A total of 61 undergraduate medical students who majored in Medical Imaging at the School of Medicine, South China University of Technology (SCUT) attended this training program voluntarily. Finally, 49 of them who completed all the questionnaires were included in the current analysis. Among the 49 participants, 31 were at year 2, and 18 were at year 3 of their medical study. Their ages range from 17 to 22 years old, with an average of 19.5. 36 of the participants were female, and 13 were male. The social demographic characteristics of the participant students are described in Table 1.
The positive psychology training program was set as a selective course, which was embedded into the regular school curriculum. The students who consented to participate in the course were then invited to complete multiple outcome measure questionnaires as detailed in the following Measures section prior to the commencing of the training and also in the week following the completion of the course, respectively. The surveys were anonymous with the exception of study year, gender and age, and no compensation was provided for the participation. All the 61 enrolled students finished the whole training class, and 49 of them who completed the whole set of questionnaires were included in the current analysis.
The positive psychology training program was set as a 1.5-hour group class once a week, and lasted for 8 continuous weeks. The protocol of this training program is based on Dr. Martin Seligman’s PERMA (Positive emotion, Engagement, Relationship, Meaning, Accomplishment) model. In brief, during each weekly class, a different topic related to the cultivation of PERMA will be talked, including the cultivation of positive emotional states (e.g. gratitude and appreciation), cultivation of intrinsic motivation through ‘flow”, and learning of being in harmony with the bad mood by highlighting the meaning of life. In addition, multiple cases about medical professional (e.g. doctor-patient relationships) were also introduced and discussed in class to guide the students to find the thinking traps using positive psychology theory. The class involved both conceptual and experiential learning. At the same time, multiple out-of-class exercises were also assigned, for example, the students were instructed to write down the good things which happened during the day, and encouraged to identify and develop their key character strengths in daily life.
The following five scales were used to measure the psychology status of the participants, including hope trait scale, life satisfaction scale, subjective happiness scale, depression and anxiety scale (S-Document). All these scales were first translated from English into Chinese by one of the authors who were fluent in both Chinese and English. Translations were then checked by another author of the study to ensure the consistency with the original meaning of the scale items, and no other adaptations to these scales were made.
The trait hope scale. The hope trait was measured by using the 12-item Trait Hope scale[26, 27]. This questionnaire asks respondents to rate their agreement with 12 statements related with hope, which is rated on a 1–8 scale ranging from 1 (definitely false) to 8 (definitely true). A sample item is: ‘‘I can think of many ways to get the things that are important to me’’.
Life satisfaction scale. The life satisfaction was measured by using the 5-item satisfaction scale developed by Dr. Ed Diener Emmons[28, 29]. This scale utilizes a 7-point response scale ranging from 1 (strongly disagree) to 7 (strongly agree) for 5 items. A sample item from this scale is, ‘‘In most ways, my life is close to ideal’’.
Subjective happiness scale. The subjective happiness scale is a 4-item scale of global subjective happiness[30, 31]. Amongst, two of the items ask respondents to characterize themselves using both absolute ratings and ratings relative to peers, whereas the other two items offer brief descriptions of happy and unhappy individuals and ask respondents the extent to which each characterization described them. Each item is rated on a 7-point scale ranging from 1 (strongly disagree) to 7 (strongly agree). A sample item from this scale is, ‘‘Compared to most of my peers, I consider myself (1-less happy to 7-more happy)’’.
Depression and anxiety scale
Participants’ symptoms of depression and anxiety were measured by using the patient-reported outcome measurement information system (PROMIS), which is a five item Likert-type response scale to measure the frequency with which respondents had experienced symptoms of depression and anxiety over the past week. A sample item from this scale is, ‘‘I felt worried’’. Participants were asked to rate their agreement with 5 answer choices ranging from “Never” to “Always”.
- Data analyses
The data were analyzed by using SPSS (version 18). Independent t tests were used to determine whether there were any differences between pre- and post-test scores on each outcome measure. Estimated means were used to describe the averaged pre-test and post-test scores on the outcome measures. P≤0.05 was considered as statistically significant.