JMIR Publications

ABSTRACT

Background:

With burnout at crisis levels among doctors and medical students, there is a need for early implementation of preventive initiatives during undergraduate medical training. Interventions that facilitate adaptive coping behavior (eg, Psychological Flexibility) in the context of inherent stressors associated with medical work and training could mitigate burnout risk and improve well-being. Delivering these interventions using smartphone apps offers advantages, such as accessibility, scalability, mitigation of time and stigma barriers, and facilitation of individual tailoring (“individualization”). There is need for feasibility trials among medical students in this emerging field. Formal evaluation of user experiences of app-based psychological skills training is required to identify barriers and facilitators of engagement, and to optimize intervention development prior to implementation in efficacy trials and real-world settings.

Objective:

This study aimed to assess the feasibility of delivering an individualized Psychological Flexibility (Acceptance and Commitment Training (ACT)) intervention to medical students using an app-based delivery format. We aimed to explore how formal evaluation of user experiences might inform and guide (a) development of the current app prior to implementation in a planned efficacy trial, and (b) future researchers and stakeholders developing app-delivered psychological skills training for medical students.

Methods:

This single-arm study was an early phase feasibility trial of a standalone ACT app conducted with a sample (N=11) of Australian medical students. We collected app usability and user experience data across a broad range of domains (eg, perceived helpfulness and relevance, learning experiences, self-efficacy etc.) using self-report questionnaires (quantitative and qualitative) and behavioral engagement outcomes.

Results:

Behavioral engagement data demonstrated the feasibility of the current app in delivering the ACT intervention to medical students as intended. Subjective feedback provided by students who actively engaged with the app was generally positive across several indicators, including usability, perceived relevance and helpfulness, accessibility, maintenance of privacy, and opportunity for self-reflection. Disengagement from the app was an identified challenge throughout the trial. Participant feedback identified several factors that may have impacted engagement, such as time, expectations regarding app interface functioning, and individual differences in confidence and self-efficacy when implementing skills.

Conclusions:

This study provides preliminary support for the feasibility of app-delivered Psychological Flexibility training for medical students, and the value of further evaluation of this approach. User experience feedback provided important insights that could improve the current app prior to planned efficacy trials. Our findings highlight the importance of evaluating subjective user experiences during psychological app development, in order to better understand and address factors that drive medical students’ engagement and disengagement.