Abstracts
Abstract
Purpose: We questioned whether an intensive experiential core course would change medical students’ intention to practice mindful clinical congruence. Our primary hypothesis was that we would see more of a change in the intention to practice mindful clinical congruence in those who had taken versus not yet taken our course.
Methods: From a class of 179 in second year we recruited 57 (32%) students who had been already divided into three groups that completed the course in successive periods. We measured mindful clinical congruence using a questionnaire developed and evaluated for validity. We also measured students’ level of stress to determine if any effects we saw were related to stress reduction.
Results: Students who had just completed the course showed a greater intention to practice mindful clinical congruence than students who had not yet started the course. There was an apparent slight increase in perceived stress in those who had completed our course.
Conclusions: We can change students’ intention to practice mindfully and congruently, which we believe will prevent a decline in compassion and ethical values in clerkship. The results did not appear to be explained by a decrease in stress in students who completed the course.
Résumé
Objectif : Nous avons cherché à savoir si un cours de base expérientiel intensif modifierait l'intention des étudiants en médecine de pratiquer la congruence clinique en pleine conscience. Notre hypothèse principale était que nous verrions un changement plus important dans l'intention de pratiquer la congruence clinique en pleine conscience chez ceux qui avaient suivi notre cours par rapport à ceux qui ne l'avaient pas encore suivi.
Méthodes : Sur une classe de 179 étudiants en deuxième année, nous avons recruté 57 (32%) étudiants qui avaient déjà été divisés en trois groupes qui ont suivi le cours dans des périodes successives. Nous avons mesuré la congruence clinique en pleine conscience à l'aide d'un questionnaire dont la validité a été évaluée. Nous avons également mesuré le niveau de stress des étudiants afin de déterminer si les effets observés étaient liés à une réduction du stress.
Résultats : Les étudiants qui venaient de terminer le cours ont montré une plus grande intention de pratiquer la congruence clinique en pleine conscience que les étudiants qui n'avaient pas encore commencé le cours. On a constaté une légère augmentation apparente du stress ressenti chez ceux qui avaient terminé notre cours.
Conclusions : Nous pouvons modifier l'intention des étudiants de pratiquer la pleine conscience et la congruence, ce qui, selon nous, empêchera un déclin de la compassion et des valeurs éthiques au cours de l'externat. Les résultats ne semblent pas s'expliquer par une diminution du stress chez les étudiants qui ont suivi le cours.
Download the article in PDF to read it.
Download
Appendices
Bibliography
- Patenaude J, Niyonsenga T, Fafard D. Changes in students’ moral development during medical school: a cohort study. CMAJ. 2003;168:840–4.
- Sinclair S, Kondejewski J, Jaggi P, et al. What is the state of compassion education? A systematic review of compassion training in health care. Acad Med. 2021;96(7):1057-70. https://doi.org/10.1097/ACM.0000000000004114.
- Neumann M, Edelhauser F, Tauschel D, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med. 2011;86:996–1009. https://doi.org/10.1097/ACM.0b013e318221e615
- Shapiro J. Walking a mile in their patients’ shoes: Empathy and othering in medical students’ education. Philos Ethics Humanit Med. 2008;3:10. https://doi.org/10.1186/1747-5341-3-10
- Hutchinson TA, Liben S. Mindful medical practice: An innovative core course to prepare medical students for clerkship. Perspect Med Educ. 2020 Aug;9(4):256-259. https://doi.org/10.1007/s40037-020-00591-3.
- Kabat-Zinn J. Introduction: stress, pain, and illness: facing the full catastrophe. In: Full Catastrophe Living. Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York, NY: Dell Publishing; 1990. p. 1-14.
- Kabat-Zinn J. Full Catastrophe Living. Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York, NY: Dell Publishing; 1990.
- Malpass A, Binnie K, Robson L. Medical students’ experience of mindfulness training in the UK: well-being, coping reserve, and professional development. Educ Res Int. 2019. https://doi.org/10.1155/2019/4021729.
- Satir V, Banmen J, Gerber J, et al. Chapter 4, Congruence. In: The Satir model: family therapy and beyond. Palo Alto: Science and Behavior Books; 1991. p. 65–84.
