigate the challenges of their field with empathy, adaptability, and a strong sense of well-being, aligning their personal growth with professional excellence. Medical educators play a pivotal role in shaping a generation of practitioners who prioritise both their own holistic development and the sustainable delivery of compassionate, high-quality care. By embracing this approach, the medical community can ensure a future where healthcare clinicians are equipped to contribute meaningfully to a sustainable and patient-centered healthcare system.

Notes on Contributors

Sulthan Al Rashid was responsible for the conceptualisation, development of scientific content, data collection, manuscript preparation, editing, and proofreading. Pubalan Rajagopalan contributed significantly to drafting the manuscript and provided critical revisions for important intellectual content. He reviewed and approved the final version of the manuscript and agrees to be accountable for all aspects of the work to ensure its accuracy and integrity.

Ethical Approval

Ethical approval is not required as no human participant data was collected.

Acknowledgement

ChatGPT has been utilised in manuscript preparation, including tasks like drafting, editing, and refining text, without being credited as an author.

Funding

The authors did not receive any funding for this study.

Declaration of Interest

The authors declare that they have no conflicts of interest.

References

Giménez-Espert, M. D. C., Maldonado, S., & Prado-Gascó, V. (2023). Influence of emotional skills on attitudes towards communication: Nursing students vs. nurses. International Journal of Environmental Research and Public Health, 20(6), 4798. https://doi.org/10.3390/ijerph20064798

Hagrass, H. M., Ibrahim, S. A. E. A., Anany, R. I. E. S., & El-Sayed, H. A. (2023). Effect of an educational program about mentorship competencies on nurse mentors’ performance: A quasi-experimental study. BMC Nursing, 22, 429. https://doi.org/10.1186/s12912-023-01597-y

Mitra, L. G., Sharma, J., & Walia, H. S. (2024). Improving work-life balance and satisfaction to improve patient care. Indian Journal of Critical Care Medicine, 28(4), 326–328. https://doi.org/10.5005/jp-journals-10071-24689

Schiavone, J., Ambalu, N., Cheriyan, J., & Josephs, J. (n.d.). Financial wellness for medical students: Practical budgeting and saving tips. AAMC. Retrieved April 4, 2025, from https://students-residents.aamc.org/medical-student-well-being/financial-wellness-medical-students-practical-budgeting-and-saving-tips

Webster, C. S., Taylor, S., Thomas, C., & Weller, J. M. (2022). Social bias, discrimination and inequity in healthcare: Mechanisms, implications and recommendations. BJA Education, 22(4), 131–137. https://doi.org/10.1016/j.bjae.2021.11.011

*Mr Pubalan Rajagopalan
Farrer Park Hospital
1 Farrer Park Station Rd Singapore 217562
+6591050751
Email: pubalan83@outlook.sg

Submitted: 14 October 2024
Accepted: 4 March 2025
Published online: 6 January, TAPS 2026, 11(1), 86-88
https://doi.org/10.29060/TAPS.2026-11-1/II3542

Craig Hassed

Department of Medical Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia

I. INTRODUCTION

In this article I will outline some of the personal and clinical challenges faced by medical and allied health professionals. Mindfulness will be proposed as a necessary skill to be taught in under and postgraduate training to address a number of these challenges. To provide some insights into how this can be done effectively, I will share our experience from Monash University where we have successfully integrated the mindfulness-based Health Enhancement Program (HEP) into medical and allied health professional training for over 20 years. The case will be made for why other medical schools around the world can benefit from adopting similar curriculum.

II. DISCUSSION

It is well documented that medical and allied health professionals face many challenges in their working life including high rates of burnout, stress, alcohol and substance use, and poor mental health. Furthermore, in the complex work environments that health professionals work in, they need to make many decisions throughout the day which have major implications for patients’ health. The complexity is further complicated by the fast-paced modern world where the misuse and overuse of technology is leading to high levels of distraction and clinical errors.

The job-ready health professional needs practical skills to help them navigate such challenges. Unfortunately, these skills are often seen as optional ‘soft’ and are rarely part of the core-curriculum, but without these skills being taught in a comprehensive way, history keeps repeating itself.

One generic skill which can help address many specific challenges outlined above is mindfulness. The most widely used definition by Jon Kabat-Zinn is, “paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” In its broadest sense, mindfulness is a practice in training attention and attitude. It can be practiced formally as in mindfulness meditation, and informally by being present and engaged as one goes about daily life.

