Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement

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Abstract

Background

Medical practitioners and students are at increased risk of a number of personal and psychological problems. Stress and anxiety due to work-load and study requirements are common and self-care methods are important in maintaining well-being. The current study examines perceptions of and satisfaction ratings with a mindfulness based stress reduction (MBSR) programme for 1 ^st year (compulsory) and 2 ^nd year (optional) Graduate Entry Medical School students.

Methods

A mixed method pre and post study of Year 1 ( n = 140) and Year 2 ( n = 88) medical students completing a 7 week MBSR course compared student satisfaction ratings. Thematic analysis of feedback from the students on their perception of the course was also carried out.

Results

Year 1 students (compulsory course) were less satisfied with content and learning outcomes than Year 2 students (optional course) ( p < .0005). Thematic analysis of year 1 student feedback identified themes including great concept, poorly executed; and less discussion, more practice. Year 2 themes included session environment and satisfaction with tutors.

Conclusions

The MBSR course was associated with high levels of satisfaction and positive feedback when delivered on an optional basis. Catering for the individual needs of the participant and promoting a safe environment are core elements of a successful self-care programme.

Electronic supplementary material

The online version of this article (doi:10.1186/s12909-016-0728-8) contains supplementary material, which is available to authorized users.

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Most cited references 53

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Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians.

Michael Krasner, Ronald M Epstein, Howard Beckman … (2009)

Primary care physicians report high levels of distress, which is linked to burnout, attrition, and poorer quality of care. Programs to reduce burnout before it results in impairment are rare; data on these programs are scarce. To determine whether an intensive educational program in mindfulness, communication, and self-awareness is associated with improvement in primary care physicians' well-being, psychological distress, burnout, and capacity for relating to patients. Before-and-after study of 70 primary care physicians in Rochester, New York, in a continuing medical education (CME) course in 2007-2008. The course included mindfulness meditation, self-awareness exercises, narratives about meaningful clinical experiences, appreciative interviews, didactic material, and discussion. An 8-week intensive phase (2.5 h/wk, 7-hour retreat) was followed by a 10-month maintenance phase (2.5 h/mo). Mindfulness (2 subscales), burnout (3 subscales), empathy (3 subscales), psychosocial orientation, personality (5 factors), and mood (6 subscales) measured at baseline and at 2, 12, and 15 months. Over the course of the program and follow-up, participants demonstrated improvements in mindfulness (raw score, 45.2 to 54.1; raw score change [Delta], 8.9; 95% confidence interval [CI], 7.0 to 10.8); burnout (emotional exhaustion, 26.8 to 20.0; Delta = -6.8; 95% CI, -4.8 to -8.8; depersonalization, 8.4 to 5.9; Delta = -2.5; 95% CI, -1.4 to -3.6; and personal accomplishment, 40.2 to 42.6; Delta = 2.4; 95% CI, 1.2 to 3.6); empathy (116.6 to 121.2; Delta = 4.6; 95% CI, 2.2 to 7.0); physician belief scale (76.7 to 72.6; Delta = -4.1; 95% CI, -1.8 to -6.4); total mood disturbance (33.2 to 16.1; Delta = -17.1; 95% CI, -11 to -23.2), and personality (conscientiousness, 6.5 to 6.8; Delta = 0.3; 95% CI, 0.1 to 5 and emotional stability, 6.1 to 6.6; Delta = 0.5; 95% CI, 0.3 to 0.7). Improvements in mindfulness were correlated with improvements in total mood disturbance (r = -0.39, P < .001), perspective taking subscale of physician empathy (r = 0.31, P < .001), burnout (emotional exhaustion and personal accomplishment subscales, r = -0.32 and 0.33, respectively; P < .001), and personality factors (conscientiousness and emotional stability, r = 0.29 and 0.25, respectively; P < .001). Participation in a mindful communication program was associated with short-term and sustained improvements in well-being and attitudes associated with patient-centered care. Because before-and-after designs limit inferences about intervention effects, these findings warrant randomized trials involving a variety of practicing physicians.

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Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial.

