Mindfulness in medical education: Students’ perceptions and four recommendations for implementation of a mindfulness intervention
Article Sidebar
Main Article Content
Abstract
Background: Faculties of Medicine around the globe have implemented mindfulness-based curricula to deal with medical student’s burnout, anxiety and depression. The purpose of this qualitative study is to assess students’ perception of a mandatory mindfulness intervention and their recommendations for further curricula development and implementation.
Methods: Third-year medical students participated in a mandatory three-hour mindfulness workshop embedded in their family medicine academic week. Eleven students consented to two interviews which explored their perceptions of mindfulness and the workshop in relation to their personal and professional wellbeing as well as their views for the implementation of a longitudinal mindfulness curriculum.
Results: Student and institutional benefits and barriers relating to the curriculum were identified. Student’s benefits included positive changes in stress, self-awareness and personally that also translated into self-reported better patient care. Students reported lack of time, forgetting to practice and lack of knowledge about mindfulness as barriers. Institutional pride for their support of student wellness and an overfilled curriculum, were the major institutional benefits and barriers respectively, to the expansion of this curriculum. Among developing an implementing a longitudinal mindfulness curriculum, we found four key features to consider: Firstly to engage the stakeholders; secondly, to incorporate the mindfulness intervention into the curriculum with both a mandatory and elective component; thirdly, to emphasize the clinical implications of the mindfulness intervention and fourthly, to have protected time for wellness interventions.
Conclusions: Introducing mindfulness into the undergraduate medical school curriculum through this workshop resulted in perceived personal, institutional and professional benefits. For faculties of medicine that want to implement a mindfulness intervention, we found four key components for implementing a mindfulness intervention in their institutions. Further research is needed to better quantify the benefits and to identify ways to manage barriers at both individual and institutional levels.
Article Details
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Creative Comons 4.0 CC-BY
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
References
Ludwig AB, Burton W, Weingarten J, Milan F, Myers DC, Kligler B. Depression and stress amongst undergraduate medical students. BMC Med Educ. 2015. Aug 27;15:141. doi:10.1186/s12909-015-0425-z
Reed DA, Shanafelt TD, Satele DW, et al. Relationship of pass/fail grading and curriculum structure with well-being among preclinical medical students: A multi-institutional study. Acad Med. 2011. Nov;86(11):1367-73. doi:10.1097/ACM.0b013e3182305d81
Slavin SJ, Schindler DL, Chibnall JT. Medical student mental health 3.0: Improving student wellness through curricular changes. Acad Med. 2014. Apr;89(4):573-7. doi:10.1097/ACM.0000000000000166
Pattani R, Wu PE, Dhalla IA. Resident duty hours in Canada: Past, present and future. CMAJ. 2014;186(10):761-5. doi:10.1503/cmaj.131053
Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students a systematic review and meta-analysis. JAMA. 2016;316(21):2214-36. doi:10.1001/jama.2016.17324
Williams D, Tricomi G, Gupta J, Janise A. Efficacy of burnout interventions in the medical education pipeline. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0197-5
Dyrbye LN, Massie FSJ, Eacker A, et al. Relationship between burnout and professional
conduct and attitudes among US medical students. JAMA. 2010;304(11):1173-80. doi: http://dx.doi.org/10.1001/jama.2010.1318
Roberts LW. Among medical students. Psychiatry Interpers Biol Process. 2010;304(11):1231-3.