Before introducing such training into the medical and allied health curriculum one needs a rationale for doing it supported by a sound evidence-base. The exponential growth of research into mindfulness for health professionals has confirmed its efficacy in managing stress and anxiety, reducing relapse rates from depression, lowering burnout, and reducing addictive behaviours. Importantly, the modern doctor also needs to be equipped with non-pharmaceutical options or adjuncts for their patients in the management of stress and mental health problems, chronic pain, and coping with chronic illness.

Because of the enhanced attentional, situational awareness and self-monitoring capacities that mindfulness provides, there is evidence that it enhances clinical decision making, reduces the impact of cognitive biases and helps prevent clinical errors, in part because doctors can learn to be alert to the negative impact of practices like complex multitasking or the distracting effect of technology.

Also important is the evidence from Krasner and Epstein (Krasner et al., 2009) showing that mindfulness not only enhances physician wellbeing but also conscientiousness, emotional intelligence, communication and compassion leading to better clinical interactions with patients.

Mindfulness training has been a part of the core curriculum for medical students at Monash University since 1992. Initially it was on a small scale and then in 2002 the program grew into what we call the Health Enhancement Program. Monash was the first university in the world to integrate mindfulness as core-curriculum and soon after Rochester University introduced a mindfulness program into its curriculum (Dobkin & Hutchinson, 2013).

The HEP is a mindfulness-based healthy lifestyle program delivered in the first semester of the first year of Monash’s five-year undergraduate medical curriculum. It is underpinned by mindfulness training alongside content on lifestyle including the benefits of healthy diet, exercise, environment, connectedness and spirituality, as well as behaviour change strategies and goal setting.

A lecture series providing the evidence and clinical rationale for learning about mindfulness and other elements of the HEP followed by a series of five two-hour tutorials where the students learn to apply mindfulness and lifestyle-focused behaviour change skills in their own lives.

This experiential and deep learning model helps students to foster their own wellbeing, be better manage their stress, and to build an understanding of how these approaches can be used with patients in future medical practice. To assist in the reflective learning approach, students are very actively engaged in group discussions during tutorials. They also keep a weekly reflective journal sharing their reflections, insights, challenges and questions in applying mindfulness and healthy lifestyle change in their own lives. These journals are read by the tutor who provides personalised feedback and encouragement to the students.

The authenticity, credibility and motivation of the tutoring team is crucial for the effectiveness of the program. All tutors are working health professionals – nearly all doctors and psychologists – who personally and professionally use the mindfulness skills they are teaching.

The HEP is core-curriculum and, like any other part of core-curriculum, is assessable and students are required to attend tutorials and learn the content, but we are very clear in communicating to the students that what they practice or apply outside of the tutorial room in their personal life is very much their own personal choice. Students are invited to explore the techniques and apply them in ways that are meaningful for them, but mindfulness is not being imposed on them.

Contextualisation of mindfulness to fit with students’ studies, lives and future work is vital otherwise it won’t be seen as being relevant in the medical curriculum. If this is done well then students receive mindfulness very positively and they apply it in meaningful ways. We have found that over 90% of students report personally applying the formal and informal mindfulness practices in their own lives outside of tutorials (Hassed et al., 2009). If it’s done poorly then the opposite will happen. Contextualisation is further reinforced with mindfulness-based experiments like exploring the effects of complex multitasking, mindful communication, dealing with distractors, and a mindful eating and exercise.

Students need to understand that mindfulness is a transferable skill relevant to their work and life generally, and it is not just seen as a superfluous addition to the ‘serious’ medical curriculum. It is therefore important that mindfulness is horizontally and vertically integrated with other relevant curriculum such as being more present in communication skills training, better focus when learning medical procedures like venepuncture, learning how to manage exam anxiety and, in later years, being more self-aware in clinical decision-making. One method of increasing integration and giving the content a clinical focus is through weekly role-plays similar to the kinds of cases students might meet in OSCE exams.

For the students to take any part of the curriculum seriously and to engage with it, it needs to be assessable. If the mindfulness content is not assessable students will not think it’s important because, in their perception, if it was important, it would be assessed. The journal is marked by the tutors based on the insights students glean and the authenticity and quality of their self-reflection. The knowledgebase and science covered in the HEP lectures is assessed in written exams. Students’ understanding of how to communicate the principles of what mindfulness is about, and what kinds of clinical applications would be appropriate for its use is assessed in OSCE exams. We do not expect the students to reach a point where they could teach mindfulness skills to patients. Further training would be required to reach this objective.