Timothy Call, Jeffrey Rabatin, Joan M Henriksen Hellyer … (2014)

IMPORTANCE Despite the documented prevalence and clinical ramifications of physician distress, few rigorous studies have tested interventions to address the problem. OBJECTIVE To test the hypothesis that an intervention involving a facilitated physician small-group curriculum would result in improvement in well-being. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 74 practicing physicians in the Department of Medicine at the Mayo Clinic in Rochester, Minnesota, conducted between September 2010 and June 2012. Additional data were collected on 350 nontrial participants responding to annual surveys timed to coincide with the trial surveys. INTERVENTIONS The intervention involved 19 biweekly facilitated physician discussion groups incorporating elements of mindfulness, reflection, shared experience, and small-group learning for 9 months. Protected time (1 hour of paid time every other week) for participants was provided by the institution. MAIN OUTCOMES AND MEASURES Meaning in work, empowerment and engagement in work, burnout, symptoms of depression, quality of life, and job satisfaction assessed using validated metrics. RESULTS Empowerment and engagement at work increased by 5.3 points in the intervention arm vs a 0.5-point decline in the control arm by 3 months after the study (P = .04), an improvement sustained at 12 months (+5.5 vs +1.3 points; P = .03). Rates of high depersonalization at 3 months had decreased by 15.5% in the intervention arm vs a 0.8% increase in the control arm (P = .004). This difference was also sustained at 12 months (9.6% vs 1.5% decrease; P = .02). No statistically significant differences in stress, symptoms of depression, overall quality of life, or job satisfaction were seen. In additional comparisons including the nontrial physician cohort, the proportion of participants strongly agreeing that their work was meaningful increased 6.3% in the study intervention arm but decreased 6.3% in the study control arm and 13.4% in the nonstudy cohort (P = .04). Rates of depersonalization, emotional exhaustion, and overall burnout decreased substantially in the trial intervention arm, decreased slightly in the trial control arm, and increased in the nontrial cohort (P = .03, .007, and .002 for each outcome, respectively). CONCLUSIONS AND RELEVANCE An intervention for physicians based on a facilitated small-group curriculum improved meaning and engagement in work and reduced depersonalization, with sustained results at 12 months after the study. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01159977.

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Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain , and Illness

J Kabat-Zinn, J. KABAT-ZINN, TN Hanh … (1990)

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Author and article information

Contributors

Declan Aherne: declan.aherne@ul.ie

Katie Farrant: farrank@tcd.ie

Louise Hickey: louise.hickey@ul.ie

Emma Hickey: emma.hickey@ul.ie

Lisa McGrath: lisa.mcgrath@ul.ie

Deirdre McGrath:

ORCID: http://orcid.org/0000-0002-8666-7556

061-234850 , deirdre.mcgrath@ul.ie

Journal

Journal ID (nlm-ta): BMC Med Educ

Journal ID (iso-abbrev): BMC Med Educ

Title: BMC Medical Education

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6920

Publication date (Electronic): 18 August 2016

Publication date PMC-release: 18 August 2016

Publication date Collection: 2016

Volume: 16

Electronic Location Identifier: 209

Affiliations

[1 ]Counselling Department, University of Limerick, Limerick, Ireland

[2 ]Graduate Entry Medical School, University of Limerick, Castletroy, Limerick, Ireland

[3 ]Trinity College Dublin, Dublin, Ireland

Author information

Deirdre McGrath http://orcid.org/0000-0002-8666-7556

Article

Publisher ID: 728

DOI: 10.1186/s12909-016-0728-8

PMC ID: 4989331

PubMed ID: 27535243

SO-VID: 9e7769ad-2969-47ff-8212-afdaaf6f769a

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 17 February 2016

Date accepted : 8 August 2016

Custom metadata

ScienceOpen disciplines: Education

Keywords: mindfulness,stress reduction,doctor burnout,academic stress in medical students,self-care,student satisfaction,medical undergraduate

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ScienceOpen disciplines: Education

Keywords: mindfulness, stress reduction, doctor burnout, academic stress in medical students, self-care, student satisfaction, medical undergraduate

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Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement

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Most cited references 53

Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians.

Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial.

Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain , and Illness

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Cited by 39

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