Impact of Mind–Body Medicine Professional Skills Training on Healthcare Professional Burnout

Weinlander, E. E., Daza, E. J., & Winget, M.

2020

The impact of a mind-body medicine professional training program on burnout and quality of life in healthcare professionals was evaluated.

Abstract (OPEN ACCESS)

Background

Healthcare professional burnout has reached epidemic proportions, with downstream effects on personal and patient health and on our institutions. Solutions lie in the domains of work culture, operational efforts, and personal strategies.

Objectives

To evaluate the impact of a 5-day mind-body medicine professional training program on burnout and quality of life.

Methods

We conducted pre- and postevaluation of a mind-body medicine skills training for healthcare professionals on 6 wellness domains using 2 validated instruments: the Maslach Burnout Inventory and the Professional Quality of Life Survey.

Results

There was a statistically significant improvement in changes in emotional exhaustion, depersonalization, personal accomplishment, compassion satisfaction, burnout, and secondary traumatic stress which was sustained at 12 months. Largest relative improvements occurred in emotional exhaustion and depersonalization, 22% and 21%, respectively.

Conclusion

In addition to providing an important patient care skill set, mind-body medicine training may be an effective way to mitigate burnout and improve healthcare professional well-being.

The Integrative Psychiatry Curriculum: Development of an Innovative Model

Ranjbar, N., Ricker, M., & Villagomez, A.

2019

The development and elements of the Integrative Psychiatry Curriculum (IPC), which included The Center for Mind-Body Medicine’s mind-body skills group (MBSG) model, is described.

Abstract (OPEN ACCESS)

The Integrative Psychiatry Curriculum (IPC) was developed to train psychiatry residents and fellows to apply an Integrative Medicine (IM) approach for patients presenting with psychiatric disorders. Launched in 2015, IPC includes interactive online courses, in-person experiential sessions, and a clinical component with supervision. Twenty-one residents and fellows have completed the curriculum. The purpose of the IPC is 2-fold: to enhance patient wellness through training residents and fellows in evidence-based whole-person care and to improve physician well-being through enhanced stress management and self-awareness utilizing the practice of mind-body skills within a supportive small group setting. Course participants are trained in a broad range of prevention and treatment options and learn about their evidence base; they then practice incorporating IM into diagnosis and treatment plans through supervised clinical experience. This article describes the development of IPC and its elements. Efforts are underway to further develop and standardize the offerings and increase the portability of the course, making it easier for Psychiatry training programs with limited faculty expertise in IM to provide the curriculum for residents and fellows. To reach the goal of disseminating such a curriculum for integrative psychiatry, further funding and collaboration with multiple residency training programs is needed.

A Mind–Body Skills Course Among Nursing and Medical Students: A Pathway for an Improved Perception of Self and the Surrounding World

van Vliet, M., Jong, M. C., & Jong, M.

2018

The effect of participation in a Mind–Body (MB) skills course on self-care and self-awareness in medical and nursing students was evaluated.

Abstract (OPEN ACCESS)

Despite increased recognition of self-care and self-awareness as core competencies for health care professionals, little attention is paid to these skills during their education. Evidence suggests that a Mind–Body (MB) skills course has the potential to enhance self-care and self-awareness among medical students. However, less is known about the meaning of this course for students and how it affects their personal and professional life. Therefore, we examined the lived experiences with an MB skills course among Dutch medical and Swedish nursing students. This course included various MB techniques, such as mindfulness meditation and guided imagery. Guided by a phenomenological hermeneutical method, three main themes were identified: “ability to be more present,” “increased perception and awareness of self,” and “connection on a deeper level with others.” Overall, participation in the MB skills course served as a pathway to inner awareness and supported connecting with others as well as with the surrounding world.

Long-Term Benefits by a Mind–Body Medicine Skills Course on Perceived Stress and Empathy among Medical and Nursing Students

van Vliet, M., Jong, M., & Jong, M. C.

2017

The effect of participation in a Mind-Body Medicine (MBM) course on stress, empathy, and self-reflection in medical and nursing students was evaluated.

