Abstract
BackgroundMedical training is very demanding and associated with a high prevalence of psychological distress. Compared to the general population, medical students are at a greater risk of developing a psychological disorder. Various attempts of stress management training in medical school have achieved positive results on minimizing psychological distress; however, there are often limitations. Therefore, the use of a rigorous scientific method is needed. The present study protocol describes a randomized controlled trial to examine the effectiveness of a specifically developed mindfulness-based stress prevention training for medical students that includes selected elements of cognitive behavioral strategies (MediMind).Methods/DesignThis study protocol presents a prospective randomized controlled trial, involving four assessment time points: baseline, post-intervention, one-year follow-up and five-year follow-up. The aims include evaluating the effect on stress, coping, psychological morbidity and personality traits with validated measures. Participants are allocated randomly to one of three conditions: MediMind, Autogenic Training or control group. Eligible participants are medical or dental students in the second or eighth semester of a German university. They form a population of approximately 420 students in each academic term. A final total sample size of 126 (at five-year follow-up) is targeted. The trainings (MediMind and Autogenic Training) comprise five weekly sessions lasting 90 minutes each. MediMind will be offered to participants of the control group once the five-year follow-up is completed. The allotment is randomized with a stratified allocation ratio by course of studies, semester, and gender. After descriptive statistics have been evaluated, inferential statistical analysis will be carried out with a repeated measures ANOVA-design with interactions between time and group. Effect sizes will be calculated using partial η-square values.DiscussionPotential limitations of this study are voluntary participation and the risk of attrition, especially concerning participants that are allocated to the control group. Strengths are the study design, namely random allocation, follow-up assessment, the use of control groups and inclusion of participants at different stages of medical training with the possibility of differential analysis.Trial registrationThis trial is recorded at German Clinical Trials Register under the number DRKS00005354 (08 November 2013).
Highlights
Medical training is very demanding and associated with a high prevalence of psychological distress
Potential limitations of this study are voluntary participation and the risk of attrition, especially concerning participants that are allocated to the control group
Our study is the first to evaluate the effectiveness of a mindfulness-based intervention for medical students in Germany in a randomized controlled setting with both treatment groups, MediMind and Autogenic Training, and a control group without treatment
Summary
Medical training is very demanding and associated with a high prevalence of psychological distress. The occurrence of burnout symptoms among medical students is reported to range from 45% to 71% [1], and numerous data suggest an increase in psychological morbidity This becomes evident in a higher symptom load for mental disorders when comparing medical students with an age-matched control sample. A poorer mental health, measured by the ‘Short Form-12 Health Survey’ (SF-12), is reported for medical students in their first, second and third year of studies compared to a reference sample [3] These findings of a high level of overall psychological distress in medical students is confirmed by a variety of scientific studies and summarized in a review of the literature [4]
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