Research Partners & Studies

To Chat or Not to Chat: How can Chatbots be used to positively impact medical professionals’ mental health?

Whilst largely agreed that medical professionals face straining work conditions & psychological harm, there is often a low utilisation of mental health treatment from this group due to concerns regarding career progression. Consequently, resident medical officers (RMO), or junior doctors, suffer some of the highest rates of emotional difficulties than other disciplines. Therefore, a non-traditional approach is needed, calling for exploration of new treatment interventions to support training medical professionals.

This study used data from 52 Postgraduate resident medical officers in their First Year and above who can run the app & are willing to provide information at time-points over a 12-week period. The RCT aimed at assessing the effectiveness of mental wellbeing monitoring being delivered via mobile app. The intervention group received the full mobile wellbeing programme, which also includes a chatbot ‘Delta’ which is based on Acceptance Commitment Therapy (ACT) therapy.

The app randomized n=25 participants to the control group which received the standard daily mental wellbeing check-in and n=26 to the intervention group, who had the addition of a chatbot. The intervention group showed statistically significant increases in personal awareness & utilization of support options than control group participants. This RCT showed that a chatbot is an acceptable technology to measure and monitor mental health of RMO’s and leads to a 30% increased awareness of personal mental health. This enabled participants to seek support services 2 weeks earlier than the control group. This study lays the foundation for further research in e-mental health therapies for medical professionals.

The University of Otago

In 2015, we partnered with the Dean of the Dunedin Medical School, Professor Barry Taylor and Associate Professor Ralph Pinnock in developing a tool to measure medical student wellbeing.

Using co-design principles we ran focus groups with medical students on how they would like to report their wellbeing, and what was most important for them. These focus groups then informed the design of the project. The students were happy to give information to the Medical School about their wellbeing and experiences, but on the strict condition that it was 100% anonymous, and safe for them to do so. They also said that an App was a great way to collect this information. Paper based surveys were too time consuming, online surveys also had concerns about being ‘completely anonymous’, and they most definitely didn’t want to use the University’s online platform. They requested an App without a log-in so that they could, at any time or location, update how they were feeling. They wanted the App to be administered by chnnl as a safe intermediary that ensured their anonymity and concerns were taken seriously, and relayed back to those who could make changes.
‍
We ran the project with 4th, 5th and 6th year medical students and had a 77% response rate in the daily wellbeing survey. The results from the project informed the Medical School leadership to make changes to improve the environment to promote wellbeing. One example of a change was the students in Invercargill, a rural placement, all noted poor sleep on this placement. This prompted a review of the student accommodation in Invercargill which was converted from the old Nurses’ quarters. Small changes in the accommodation meant a big improvement in the sleep and overall wellbeing of the medical students.

“Sometimes it is hard to know that you are actually quite stressed out”

- 4th Year medical student participant

“We undertook a feasibility study of the App with our senior medical students and found the insights useful for understanding what contributed to students' wellbeing.”

- Professor Barry Taylor,
Dean of Dunedin Medical School, Otago University

Counties Manukau DHB

In February 2018 we launched a one year feasibility study at the Department of General Surgery, Middlemore Hospital. After the first initial meetings, it was decided to open the project to include all new graduate nurses in CMDHB and to enrol all Resident Medical Officers as they rotate through general surgery. There were 67 new graduate nurses, with 52 successfully recruited into the study. Every quarter (3 monthly) a new group of Resident Medical Officers attended an orientation to the general surgery department. They were asked to participate in the study and we had a 95% sign up rate.

“Data from the App has helped my understanding what is really going on for our nurses, both from work and personal issues, and has enabled me to provide the right support to our department.”

- Belinda Williams, Nurse Educator,
General Surgery, CMDHB

“I had an idea on how to improve handover between ED and the wards and my manager brought it up in a meeting – I was chuffed because I am always too scared to speak up in group meetings.”

- New Graduate Nurse,
Emergency Department

“Our house officers were unanimous in their decision to be involved and participate in this project. Those house surgeons who used it found it very helpful.”

- Ms Jenny Wagener,
General Surgeon, Medical Education Supervisor PGY1, General Surgery, Counties Manukau DHB.

Links to our published research

Berryman, E. (2016). Bullying culture: Valuing the teacher-student relationship.
New Zealand Medical Journal, 128(1424).Berryman EK, Leonard DJ, Gray AR, Pinnock R, Taylor B. Self-Reflected Well-Being via a
Smartphone App in Clinical Medical Students: Feasibility Study. JMIR medical education.
2018 Jan;4(1).Blakey, A. G., Smith-Han, K., Anderson, L., Collins, E., Berryman, E. K., &; Wilkinson, T.
(2019). It’s ‘probably the teacher!’A strategic framework for clinical staff engagement in
clinical student bullying intervention. BMC medical education, 19(1), 116.Blakey, A. G., Anderson, L., Smith-Han, K., Wilkinson, T., Collins, E., &; Berryman, E.
(2018). Time to stop making things worse: an imperative focus for healthcare student
bullying research. New Zealand medical journal, 131(1479), 81-85.Blakey, A. G., Smith-Han, K., Anderson, L., Collins, E., Berryman, E., &; Wilkinson, T. J.
(2019). Interventions addressing student bullying in the clinical workplace: a narrative
review. BMC medical education, 19(1), 220.Gamble Blakey, Althea &; Smith-Han, Kelby &; Anderson, Lynley &; Collins, Emma & Berryman, Elizabeth &;
Wilkinson, Tim. (2019). “They cared about us students:” learning
from exemplar clinical teaching environments. BMC Medical Education. 19. 10.1186/s12909-019-1551-9.Smith-Han, Kelby &; Collins, Emma & Asil, Mustafa & Gamble Blakey, Althea &; Anderson, Lynley &; Berryman, Elizabeth & Wilkinson, Tim. (2020). Measuring exposure to bullying and harassment in health professional students in a clinical workplace environment: Evaluating the psychometric properties of the clinical workplace learning NAQ-R scale. Medical Teacher. 42. 1-9. 10.1080/0142159X.2020.1746249.