1. Quality of life issues for fourth and fifth year medical students studying in New Zealand Health of Health Professionals Conference Auckland 2-5 November 2011 Drs Susan Hawken, Marcus Henning and Christian Krägeloh

2. Background Quality of life issues amongst medical students have been well documented such as coping with long hours of study and working in the clinical learning environment. Quality of life issues amongst medical students have been well documented such as coping with long hours of study and working in the clinical learning environment. There is a dearth of research into the measure of quality of teaching and learning in the medical environment in relation to ethnicity, gender and age. There is a dearth of research into the measure of quality of teaching and learning in the medical environment in relation to ethnicity, gender and age.

3. Purpose Our research documents measures of quality of life for fourth and fifth year students studying in Auckland in 2009 and considers differences between ethnic and gender groups. Our research documents measures of quality of life for fourth and fifth year students studying in Auckland in 2009 and considers differences between ethnic and gender groups.

4. Method A total of 218 students were surveyed using the World Health Organization – Quality of Life questionnaire (Bref version). It has cross cultural validity. A total of 218 students were surveyed using the World Health Organization – Quality of Life questionnaire (Bref version). It has cross cultural validity. It has 26 items. It has 26 items. Four sub-scales – physical, psychological, social and environmental. Four sub-scales – physical, psychological, social and environmental. n GenderFemale127 Male91 EthnicityEuropean99 MAPAS27 Asian92

5. Multivariate Tests Effect ValueFdf1df2p AgeWilks' Lambda.962.364208.06 SexWilks' Lambda.981.214208.31 EthnicityWilks' Lambda.864.038416.00 Sex * ethnicityWilks' Lambda.97.818416.60 Tests of Between-Subjects Effects SourceDependent Variable Type III SSdfMSFp EthnicityPhysical2.1921.096.17.00 Psychological2.9721.497.25.00 Social11.7525.889.07.00 Environmental3.6421.825.39.01

7. Results The results showed no differences with respect to the independent variables of year of study, gender, and age. The results showed no differences with respect to the independent variables of year of study, gender, and age. Significant difference for ethnicity was found. Significant difference for ethnicity was found. Post hoc analyses showed that Asian students significantly scored lower on the physical, psychological, social and environmental quality of life domains when compared with their New Zealand European peers. Post hoc analyses showed that Asian students significantly scored lower on the physical, psychological, social and environmental quality of life domains when compared with their New Zealand European peers. MAPAS students scored significantly higher than Asian students in terms of the social quality of life domain. MAPAS students scored significantly higher than Asian students in terms of the social quality of life domain.

8. Discussion Why do Asian students score lower than NZ Europeans on physical, psychological, social and environmental QOL? Why do Asian students score lower than NZ Europeans on physical, psychological, social and environmental QOL? Possible explanations: cultural difference - response bias cultural difference - response bias work ethic, lower confidence, humility work ethic, lower confidence, humility religion, sexual question ?offensive religion, sexual question ?offensive for the international students may be adaptation and enculturation issues for the international students may be adaptation and enculturation issues external pressures to succeed external pressures to succeed

9. Discussion cont. Why do MAPAS students score higher than Asian students in terms of the social quality of life domain? Why do MAPAS students score higher than Asian students in terms of the social quality of life domain? Possible explanations – emphasis on interconnectedness, family and common collective goals Possible explanations – emphasis on interconnectedness, family and common collective goals Other?? Other??

10. Implications One size does not fit all One size does not fit all Different sorts of supports and programmes for different sub groups of students Different sorts of supports and programmes for different sub groups of students Culturally appropriate and accessible Culturally appropriate and accessible Peer-led supports Peer-led supports Student driven solutions to QOL issues Student driven solutions to QOL issues

11. Conclusions The findings indicate aspects of cultural differences, external pressures, and response bias. The findings indicate aspects of cultural differences, external pressures, and response bias. Need to be proactive and research informed, in determining how to move forward together in partnership with students on QOL issues Need to be proactive and research informed, in determining how to move forward together in partnership with students on QOL issues

12. References Henning M. A., Hawken S. J., Hill A. G. The quality of life of New Zealand doctors and medical students: What can be done to avoid burnout? NZ Med J. 2009; 122 (1307). http://www.nzma.org.nz/journal/122-1307/3916/ [Selected paper in the NZMJ Digest, February 2010, 18, 26-29] Krägeloh, C., Henning, M., Hawken, S., Zhao, Y., Shepherd, D., & Billington, R. (2011). Validation of the WHOQOL-BREF quality of life questionnaire for use with medical students. Education for Health [Electronic article], 24 (2), 545. Retrieved from http://educationforhealth.net/publishedarticles/article_print_545.pdf Henning, M.A., Hawken, S. J., Krägeloh, C, Zhao Y. & Doherty, I. Asian medical students: Quality of life and motivation to learn. Asia Pacific Education Review. 25 January 2011 http://www.springerlink.com.ezproxy.auckland.ac.nz/content/121317/ Henning, M., Hawken, S., Zhao, J., & Krageloh, C. (2010). Medical Students Studying in New Zealand: Quality of Life, Motivation, and Expected Academic Achievement. Medical Education, 44 (Supplement s4), 12. Henning, M., Krägeloh, C., Hawken, S., Zhao, Y., & Doherty, I. Quality of life and motivation to learn: A study of medical students. Issues in Educational Research 2010; 20(3): 244-256.