- Hutchinson TA, Liben S. Chapter 1, Introduction. In: Liben S, Hutchinson TA. MD Aware. A Mindful Medical Practice Course Guide. Cham: Springer Nature; 2020. p. 1-7. https://doi.org/10.1007/978-3-030-22430-1_1.
- Liben S. Chapter 2, Whole person teaching and learning. In: Liben S, Hutchinson TA. MD Aware. A Mindful Medical Practice Course Guide. Cham: Springer Nature; 2020. p. 9-23. https://doi.org/10.1007/978-3-030-22430-1_2.
- Dobkin PL, Hutchinson TA. Teaching mindfulness in medical school: where are we now and where are we going? Med Educ. 2013;47:768–79. https://doi.org/10.1111/medu.12200.
- Hassed C, de Lisle S, Sullivan G, et al. Enhancing the health of medical students: outcomes of an integrated mindfulness and lifestyle program. Adv Health Sci Educ Theory Pract. 2009;14:387–98. https://doi.org/10.1007/s10459-008-9125-3.
- Dobkin PL, Hassed CS. How mindfulness has been integrated into three medical school curriculums. In: Mindful medical practitioners. Cham: Springer; 2016. p. 43–63. https://doi.org/10.1007/978-3-319-31066-4_4.
- Aherne D, Farrant K, Hickey L, et al. Mindfulness based stress reduction for medical students: optimising student satisfaction and engagement. BMC Med Educ. 2016;16(209). https://doi.org/10.1186/s12909-016-0728-8.
- Shadish WR, Cook TD, Cambell DT. Quasi-experimental designs that use both control groups and pretests. In: Experimental and Quasi-Experimental Designs for Generalized Causal Inference. Belmont, CA: Wadsworth, Cengage Learning; 2002. p. 135-69.
- Lau MA, Bishop SR, Segal ZV, et al. The Toronto Mindfulness Scale: development and validation. J Clin Psychol. 2006 Dec;62(12):1445-67. https://doi.org/10.1002/jclp.20326.
- Lee B. Development of a congruence scale based on the Satir model. Contemp Fam Ther. 2002;24:217-39. https://doi.org/10.1023/A:1014390009534.
- Downing SM. Validity: on the meaningful interpretation of assessment data. Med Educ. 2003;37:830–7. https://doi.org/10.1046/j.1365-2923.2003.01594.x
- Liben S, Hutchinson TA. MD Aware: A Mindful Medical Practice Course Guide. Cham: Springer Nature; 2020. https://doi.org/10.1007/978-3-030-22430-1.
- Moore S, Hutchinson TA. Teaching an intensive core course for medical students in the era of Covid-19: Mindful Medical Practice on Zoom. IJWPC, 2020;7(2):26-39. https://doi.org/10.26443/ijwpc.v7i2.257.
- Hanley JA, Negassa A, Edwardes M, et al. Statistical analysis of correlated data using generalized estimating equations (GEE): an orientation. Am J Epidemiol. 2003 Feb 15;157(4):364-75. https://doi.org/10.1093/aje/kwf215.
- Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96. https://doi.org/10.2307/2136404.
- Kabat-Zinn J. Chapter 2, The foundations of mindfulness practice: attitudes and commitment. In: Full Catastrophe Living. Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York, NY: Dell Publishing; 1990. p. 31-46.
- Shapiro SL, Carlson LE, Astin JA, and Freedman B. Mechanisms of Mindfulness. J Clin Psychol. 2006;62(3):373–86. https://doi.org/10.1002/jclp.20237.
- Satir V, Banmen J, Gerber J, Gomori M. Chapter 7, The transformation process. In: The Satir model: family therapy and beyond. Palo Alto: Science and Behavior Books; 1991. p. 147–74.
- Hutchinson TA. Chapter 12, End of course essays: students’ responses to the course. In: Liben S, Hutchinson TA. MD Aware. A Mindful Medical Practice Course Guide. Switzerland: Springer Nature; 2020. p. 139-57. https://doi.org/10.1007/978-3-030-22430-1_12.