The HEP has become an integral and distinctive part of the Monash medical curriculum. As core-curriculum we have never had the option of performing a randomised control trial on the program outcomes, but we have performed a series of pre-post studies. Our findings that students report improvements in mental health, perceived stress, study engagement, and mindfulness from pre- to post-intervention, even though pre-intervention measures were taken in a low stress period of semester and the post-intervention measures were taken in the period immediately prior to mid-year exams, is very encouraging and counter to evidence showing medical student wellbeing inevitably declines as the semester progresses and students approach assessment (Hassed et al., 2009; Kakoschke et al., 2021).

III. CONCLUSION

Deficiencies in medical education in providing job-ready health professional do not generally lie with a lack of biomedical knowledge and clinical teaching in undergraduate years. The main deficit in training relates to necessary personal skills like attentional control, emotional regulation, stress management, resilience, self-awareness and self-care. One generic skill that has the potential to meet these diverse needs is mindfulness. There is much to be gained by giving all medical and allied health professional students contextualised, relevant, and evidence-based training in mindfulness to help them meet the personal and professional demands that come with increasingly complex and demanding careers in healthcare. A more extensive discussion of the why and how of doing that successfully can be found in a discussion paper in the journal, Mindfulness (Hassed, 2021).

Notes on Contributors

Craig Hassed was the sole author, responsible for the conceptual development and writing of this article.

Funding

There was no funding source for this paper.

Declaration of Interest

The author declares to have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

Dobkin, P. L., & Hutchinson, T. A. (2013). Teaching mindfulness in medical school: Where are we now and where are we going? Medical education, 47(8), 768–779. https://doi.org/10.1111/medu.12200

Hassed, C., de Lisle, S., Sullivan, G., & Pier, C. (2009). Enhancing the health of medical students: Outcomes of an integrated mindfulness and lifestyle program. Advances in Health Sciences Education, 14(3), 387–398. https://doi.org/10.1007/s10459-008-9125-3

Hassed, C. (2021). The art of introducing mindfulness into medical and allied health curricula. Mindfulness, 12, 1909–1919. https://doi.org/10.1007/s12671-021-01647-z

Kakoschke, N., Hassed, C., Chambers, R., & Lee, K. (2021). The importance of formal versus informal mindfulness practice for enhancing psychological wellbeing and study engagement in a medical student cohort with a 5-week mindfulness-based lifestyle program. PloS one, 16(10), e0258999. https://doi.org/10.1371/journal.pone.0258999

Krasner, M. S., Epstein, R. M., Beckman, H., Suchman, A. L., Chapman, B., Mooney, C. J., & Quill, T. E. (2009). Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA, 302(12), 1284–1293. https://doi.org/10.1001/jama.2009.1384

*Craig Hassed
Faculty of Medicine, Nursing and Health Sciences
Monash University
Wellington Road, Clayton,
Victoria, Australia
Email: craig.hassed@monash.edu

Submitted: 28 January 2025
Accepted: 5 July 2025
Published online: 6 January, TAPS 2026, 11(1), 89-91
https://doi.org/10.29060/TAPS.2026-11-1/II3646

Darlina Hani Fadil Azim¹, Gaik Kin Teoh¹ & Nilesh Kumar Mitra²

¹Department of Psychology & Counselling, School of Psychology & Social Sciences, IMU University, Malaysia; ²Human Biology Division, School of Medicine, IMU University, Malaysia

I. INTRODUCTION

Sustainability was the key topic at APMEC 2025. However, how can we maintain care quality when patient demands overshadow healthcare workers’ well-being? The mental health challenges faced by medical students and healthcare professionals – including high workload, burnout, and the emotional toll of the second victim phenomenon, which is the emotional and psychological distress healthcare professionals experience after being involved in or witnessing an adverse patient event or medical error – are well-documented yet often insufficiently addressed (Busch et al., 2021). Despite growing awareness, existing institutional policies for managing and monitoring mental well-being remain fragmented and unsustainable (Kuhlmann et al., 2024). In the Conference workshop session, “Promoting Mental Health in HPE and Healthcare: Partnering for Change”, we were able to create a safe space in which sincere and honest experiences were shared among the participants, who were medical doctors, medical educators, and support staff for medical students and they were able to learn from one another. Therefore, the aim of this paper is to share our insights and recommendations that can be helpful for medical educators and policymakers in ensuring that the healthcare workers well-being is maintained for a sustainable future.

