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Objective: Explore which wellness behaviors have the greatest impact on wellbeing outcomes in medical students.

Methods: A total of 213 medical students were enrolled in this study between June and September 2021. Participants completed a battery of online surveys, including demographic information, and 60-second nightly surveys on the WE-MD smartphone app, which assessed wellness-related indicators (exercise duration, sleep quality, nutrition quality, etc.) and wellbeing outcomes (mood, focus, stress, etc.).

Results: 116 participants completed >50% of nightly surveys between September 2021 and November 2021 and were included in the analysis. All wellness indicators were significantly associated with at least one wellness outcome. Quality of social interactions had the greatest relative positive association with wellbeing. Any amount of exercise, including 1-30 minutes, was significantly associated with improved wellbeing outcomes compared to no exercise. A lagged analysis separating indicators and outcomes by one day found wellbeing was only associated with limited sleep (< 6 hours) and higher nutritional quality the day prior.

Conclusion: This study provides substantial information on daily wellness behaviors and their relative impact on medical student wellbeing. Social interaction and exercise of any duration may be more important to wellbeing than previously recognized. Infrequently studied behaviors, including kindness, nutrition, and screen time, were also found to have significant associations with wellbeing. The numerous significant associations between behaviors and outcomes suggest a cumulative effect and point to the multifactorial nature of medical student wellbeing. This study may aid medical schools in developing high-impact initiatives and curricular changes that promote wellbeing for their students.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.