Effectiveness of an online mental health strengthening module to build resilience and overcome stress for transitional aged medical students
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Introduction Transitional-aged youths (17-to-24-years-old) are prone to mental-health problems. Students in higher education, especially medical students, are more exposed to stressors and thus need training to increase resilience. However, there have been limited mental-health strengthening modules specifically developed for medical students of transitional age, and none in Indonesia. This study intends to test the effectiveness of an online mental-health strengthening module in altering resilience. Methods A pragmatic randomized trial with repeated measurements was employed to evaluate biopsychosocial outcomes of resilience. The intervention module was delivered in 4 weeks to 105 eligible students. Participants were divided into intervention group (n = 52) and control group (n = 53). Outcomes were measured in the 4th, 8th, and 12th weeks. Primary outcome was resilience level as measured by Connor-Davidson Resilience Scale (CD-RISC). Perceived Stress Scale (PSS), Depression Anxiety Stress Scale (DASS) were utilized to measure stress, depression and anxiety. Knowledge and attitude toward mental-health were also measured through validated questionnaires. Stress levels of participants were measured biologically by measuring salivary cortisol and alpha-amylase levels at the baseline and 12th-week. Results Compared to the control group, there were no significant difference in resilience score of the intervention group compared to control group [F(1, 103) = 2.243, P = .137]; however, there was a significant main effect of time [F(3, 309) = 18.191, P < .001] and interaction effect between intervention and time in resilience score [F(3, 309) = 5.056, P = .002]. Additionally, compared to the control group, there were significant increases in knowledge [F(1, 103) = 66.805, P < .001], attitudes and behavior towards mental-health [F(1, 103) = 5.191, P = .025], and a significant decrease in stress perception score [F(1, 103) = 27.567, P < .001]. The mean salivary delta cortisol during pre-test and post-test at week 12 in the intervention group showed significant difference (P < .001). However, there was no significant difference in the mean delta salivary alpha-amylase between pre-test and post-test at week 12, both in the intervention and control groups. Conclusion The mental-health strengthening module was accepted and applicable to first-year medical students and was found to be effective in increasing resilience from various biopsychosocial aspects. It is also advisable to have similar modules throughout the medical school to maintain sustainability.
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Three blended group studies reported an effect on stress, burnout, and depression and anxiety through the use of the Transition and Adaptation towards Resiliency module, the ThoughFullChat intervention, and the Compassion Cultivating Training.
“Three studies (79–81) reported an effect on stress (79, 81), burnout (79), and depression and anxiety (79, 80) through the Use of the Transition and Adaptation towards Resiliency module, the ThoughFullChat intervention, and the Compassion Cultivating Training.”
From Digital resilience interventions for healthcare workers: a systematic review (2025) · cites this paper as [79]
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Experimental — accuracy not yet measuredThree blended group studies investigated various variables and their interrelationships.
“Three studies investigated various variables and their interrelationships (74, 79, 83).”
From Digital resilience interventions for healthcare workers: a systematic review (2025) · cites this paper as [79]
Another blended group study demonstrated a significant interaction between time and intervention regarding outcomes such as resilience, stress, depression, and anxiety.
“Another study demonstrated a significant interaction between time and intervention regarding outcomes such as resilience, stress, depression, and anxiety (79).”
From Digital resilience interventions for healthcare workers: a systematic review (2025) · cites this paper as [79]
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Building digital resilience: leading healthcare transformation through an online community
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- Authors
- Kaligis, F., Ismail, R. I., Wiguna, T., Prasetyo, S., Gunardi, H., Indriatmi, W., Pasaribu, M. M., Pandia, V., Minayati, K., Magdalena, C. C., Nurraga, G. W., Pramatirta, B., Calvin, N., & Sourander, A.
- Affiliations
- University of Indonesia (ID)
- Dr. Hasan Sadikin General Hospital (ID)
- Corresponding author
- Kaligis, Fransiska
- ORCID
- Venue
- Frontiers in Digital Health
- Publisher
- Frontiers Media SA
- Published
- 2023-10-04
- Volume
- 5
- Pages
- 1207583-1207583
- ISSN
- 2673-253X (ISSN-L)
- PMC
- PMC10582941
- OpenAlex
- W4387335479
- Cited by
- 10
- References
- 44
- Citations by year
- 2026: 3 · 2025: 7
- FWCI
- 4.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Digital Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Universitas Indonesia (PUTI Q2)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
- Keywords
- resilience, online intervention, medical students, transitional-aged youth, stress, depression, anxiety, salivary cortisol, salivary amylase, biopsychosocial outcomes, Indonesia, university students, mental health promotion, resilience training programs, COVID-19 pandemic
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