Association between changes in chronotype during clerkship and defense style among medical students

Abstract

Objective: We explored the association of the changes in and mechanisms underlying the defense styles of medical students with their chronotype during clinical clerkship. Methods: In total, 187 medical students (94 men) aged 24-38 years completed the Morningness-Eveningness Questionnaire and the Korean version of the Defense Style Questionnaire at the start and end of their clerkship. The Hospital Anxiety and Depression Scale, Insomnia Severity Scale, and Sleep Habit-related Questionnaire were administered at the end of the clerkship. Results: The Wilcoxon signed-rank test showed a significant change toward morningness during the clinical clerkship (W=9,085.5, p=0.018, r=0.18). A multiple linear regression analysis showed that an increase in morningness (β=-0.254, p=0.001) and a decrease in splitting (β=0.397, p<0.001) predicted less use of an immature defense style after the clerkship when controlling for age, sex, depression, and sleep quality. Conclusion: Increased morningness and a gradual reduction in splitting during clerkship may help reduce immaturity in medical students.