Abstract (NO OPEN ACCESS)

Background

A significant number of medical students suffer from burnout symptoms and reduced empathy. This controlled, quasi-experimental study aimed to investigate whether a mind–body medicine (MBM) skills course could reduce perceived stress and increase empathy and self-reflection in medical and nursing students.

Methods

The MBM course (consisting of experiential sessions of mind–body techniques and group reflections) was piloted among Dutch medical students and Swedish nursing students. Main outcome variables were perceived stress (PSS), empathy (IRI subscales perspective taking, fantasy, empathic concern, and personal distress), and self-reflection (GRAS). Participating and control students completed questionnaires at baseline, post-intervention, at 6 and 12 months follow-up.

Results

Seventy-four medical and 47 nursing students participated in the course. Participating medical students showed significantly increased empathic concern [1.42 (95% CI 0.05, 2.78), p = 0.042], increased fantasy [3.24 (95% CI 1.58, 4.90), p < 0.001], and decreased personal distress [−1.73 (95% CI −3.04, −0.35), p = 0.010] compared to controls until 12 months follow-up. Participating nursing students showed significantly decreased levels of perceived stress [−5.09 (95% CI −8.37, −1.82), p = 0.002] and decreased personal distress [−5.01 (95% CI −6.97, −3.06), p < 0.001] compared to controls until 12 months follow-up.

Conclusions

This study demonstrated long-term beneficial effects of the MBM course on perceived stress and empathy in medical and nursing students.

The Impact of Mind-Body Medicine Facilitation on Affirming and Enhancing Professional Identity in Health Care Professions Faculty

Talisman, N., Harazduk, N., Rush, C., Graves, K., & Haramati, A.

2015

The impact of facilitating a mind-body medicine course on changes in professional identity, self-awareness, and/or perceived stress was examined.

Abstract (OPEN ACCESS)

Problem

Georgetown University School of Medicine (GUSOM) offers medical students a course in mind–body medicine (MBM) that introduces them to tools that reduce stress and foster self-awareness. Previous studies reported decreases in students’ perceived stress and increases in mindfulness—changes that were associated with increased empathic concern and other elements of professional identity formation. However, no reports have described the impact of an MBM course on the facilitators themselves.

Approach

To explore whether MBM facilitation is associated with changes in professional identity, self-awareness, and/or perceived stress, 62 facilitators, trained by the GUSOM MBM program, were invited to complete two validated surveys: the Freiburg Mindfulness Inventory (FMI) and the Perceived Stress Scale (PSS). Forty-two participants also completed a six-item open-ended questionnaire addressing their experience in the context of their professional identity.

Outcomes

Facilitators’ scores were significantly lower on PSS and higher on FMI compared with normative controls (P < .05), and the two parameters were inversely correlated (−0.46, P < .01). Qualitative analysis revealed three main themes: (1) aspects of professional identity (with subthemes of communication; connections and community; empathy and active listening; and self-confidence); (2) self-care; and (3) mindful awareness.

Next Steps

Preliminary findings will be extended with larger studies that examine longitudinal quantitative assessment of communication, connection, and self-confidence outcomes in MBM facilitators, and the impact of MBM facilitation on burnout and resilience.

An Adapted, Four-Week Mind-Body Skills Group for Medical Students: Reducing Stress, Increasing Mindfulness, and Enhancing Self-Care

Greeson, J. M., Toohey, M. J., & Pearce, M. J.

2015

A study evaluating the feasibility, acceptability, and initial effectiveness of an adapted, four-week stress management and self-care workshop for medical students.

Abstract (NO OPEN ACCESS)

Objective

Despite the well-known stress of medical school, including adverse consequences for mental and behavioral health, there is little consensus about how to best intervene in a way that accommodates students׳ intense training demands, interest in science, and desire to avoid being stigmatized. The objective of this study, therefore, was to evaluate the feasibility, acceptability, and initial effectiveness of an adapted, four-week stress management and self-care workshop for medical students, which was based on the science and practice of mind-body medicine.

