Psychological Distress in the Association between Medical Education Changes and Clinical Learning Worry among Students Receiving Clinical Education during the COVID-19 Pandemic in Taiwan

Background: The COVID-19 pandemic profoundly impacted medical education and caused psychological distress and worry about clinical learning for those who received clinical medical education during this period. Although the acute phase of COVID-19 has now ended, understanding its impact is essential for strengthening medical system preparedness. Therefore, the present study examined the association between changes in medical education and worry about clinical learning, considering the mediating role of psychological distress among participants who received clinical training. Methods: A cross-sectional online survey was conducted with 542 post-graduate year (PGY) doctors and allied health students from the 2020 and 2021 cohorts in Taiwan. The survey assessed changes in clinical training modes, direct patient care, learning stress, psychological distress, and worry about clinical learning. Results: Among the participants, 76.0% experienced changes in clinical training mode, and 84.3% had direct patient care experience. Direct patient care/contact was significantly correlated with lower levels of worry about clinical learning. Learning stress was positively correlated with increased psychological distress and worry about clinical learning. Psychological distress partially mediated the relationship between learning stress and worry about clinical learning. Conclusion: The findings highlight the importance of direct contact with patients because it was associated with lower levels of worry about clinical learning. Moreover, increased learning stress was associated with psychological distress and worry about clinical learning. Therefore, effective support systems are essential to mitigate these impacts and enhance clinical training during national health crises. The findings provide valuable insights for improving medical education and support systems in future health emergencies. However, the present study used a cross-sectional study design. Therefore, the mediation findings should be interpreted with caution (i.e., no causal relationships can be determined based on cross-sectional data).