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After completing an MBM course, students reported reduced perceived stress, increased self-efficacy, mindfulness, empathy and positive engagement with integrative concepts of doctor–patient relationships. Further research with larger randomized confirmatory studies is needed to validate these benefits. Ann Dutton M, Arun P, Talley J, et al. Mind–body skills training for improving emotional well-being in medical students. Explore. 2013;9(5):328. At baseline, participants scored about one standard deviation above the mean of the standard PSS for German students [ 21], indicating a high stress load (see Table 3).
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All models pictured nude on Body in Mind were at least 18 years old and of legal age when photographed. I tried to remember the thoughts that would come up [during meditation] and take them with me. I had the feeling, ‘What’s coming up in my mind there […] is really [what is] concerning me at the moment, even if I do not realize it usually’. And that has helped me a lot. (FGWS18.PF) In her paper on problems with psychometric evaluation of health based QoL, Güthlin [ 15] expands on the confounding effect of “response shift”. Outcomes of QoL measurements may reflect real changes or they may be the consequence of “response shift” - a cognitive change in the reference system of the patient or changes in the values and concepts held about health and disease [ 15, 30]. After course participation students reported an increased awareness of the connection between stress, well-being, and self-care practices. However, they also described their difficulties to implement and sustain MBM practices both personally and in the face of a wider academic and medical system often perceived as largely uncaring about self-care practices. Thus, while both qualitative data and a reduction in quantitative stress measure (PSS) support a beneficial effect of course participation on students’ well-being, the overall experience may also have resulted in a shift of values and views that adversely affected QoL appraisal. Saunders PA, Tractenberg RE, Chaterji R. Promoting self-awareness and reflection through an experiential mind-body skills course for first year medical students. Med Teach. 2007;29(8):778–84.This study hasn’t shown a meaningful change in MBM course participants’ mental or physical health QoL, as assessed by the SF-12, whereas Esch et al. showed an improvement for mental QoL SF-12 levels in MBM group compared to control [ 13]. Yet it is possible that the SF-12 is not suitable for use in a sample of generally healthy medical students. The SF-36, and its short version SF-12, were originally developed to assess QoL changes in patients with reduced health [ 5, 35] and when tested within a sample of healthy patients, the original SF-36 sub-scales, MCS and PCS, were not always found to be independent [ 27]. Potential MCS changes in our healthy population sample may therefore have been masked. Learning about MBM and CIM as disciplines of modern medicine was reported as a primary motivation for course enrollment. Some participants sought to acquire proficiency in MBM techniques as tools for their future patient care. Students reported increased knowledge of MBM techniques as a main benefit of the course, emphasizing the value of practical experience. New perspectives on the value of MBM and CIM gained through the course led to what students described as a broader, “more holistic” view of the scope of medical practice and the relationship between healthcare professionals and their patients. Triangulation—experiences of self and the other Reith TP. Burnout in United States Healthcare Professionals: a narrative review. Cureus. 2018;10(12):e3681.
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Dobos G, Altner N, Lange S, et al. [Mind-body medicine as a part of german integrative medicine]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2006;49(8):723–8. Ware J Jr, Kosinski M, Keller SD. A 12-Item short-form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33. Ware J, Kosinski M, Turner-Bowker D, et al. How to score version 2 of the SF-12 Health Survey. Lincoln, US: Quality Metric Incorporated; 2002.Güthlin C. Response shift: alte Probleme der Veränderungsmessung, neu angewendet auf gesundheitsbezogene Lebensqualität. Z für Medizinische Psychologie. 2004;13:165–74. Participants showed improvement across most quantitative measures, including mindfulness, self-reflection, self-efficacy, and perceived stress. However, there were no changes in participant-reported QoL. Empathy, as an ability to take others’ perspective, showed improvement, as did the sense of distress at experiencing empathy. These outcomes were corroborated by focus groups reporting increases in students’ ability to self-regulate stressful experiences and improve their relationships with themselves and others. Participants also recognized the importance of MBM values in the doctor–patient relationship, patient care, and a more holistic view of medicine. Sociodemographic variables and questionnaire scores were analyzed descriptively. Student’s paired t-test was used to investigate changes in the scores of the above-mentioned questionnaires. Due to its exploratory nature, this study does not determine statistical significance; instead, it attempts to draw conclusions based on a wider picture of quantitative and qualitative data, alongside a triangulation of these datasets. Computed two-sided p-values, where provided, should be regarded as exploratory and are not meant to imply levels of significance. All quantitative data were analyzed using SPSS (version 1.0.0.1406). Qualitative data and analysis Aukes LC, Geertsma J, Cohen-Schotanus J, et al. The development of a scale to measure personal reflection in medical practice and education. Med Teach. 2007;29(2–3):177–82. Schwarzer R, Jerusalem M. Measures in Health psychology: a user’s portfolio. Causal and control beliefs. Causal and Control Beliefs. 1995;01(011):35–7.
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van Vliet M, Jong M, Jong MC. Long-term benefits by a mind-body medicine skills course on perceived stress and empathy among medical and nursing students. Med Teach. 2017;39(7):710–9. Walach H, Buchheld N, Buttenmüller V, et al. Empirische Erfassung der Achtsamkeit - Die Konstruktion des Freiburger Fragebogens zur Achtsamkeit (FFA) und weitere Validierungsstudien. In: Heidenreich T, Michalak J, editors. Achtsamkeit und Akzeptanz in der Psychotherapie. Tübingen: dgvt; 2004. p. 727–65. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2003;84(4):822–48. Quek TT, Tam WW, Tran BX, et al. The global prevalence of anxiety among medical students: a Meta-analysis. Int J Environ Res Public Health. 2019;16(15):2735. This study’s qualitative results show that stress relief and self-regulation were primary motivations, but other motivations, such as professional interest in MBM as a future tool for patient care, have also been reported. It is possible that students motivated primarily by personal stress relief benefit from course participation in a different way from others. Divergent study outcomes may thus be a result of their respective group composition.
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Maclaughlin BW, Wang D, Noone AM, et al. Stress biomarkers in medical students participating in a mind body medicine skills program. Evid Based Complement Alternat Med. 2011;2011:950461. Relating to the patient from your own experience] creates a completely different impression than working from book [knowledge].(FGWS16.F1). Well-being & stress reduction
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