Methods

The current study used a prospective, observational, and mixed methods design, with pretest and posttest evaluations. Participants (n = 44) included medical and physician-scientist (MD/PhD) students from a large, southeastern medical school. Feasibility was assessed by rates of workshop enrollment and completion. Acceptability was assessed using qualitative ratings and open-ended responses that queried perceived value of the workshop. Quantitative outcomes included students׳ ratings of stress and mindfulness using validated self-report surveys.

Results

Enrollment progressively increased from 6 to 15 to 23 students per workshop in 2007, 2009, and 2011, respectively. Of the 44 enrolled students, 36 (82%) completed the workshop, indicating that the four-session extracurricular format was feasible for most students. Students reported that the workshop was acceptable, stating that it helped them cope more skillfully with the stress and emotional challenges of medical school, and helped increase self-care behaviors, such as exercise, sleep, and engaging in social support. Students also reported a 32% decrease in perceived stress (P < .001; d = 1.38) and a 16% increase in mindfulness (P < .001; d = 0.92) following the workshop. Changes in stress and mindfulness were significantly correlated (r = -0.42; P = .01).

Conclusion

Together, these findings suggest that a brief, voluntary mind-body skills workshop specifically adapted for medical students is feasible, acceptable, and effective for reducing stress, increasing mindfulness, and enhancing student self-care.

Mind-Body Skills Groups for Medical Students: Reducing Stress, Enhancing Commitment, and Promoting Patient-Centered Care

Gordon, J. S.

2014

This paper describes The Center for Mind-Body Medicine’s Mind-Body Skills Group (MBSG) model, surveys its use in medical schools, summarizes published research on it, and discusses obstacles to successful implementation as well as its benefits.

Abstract (OPEN ACCESS)

Background

For several decades, psychological stress has been observed to be a significant challenge for medical students. The techniques and approach of mind-body medicine and group support have repeatedly demonstrated their effectiveness at reducing stress and improving the quality of the education experience.

Discussion

Mind-Body Skills Groups provide medical students with practical instruction in and scientific evidence for a variety of techniques that reduce stress, promote self-awareness and self-expression, facilitate imaginative solutions to personal and professional problems, foster mutual understanding among students, and enhance confidence in and optimism about future medical practice. The Center for Mind-Body Medicine, which developed this model 20 years ago, has trained medical school faculty who offer these supportive small groups to students at more than 15 US medical schools. This paper describes the model, surveys its use in medical schools, summarizes published research on it, and discusses obstacles to successful implementation as well as its benefits.

Summary

Mind-Body Skills groups have demonstrated their effectiveness on reducing stress in medical students; in enhancing the students’ experience of medical education; and in helping them look forward more confidently and hopefully to becoming physicians. The experience of these 15 institutions may encourage other medical schools to include mind-body skills groups in their curricula.

Stress Biomarkers in Medical Students Participating in a Mind Body Medicine Skills Program

Amri, H., MacLaughlin, B. W., Wang, D., Noone, A. M., Liu, N., Harazduk, N., & Dutton, M.

2011

In this study, we sought to assess the stress-reducing effects of an elective Mind-Body Medicine Skills (MBMS) course by measuring physiological changes in first-year medical students was assessed.

Abstract (OPEN ACCESS)

Georgetown University School of Medicine offers an elective Mind-Body Medicine Skills (MBMS) course to medical students to promote self-care and self-awareness. Participating medical students reported better management of academic stress and wellbeing than non-participants. In this study, we sought to assess the stress-reducing effects of MBMS by measuring physiological changes in first-year medical students. Saliva samples were collected before (January, time 1 (T1)-pre-intervention) and upon completion of the course (May, time 2 (T2p)-post-intervention), as well as from non-participating medical students (May, time 2 (T2c)-control). The T2p and T2c collections coincided with the period of final examinations. Cortisol, dehydroepiandrosteronesulfate (DHEA-S), testosterone and secretory immunoglobulin A (sIgA) were measured. The mean morning salivary cortisol at T2p was 97% of the mean at baseline T1 which was significantly lower than for T2c (2.4) (95% confidence interval (CI) 0.57– 1.60, P = .001); DHEA-S showed similar pattern as cortisol where the T2p levels were significantly lower than T2c (P < .001) in both morning and evening collections. Testosterone ratio at T2p (0.85) was also lower than T2c (1.6) (95% CI 0.53–1.3, P = .01). sIgA levels were not statistically different. On direct comparison, the T2c and T2p means were significantly different for all cortisol, DHEA-S and testosterone values. Participants maintained their hormonal balance within the normal range throughout the academic semester while the control group showed significantly increased levels, probably exacerbated by the end of the semester exam stress. To our knowledge, this is the first study to assess the physiologic benefits of a MBMS program in medical students.

