Liselotte N Dyrbye1, Tait D Shanafelt2, Ling Werner3, Amit Sood2, Daniel Satele4, Alexandra P Wolanskyj3. 1. Department of Medicine, Mayo Clinic, Rochester, MN, USA. dyrbye.liselotte@mayo.edu. 2. Department of Medicine, Mayo Clinic, Rochester, MN, USA. 3. Department of Medicine, Mayo Clinic School of Medicine, Rochester, MN, USA. 4. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: Although psychological distress is common among medical students, little remains known about effective interventions. One promising individual-focused approach is mindfulness-based stress management interventions; however, studies to date have relied on volunteers. OBJECTIVE: To determine whether a required longitudinal stress management and resilience course improves well-being among first-year medical students. DESIGN: A quasi-experimental study. PARTICIPANTS: Two cohorts of medical students who participated in a required stress management and resilience course and completed pre and post questionnaires. MAIN MEASURES: Validated instruments were used to examine the effects on burnout, quality of life (QOL), stress, resilience, happiness, and empathy. Paired analysis was conducted to explore changes from baseline. KEY RESULTS: On paired analysis of individual students, mean mental QOL and happiness declined (mental QOL: -5.63 [P < 0.001] and -5.15 [P = 0.015] and happiness: -0.31 [P = 0.02] and -0.4 [P = 0.01], cohorts 1 and 2, respectively) over the course of the year. Similarly, stress scores increased by 4.22 (P < 0.0001) and 3.62 (P = 0.03) in cohorts 1 and 2, respectively. Cognitive and emotive empathy declined in both cohorts but was only statistically significant for cohort 1 (-1.64 and -2.07, P < 0.01). No statistically significant differences in burnout or resilience were seen. CONCLUSIONS: The required longitudinal mindfulness-based stress management course tested in first-year medical students did not lead to measurable improvements in medical student well-being or empathy. These findings contrast with those of studies using volunteer medical students or physicians, which suggested a reduction in burnout and stress using a similar curriculum. Medical schools should consider offering a variety of effective options so that students can select activities they want to engage in.
BACKGROUND: Although psychological distress is common among medical students, little remains known about effective interventions. One promising individual-focused approach is mindfulness-based stress management interventions; however, studies to date have relied on volunteers. OBJECTIVE: To determine whether a required longitudinal stress management and resilience course improves well-being among first-year medical students. DESIGN: A quasi-experimental study. PARTICIPANTS: Two cohorts of medical students who participated in a required stress management and resilience course and completed pre and post questionnaires. MAIN MEASURES: Validated instruments were used to examine the effects on burnout, quality of life (QOL), stress, resilience, happiness, and empathy. Paired analysis was conducted to explore changes from baseline. KEY RESULTS: On paired analysis of individual students, mean mental QOL and happiness declined (mental QOL: -5.63 [P < 0.001] and -5.15 [P = 0.015] and happiness: -0.31 [P = 0.02] and -0.4 [P = 0.01], cohorts 1 and 2, respectively) over the course of the year. Similarly, stress scores increased by 4.22 (P < 0.0001) and 3.62 (P = 0.03) in cohorts 1 and 2, respectively. Cognitive and emotive empathy declined in both cohorts but was only statistically significant for cohort 1 (-1.64 and -2.07, P < 0.01). No statistically significant differences in burnout or resilience were seen. CONCLUSIONS: The required longitudinal mindfulness-based stress management course tested in first-year medical students did not lead to measurable improvements in medical student well-being or empathy. These findings contrast with those of studies using volunteer medical students or physicians, which suggested a reduction in burnout and stress using a similar curriculum. Medical schools should consider offering a variety of effective options so that students can select activities they want to engage in.
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