II. STRESSORS OF STUDENTS AND RESIDENTS

The participants highlighted in the small group discussions that the stressors among residents are quite different from those faced by medical students. While students tend to be more concerned about academic pressures and uncertainties about their future careers, residents are more concerned about the high workload and challenging work demands, including patient care responsibilities and personal factors such as managing a young family.

The participants also expressed their concerns about providing the necessary support for both students and residents under their care. They have observed that they tend not to reach out for help when they need it, and for those who do, participant X mentioned that “they are not as forthcoming in sharing about the core of the problem and instead tend to keep it at a superficial level”. Several participants hypothesised that this could be due to the stigma surrounding mental health and the limited time to consult with a senior or superior. This is supported by the study by Hawsawi et al. (2024) who also found other factors such as no or minimal access to mental health support, as well as the normalisation of stress and burnout in the medical field.

To address this, participant Y shared his strategy of “approaching students during informal settings such as class break time or lunch breaks” to make the interaction less formal and a more congenial interaction. He also prefers to “just listen and support, instead of trying to change or correct the student”. Another participant who works in a teaching hospital found that “my students were more willing to open up when I shared my own struggles from when I was a junior doctor”. These practices can help encourage more open communications from the medical students and residents.

III. COPING STRATEGIES OF MEDICAL EDUCATORS

To explore the participants’ coping strategies in managing their own stressors, each participant was requested to list both internal and external supports that are available to them and to share with the whole group. Internal coping mechanisms such as turning to religion offer comfort, meaning, and community support. Positive self-talk and acceptance promote self-compassion and reduce negative thinking. Distraction techniques, such as engaging in hobbies, practicing mindfulness, or exercising, provide temporary relief and improve mood. In terms of external support, most of the participants have a strong support system from family, colleagues and mentors who provide emotional support, understanding, and a sense of belonging. Having a safe space to vent frustrations and anxieties without judgment offers crucial emotional release. One participant found this workshop activity of self-disclosure and sharing helped her to see that she is not alone in her own struggles with mental health issues. Interestingly, none of the participants mentioned systemic support as one of the coping factors. Could this imply systemic support is beyond their capacity, or are they not aware of its availability or significance? The participants highlighted that while there are efforts in their institutions to promote mental health and well-being, these tend to be more focused on the students, rather than on staff. Two of the participants also discussed how their institutions have made available third-party digital therapeutics companies that includes access to mental health professionals and also AI chatbots that can provide online support. This could be a more accessible option for those who are hesitant to reach out for help.

IV. PROPOSED SOLUTIONS

Considering the input from the workshop participants, we recommend the following:

1) To reduce the stigma of seeking formal mental health support that are provided by the institutions, incorporate in the medical curriculum the provision of a safe platform for sharing personal stories from senior staff or alumni that showcase their mental health challenges in different stages of their career and how they managed it. This fosters a work culture that powerfully conveys mental health challenges are not signs of weakness, but rather that understanding how and where to seek help is an essential component of professional practice.

2) To further harness the support that staff are already providing informally to their peers and students, a mandatory training programme on Mental Health First Aid focusing on recognising signs of distress, basic active listening skills, motivational interviewing skills and appropriate referral pathways can be implemented. This can be made available to the students as well.

3) To address the perceived lack of systemic support for staff, a mandatory wellness program is recommended. This may include regular and dedicated mental health check-ins with independent mental health professionals who are familiar with the unique stressors and challenges faced by healthcare professionals and students including the second victim phenomenon. These check-ins can be in an informal setting like during coffee breaks or gym sessions to encourage open and non-judgmental conversations, reduce stigma, and normalise seeking psychological support as a routine part of professional well-being. Using AI chatbots could also be an alternative approach. These conversations can provide valuable opportunities to identify early warning signs and offer timely support.

V. CONCLUSION

The format of this APMEC 2025 workshop can serve as a model for fostering collaborative mental health discussions, thus making it a replicable innovation. The insight from the workshop clearly shows that more needs to be done to address healthcare workers’ well-being at the systemic level. This is a direct call to action for HPE institutions to prioritise and implement strong, dedicated mental health support systems. Furthermore, HPEs must equip all staff and students with the essential skills to proactively offer mental health support to their peers and colleagues, fostering a truly supportive academic and professional environment.