Effectiveness of CancerGuides®: A Study of an Integrative Cancer Care Training Program for Health Professionals

Staples, J. K., Wilson, A. T., Pierce, B., & Gordon, J. S.

2007

The effect of an integrative cancer care training program on participants’ perception of their professional skills, their mood, use of self care and mind-body modalities, and the acceptance of integrative cancer care at their institutions was assessed.

Abstract (OPEN ACCESS)

Purpose

To determine how CancerGuides®, an integrative cancer care training program, would affect participants’ perception of their professional skills, their mood, use of self care and mind-body modalities, and the acceptance of integrative cancer care at their institutions.

Study Design

Qualitative and quantitative measures were used during the training program and at 6-month follow-up. A focus group met before and after the training, and individual interviews of focus group participants were done at follow-up.

Methods

The week-long program consisted of lectures that provided information on integrating conventional and complementary therapies into individualized programs of cancer care. Small group sessions used mind-body techniques to allow participants to understand the dilemmas faced by cancer patients. A self-report survey was administered at the training program and at 6-month follow-up. The survey included questions on the personal and professional use of modalities and on participants’ sense of how well they met the course objectives. Qualitative questions addressed self-care, changes in clinical practice, and the acceptance of integrative therapies by their institutions. The Profile of Mood States was administered before and after the training.

Results

Six months after the training, there was a significant increase in the use and/or recommendation of complementary and alternative medicine modalities in clinical practice and a significant increase in the personal practice of these modalities. Participants’ perceived level of skill for all of the course objectives was significantly increased following the training and was maintained at 6-month follow-up. There were significant reductions in the Anger-Hostility and Tension-Anxiety subscale scores of the Profile of Mood States questionnaire. In response to qualitative questions, participants reported positive changes in patient care and in their clinical practices at 6-month follow-up. The subset of participants in the focus group interviews reported similar improvements. Thirty-five percent of those responding at follow-up reported an increase in acceptance of integrative cancer therapies at their institutions, and 77% reported making positive changes in self-care.

Conclusions

CancerGuides® provided training that allowed participants to enhance personal self-care, to interact more effectively with their patients, and to develop programs of integrative cancer care.

Promoting Self-Awareness and Reflection through an Experiential Mind-Body Skills Course for First Year Medical Students

Saunders, P. A., Tractenberg, R. E., Chaterji, R., Amri, H., Harazduk, N., Gordon, J., & Haramati, A.

2007

An examination of the impact of an 11-week week mind-body skills course on first year medical students’ self-awareness, self-reflection, and self-care.

Abstract (OPEN ACCESS)

Background

This research examines student evaluations of their experience and attitudes in an 11 week mind-body skills course for first year medical students.

Aims

The aim is to understand the impact of this course on students’ self-awareness, self-reflection, and self-care as part of their medical education experience.

Methods

This study uses a qualitative content analysis approach to data analysis. The data are 492 verbatim responses from 82 students to six open-ended questions about the students’ experiences and attitudes after a mind-body skills course. These questions queried students’ attitudes about mind-body medicine, complementary medicine, and their future as physicians using these approaches.

Results

The data revealed five central themes in students’ responses: connections, self discovery, stress relief, learning, and medical education.

Conclusions

Mind-body skills groups represent an experiential approach to teaching mind-body techniques that can enable students to achieve self-awareness and self-reflection in order to engage in self-care and to gain exposure to mind-body medicine while in medical school.