Epstein RM. Mindful practice in action (II): Cultivating habits of mind. Fam Syst Heal. 2003. 21(1):11-7. doi:10.1037/h0089495
Dyche L, Epstein RM. Curiosity and medical education. Med Educ. 2011;45:663–8. doi:10.1111/j.1365-2923.2011.03944.x
MacLean H, Braschi E, Archibald D, et al. A pilot study of a longitudinal mindfulness curriculum in undergraduate medical education. Can Med Educ J. 2020. doi:10.36834/cmej.56726
Dobkin PL, Hutchinson TA. Teaching mindfulness in medical school: Where are we now and where are we going? Med Educ. 2013;47(8):768-779. doi:10.1111/medu.12200
Outram S, Kelly B. “You teach us to listen,… but you don’t teach us about suffering”: self-care and resilience strategies in medical school curricula. Perspect Med Educ. 2014. Nov;3(5):371-8. doi:10.1007/s40037-014-0145-9
Epstein RM, Krasner MS. Physician resilience: What it means, why it matters, and how to promote it. Acad Med. 2013. Mar;88(3):301-3. doi:10.1097/ACM.0b013e318280cff0
Schreiner I, Malcolm JP. The benefits of mindfulness meditation: Changes in emotional states of depression, anxiety, and stress. Behav Chang. 2008;25:156-68. doi:10.1375/bech.25.3.156
Chiesa A, Serretti A. Mindfulness-based stress reduction for stress management in healthy
people: A review and meta-analysis. J Altern Complement Med. 2009. May;15(5):593-600 doi:10.1089/acm.2008.0495
Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits: A meta-analysis. J Psychosom Res. 2004. Jul;57(1):35-43. doi:10.1016/S0022-3999(03)00573-7
Byron G, Ziedonis DM, McGrath C, Frazier JA, deTorrijos F, Fulwiler C. Implementation of mindfulness training for mental health staff: organizational context and stakeholder perspectives. Mindfulness (N Y). 2015;6(4):861‐872. doi:10.1007/s12671-014-0330-2
Ray JL, Baker LT, Plowman DA. Organizational mindfulness in business schools. Acad Manag Learn Educ. 2011;10(2):188-203. doi:10.5465/AMLE.2011.62798929
Lynn R. Mindfulness in social work education. Soc Work Educ. 2010;29(3):289-304. doi:10.1080/02615470902930351
Mellor NJ, Ingram L, Van Huizen M, Arnold J, Harding AH. Mindfulness training and employee well-being. Int J Work Heal Manag. 2016;9(2):126-45. doi:10.1108/IJWHM-11-2014-0049
Rycroft-Malone J, Anderson R, Crane RS, et al. Accessibility and implementation in UK services of an effective depression relapse prevention programme - mindfulness-based cognitive therapy (MBCT): ASPIRE study protocol. Implement Sci. 2014;9(1):62. doi:10.1186/1748-5908-9-62
Kielty ML, Gilligan TD, Staton AR. Whole-school approaches to incorporating mindfulness-basedi Interventions: supporting the capacity for optimal functioning in school settings. Child Educ. 2017;93(2):128-35, doi:10.1080/00094056.2017.1300491
Aherne D, Farrant K, Hickey L, Hickey E, McGrath L, McGrath D. Mindfulness based stress reduction for medical students: Optimising student satisfaction and engagement. BMC Med Educ. 2016;16(1):209. doi:10.1186/s12909-016-0728-8
McKenzie SP, Hassed CS, Gear JL. Medical and psychology students’ knowledge of and attitudes towards mindfulness as a clinical intervention. Explor J Sci Heal. 2012;8(6):360‐7. doi:10.1016/j.explore.2012.08.003
Greeson JM, Toohey MJ, Pearce MJ. An adapted, four-week mind-body skills group for medical students: Reducing stress, increasing mindfulness, and enhancing self-care. Explor J Sci Heal. 2015;11(3):186-92. doi:10.1016/j.explore.2015.02.003
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9): 1277-88. doi:10.1177/1049732305276687
Rojiani R, Santoyo JF, Rahrig H, Roth HD, Britton WB. Women benefit more than men in response to college-based meditation training. Front Psychol. 2017;8:551. doi:10.3389/fpsyg.2017.00551
Rac T, Chakravarti A. Black Ice: Eight ways to get a grip on implementing mindfulness sessions in medical schools. Can Med Educ J. 2020;11(10:e130-e134. doi:10.36834/cmej.57011