Mindfulness training for medical students in their clinical clerkships: two cross-sectional studies exploring interest and participation.

Inge Van Dijk,Peter Lbj Lucassen,Anne Em Speckens

doi:10.1186/s12909-015-0302-9

Abstract

BackgroundSo far, studies investigating Mindfulness Based Stress Reduction (MBSR) training in medical students are conducted in self-selected, pre-clinical samples, with modest response rates without collecting data on non-participants. This study first examines interest and participation rates of students starting their clinical clerkships. Second, it compares students interested in a mindfulness training with non-interested students and students participating in a trial on the effect of MBSR with non-participating students on levels of psychological distress, personality traits, cognitive styles and mindfulness skills.MethodsWe examined two student samples from the Radboud University Medical Center, Nijmegen:Study 1 From March to December 2010 we performed a cross-sectional pilot-study among 4th year medical students starting their clinical clerkships, assessing interest in a MBSR training. We compared scores on the Brief Symptom Inventory, the Neo Five Factor Inventory and the Five Facet Mindfulness Questionnaire of interested students with those of non-interested students using t-tests with Bonferroni correction.Study 2 From February 2011 to August 2012 we invited 4th year medical students starting their clinical clerkships to participate in a randomized controlled trial (RCT) on the effectiveness of MBSR. We compared scores on the Brief Symptom Inventory, the Irrational Beliefs Inventory and the Five Facet Mindfulness Questionnaire of participating students with those of non-participants using t-tests with Bonferroni correction.ResultsStudy 1: Ninety-five out of 179 participating students (53%) were interested in a MBSR training. Interested students scored significantly higher on psychological distress (p = .004) and neuroticism (p < .001), than 84 non-interested students.Study 2: Of 232 eligible students, 167 (72%) participated in our RCT. Participants scored significantly higher on psychological distress (p = .001), worrying (p = .002), problem avoidance (p = .005) and lower on mindfulness skills (p = .002) than 41 non-participants.ConclusionsInterest in mindfulness training and response rates in a RCT on the effectiveness of MBSR among clinical clerkship students are equal to (study 1) or higher (study 2) than in studies on pre-clinical students. Interested students and participants in a RCT reported more psychological distress and psychopathology related character traits. Participants scored lower on mindfulness skills.

Highlights

Studies investigating Mindfulness Based Stress Reduction (MBSR) training in medical students are conducted in self-selected, pre-clinical samples, with modest response rates without collecting data on non-participants
We aim to contribute to the existing knowledge by further exploring two questions raised by the above results from literature: 1. Given the modest response percentages in pre-clinical medical students, how would interest in MBSR and participation in a randomized controlled trial (RCT) on the effectiveness of MBSR be among clinical clerkship students? Clinical clerkships might be the time that the need for support is highest among students and the time that offers many opportunities to integrate exercises from the training in daily activities
Study 2 Participation in a trial on the effect of MBSR and comparison of baseline measurements of participants to non-participants Of 232 eligible students, 167 (72%) students participated in the RCT, knowing that they could be randomized to receive the mindfulness training

Summary

Introduction

Studies investigating Mindfulness Based Stress Reduction (MBSR) training in medical students are conducted in self-selected, pre-clinical samples, with modest response rates without collecting data on non-participants. The scientific literature reports an increase of psychological distress [3,4] and a decrease of self-reported empathy [5,6] and life satisfaction [7] during medical school. This is relevant for clinical practice, because stress during medical school seems to be predictive for a lower work satisfaction and more work related problems after graduation [8,9]. Physician distress contributes to a lower quality of patient care [10,11,12] and patient satisfaction [13,14,15]

Objectives

Methods

Results

Discussion

Conclusion