Anxiety and Stress Reduction in Medical Education: An Intervention

Finkelstein, C., Brownstein, A., Scott, C., & Lan, Y. L.

2007

An assessment of the effectiveness of participation in an elective course, ‘Mind-Body Medicine: an Experiential Elective,’ on Year 2 medical students’ anxiety, stress, mood states and depression.

Abstract (NO OPEN ACCESS)

Objectives

To assess the effectiveness of a stress reduction elective on Year 2 medical students and to assess the sustainability of any noted improvement.

Methods

A new elective entitled ‘Mind-Body Medicine: an Experiential Elective’ was offered to Year 2 medical students. It was based on a course developed by the Center for Mind-Body Medicine. Enrolled students were surveyed on the first (time 1) and last (time 2) days of the elective and again 3 months later (time 3). Four validated self-report instruments were used to examine effects on anxiety, stress, mood states and depression. A comparison group of non-enrolled classmates completed the same instruments during the same timeframes. The study began in autumn 2004 and ended in June 2005.

Methods

This study uses a qualitative content analysis approach to data analysis. The data are 492 verbatim responses from 82 students to six open-ended questions about the students’ experiences and attitudes after a mind-body skills course. These questions queried students’ attitudes about mind-body medicine, complementary medicine, and their future as physicians using these approaches.

Results

Participating students had higher initial anxiety scores than students in the comparison group. Anxiety in the study group declined significantly during the course, with enrolled students becoming indistinguishable from non-enrolled counterparts. These decreased anxiety levels were sustained for 3 months following the conclusion of the course.

Conclusions

This elective was successful in attracting students who were more anxious than their peers. Enrolees had higher baseline anxiety levels than their peers. The course decreased anxiety levels. The significant drop in anxiety scores of the study group suggests that this mind-body elective was an effective way to decrease anxiety in these pre-clinical medical students. Decreases in anxiety were sustained 3 months after the course ended, indicating that the benefits of the course may be longlasting.

Effectiveness of a Mind-Body Skills Training Program for Healthcare Professionals

Staples, J. K., & Gordon, J. S.

2005

Healthcare professionals who attended The Center for Mind-Body Medicine’s mind-body medicine training program were surveyed to determine if they were incorporating mind-body skills into their professional or personal practices and whether they had a greater sense of life satisfaction.

Abstract (POSTED WITH PUBLISHER PERMISSION)

Context

Because of the increased use and benefits of mind-body therapies, it is important that healthcare professionals receive training in these modalities.

Objective

To determine whether healthcare professionals who attended the Center for Mind-Body Medicine’s training program were incorporating mind-body skills into their professional or personal practices and whether they had a greater sense of life satisfaction.

Design

Repeated measures analysis.

Setting

Annual training programs were held in hotels and conference centers in the US.

Participants

Four hundred fifty-one healthcare professionals attended the programs from 1998 to 2001. Two hundred fifty-nine completed the one-year follow-up survey, and 307 completed the well-being survey.

Intervention

The week-long program included didactic and experiential training in biofeedback, meditation, autogenics, imagery, and movement/exercise, as well as self-expression in small groups through drawings, written exercises, and genograms.

Main Outcome Measures

Questionnaires on previous training and personal and professional use of mind-body approaches were administered before and one year after the program. The Existential Well-Being (EWB) scale also was administered before and immediately after the training.

Results

There was a significant increase in the personal use of mind-body skills and the number of participants who were teaching their clients to use all modalities and a significant decrease in the number of participants who were referring clients to others for training. Participants also had significantly higher life satisfaction scores after the program.

Conclusion

This professional training program was effective in promoting the personal and professional use of mind-body skills and in enhancing the personal fulfillment of trainees.

Currently being Prepared for Publication:

Wellness Training for Providers and Staff at a Community Mental Health Center

A wellness training program was evaluated at Eskenazi Health’s Midtown Community Mental Health Center
to determine its effect on professional quality of life, health-promoting lifestyle behaviors, stress, and mood among providers and staff.

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