title: Association Between Perceived Medical School Diversity Climate and Change in Depressive Symptoms Among Medical Students: A Report from the Medical Student CHANGE Study.
abstract: To determine whether perceptions of the medical school diversity climate are associated with depression symptoms among medical students.
  
  
  
  Longitudinal web-based survey conducted in the fall of 2010 and spring of 2014 administered to a national sample of medical students enrolled in 49 schools across the U.S. (n = 3756). Negative diversity climate measured by perceptions of the institution's racial climate; exposure to negative role modeling by medical educators; frequency of witnessing discrimination in medical school. Depression symptoms measured by the PROMIS Emotional Distress-Depression Short-Form.
  
  
  
  64% of students reported a negative racial climate; 81% reported witnessing discrimination toward other students at least once, and 94% reported witnessing negative role modeling. Negative racial climate, witnessed discrimination, and negative role modeling were independently and significantly associated with an increase in depression symptoms between baseline and follow-up. Adjusting for students' personal experiences of mistreatment, associations between depressive symptoms and negative racial climate and negative role modeling, remained significant (.72 [.51-.93]; .33 [.12-.54], respectively).
  
  
  
  Among medical students, greater exposure to a negative medical school diversity climate was associated with an increase in self-reported depressive symptoms.
authors.affiliation: Division of Health Policy and Management, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455, USA. Electronic address: Hard0222@umn.edu.
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Hardeman
authors.affiliation: University of Minnesota, School of Public Health, Division of Health Policy and Management, Minneapolis, MN, USA.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Przedworski
authors.affiliation: Yale University, Department of Psychology, New Haven, CT, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Burke
authors.affiliation: Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA; University of Minnesota Medical School, Department of Medicine, Minneapolis, MN, USA.
authors.forename: Diana J
authors.initials: DJ
authors.lastname: Burgess
authors.affiliation: Northwestern University, Department of Psychology, Evanston, IL 60208, USA.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Perry
authors.affiliation: Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Phelan
authors.affiliation: Yale University, Department of Psychology, New Haven, CT, USA.
authors.forename: John F
authors.initials: JF
authors.lastname: Dovidio
authors.affiliation: Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: van Ryn
mesh_terms: D003863:Depression / Q000453:epidemiology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D010465:Perception; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology*
keywords: Depressive symptoms; Diversity climate; Medical students; Racial climate; Well-being