Notes on Contributors

DHFA conceptualised the core idea, developed the argument and wrote the paper.
GKT initiated, conceptualised, analysed the literature and revised the paper.
NKM analysed the literature and revised the paper.

Ethical Approval

There is no data presented in this paper, and thus ethical approval is not required.

Acknowledgement

We would like to thank the Deans of the School of Psychology and Social Sciences and the School of Medicine at IMU University, for supporting our participation in this conference.

Funding

IMU University, Malaysia, funded our participation in this conference.

Declaration of Interest

All authors have no conflict of interest to declare.

References

Busch, I. M., Moretti, F., Campagna, I., Benoni, R., Tardivo, S., Wu, A. W., & Rimondini, M. (2021). Promoting the psychological well-being of healthcare providers facing the burden of adverse events: A systematic review of second victim support resources. International Journal of Environmental Research and Public Health, 18(10), 5080. https://doi.org/10.3390/ijerph18105080

Hawsawi, A. A., Nixon, N., Stewart, E., & Nixon, E. (2024). Exploring access to support services for medical students: Recommendations for enhancing wellbeing support. BMC Medical Education, 24(1), 671. https://doi.org/10.1186/s12909-024-05492-1

Kuhlmann, E., Falkenbach, M., Brînzac, M. G., Correia, T., Panagioti, M., & Ungureanu, M. I. (2024). The mental health needs of healthcare workers: When evidence does not guide policy. A comparative assessment of selected European countries. The International Journal of Health Planning and Management, 39(3), 614-636. https://doi.org/10.1002/hpm.3752

*Darlina Hani Fadil Azim
126, Jalan Jalil Perkasa 19, Bukit Jalil,
57000 Kuala Lumpur, Malaysia
+60122846675
Email: darlinahani@imu.edu.my

https://doi.org/10.29060/TAPS.2026-11-1/TT005

Tim Wilkinson

Professor of Medicine and Medical Education,
Dean’s Department (Christchurch),
University of Otago, New Zealand

“My student is not very professional.”

“They failed their OSCE station because they need to be more professional.”

“What’s the best tool to assess professionalism?”

These kinds of comments and questions are common in medical education – and they reflect an unhelpful tendency to treat professionalism as a singular, all-encompassing trait. In reality, professionalism is not one thing. It’s many things. It’s time we started talking about professionalisms – plural.

A student might be honest but disorganised. Another might communicate beautifully with patients but struggle to take feedback from colleagues. Being professional in one domain doesn’t mean being professional in all. Just as we wouldn’t assess clinical knowledge with a single multiple-choice test, we can’t evaluate or develop professionalism with a single lens.

In my systematic review (Wilkinson et al., 2009), I found that while definitions of professionalism vary, most can be clustered into five broad domains:

1. Ethical practice – Honesty, integrity, and respect for confidentiality.
2. Interpersonal behaviour with patients and families – Empathy, rapport, communication.
3. Teamwork and collaboration – Collegiality, accountability to the wider health system.
4. Reliability – Following through, being prepared, respecting deadlines.
5. Commitment to improvement – Reflectiveness, lifelong learning, system contributions.

 

Different cultures, institutions, and disciplines may emphasise some of these more than others, but none of them captures professionalism alone. What matters most is not drawing hard boundaries, but being clear and specific – with ourselves, our colleagues, and our students – about which dimensions we are referring to in a given context.

When we shift from thinking about professionalism as a singular trait to seeing it as a set of behaviours and commitments that evolve over time, we create more space for growth.

Here are some useful questions to ask ourselves:

• What specific behaviour or value am I referring to when I talk about “professionalism”?
• How can I name and model that behaviour clearly for learners?
• What would the learner need to do to convince me the concern about professionalism has resolved?
• Where might I be expecting students to “just know” what’s expected?

By embracing professionalism in the plural, we make it more meaningful, teachable, and explicit.

Reference

Wilkinson, T. J., Wade, W. B., & Knock, L. D. (2009). A blueprint to assess professionalism: Results of a systematic review. Academic Medicine, 84(5), 551-558. https://doi.org/10.1097/acm.0b013e31819fbaa2