Acceptability and perceived effectiveness of a single-session mindfulness intervention for medical residents

Authors

  • Dana Carsley McGill University
  • Isabel Sadowski
  • Nancy Heath
  • Richard Montoro
  • Stella Miller

DOI:

https://doi.org/10.11157/fohpe.v21i3.399

Keywords:

medical residents, mindfulness, stress management, medical education, resilience

Abstract

Introduction: Medical residents report high levels of stress, with many work-related demands contributing to their experience of heightened stress. Mindfulness training has been suggested as a beneficial strategy for stress management with residents; however, many mindfulness programs are time-consuming, and compliance with conventional mindfulness training programs becomes challenging given the intense, competing time commitments of residency. The present study sought to evaluate the acceptability and perceived effectiveness of a single-session, mindfulness-based stress management workshop for medical residents.

Methods: Residents (n = 142) from family medicine, internal medicine and general surgical residency programs participated in a 1.5-hour mindfulness workshop in 2016 and completed: a measure of workshop satisfaction immediately post-workshop; a measure of adherence to suggested strategies 4–6 weeks post-workshop; and measures of stress, mindfulness and positive and negative affect immediately post-workshop and 4–6 weeks post-workshop.

Results: Results revealed high levels of satisfaction with the workshop. Participants who used the recommended strategies over the 4 to 6-week post-workshop period reported significant increases in mindfulness and significant decreases in stress at follow-up.

Conclusions: Results suggest single-session mindfulness training can be beneficial for residents who use the strategies effectively; however, ensuring strategy use following training is challenging. Future research is needed to investigate facilitators and barriers to strategy use.

References

Anagnostopoulos, F., Demerouti, E., Sykioti, O., Niakas, D., & Zis, P. (2015). Factors associated with mental health status of medical residents: A model-guided study. Journal of Clinical Psychology in Medical Settings, 22(1), 90–109. https://doi.org/10.1007/s10880-014-9415-2

Bazarko, D., Cate, R. A., Azocar, F., & Kreitzer, M. J. (2013). The impact of an innovative mindfulness-based stress reduction program on the health and well-being of nurses employed in a corporate setting. Journal of Workplace Behavioral Health, 28(2), 107–133. https://doi.org/10.1080/15555240.2013.779518

Bellini, L. M., Baime, M., &. Shea, J. A. (2002). Variation of mood and empathy during internship. JAMA, 287(23), 3143–3146. https://doi.org/10.1001/jama.287.23.3143

Bellini, L. M., & Shea, J. A. (2005). Mood change and empathy decline persist during three years of internal medicine training. Academic Medicine, 80(2),164–167. https://doi.org/10.1097/00001888-200502000-00013

Brown, K., & Ryan, R. (2003). The benefits of being present: Mindfulness and its role in psychological wellbeing. Journal of Personality and Social Psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822

Burke, C. A. (2010). Mindfulness-based approaches with children and adolescents: A preliminary review of current research in an emergent field. Journal of Child and Family Studies, 19(2), 133–144. https://doi.org/10.1007/s10826-009-9282-x

Cavanaugh, E., & Rose, M. (2017). An 8-week mindfulness-based stress reduction course for ob/gyn residents: A pilot study. Obstetrics & Gynecology, 130, 45S. https://doi.org/10.1097/01.AOG.0000525734.33435.0b

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. https://doi.org/10.2307/2136404

Dimidjian, S., & Linehan, M. M. (2003). Defining an agenda for future research on the clinical application of mindfulness practice. Clinical Psychology: Science and Practice, 10(2), 166–171. https://doi.org/10.1093/clipsy.bpg019

Dobkin, P. L., & Hutchinson, T. A. (2013). Teaching mindfulness in medical school: Where are we now and where are we going? Medical Education, 47(8), 768–779. https://doi.org/10.1111/medu.12200

Dyrbye, L., & Shanafelt, T. (2016). A narrative review on burnout experienced by medical students and residents. Medical Education, 50(1), 132–149. https://doi.org/10.1111/medu.12927

Dyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J., & Shanafelt, T. D. (2014). Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Academic Medicine, 89(3), 443–451. https://doi.org/10.1097/ACM.0000000000000134

Eckleberry-Hunt, J., Lick, D., Boura, J., Hunt, R., Balasubramaniam, M., Mulhem, E., & Fisher, C. (2009). An exploratory study of resident burnout and wellness. Academic Medicine, 84(2), 269–277. https://doi.org/10.1097/ACM.0b013e3181938a45

Epstein, R. M. (1999). Mindful practice. JAMA, 282(9), 833–839. https://doi.org/10.1001/jama.282.9.833

Fahrenkopf, A. M., Sectish, T. C., Barger, L. K., Sharek, P. J., Lewin, D., Chiang, V. W., Edwards, S., Wiedermann, B. L., & Landrigan, C. P. (2008). Rates of medication errors among depressed and burnt out residents: Prospective cohort study. BMJ, 336(7642), 488–491. https://doi.org/10.1136/bmj.39469.763218.BE

Fjorback, L. O., Arendt, M., Ørnbøl, E., Fink, P., & Walach, H. (2011). Mindfulness‐based stress reduction and mindfulness‐based cognitive therapy: A systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica, 124(2), 102–119. https://doi.org/10.1111/j.1600-0447.2011.01704.x

Fredrickson, B. L., Cohn, M. A., Coffey, K. A., Pek, J., & Finkel, S. M. (2008). Open hearts

build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of Personality and Social Psychology, 95(5), 1045–1062. https://doi.org/10.1037/a0013262

Huebner, E. S., & Dew, T. (1995). Preliminary validation of the positive and negative affect schedule with adolescents. Journal of Psychoeducational Assessment, 13(3), 286–293. https://doi.org/10.1177/073428299501300307

Ireland M. J., Clough, B., Gill, K., Langan, F., O'Connor, A., & Spencer, L. (2017). A randomized controlled trial of mindfulness to reduce stress and burnout among intern medical practitioners. Medical Teacher, 39(4), 409–414. https://doi.org/10.1080/0142159X.2017.1294749

Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10(2), 144–156. https://doi.org/10.1093/clipsy/bpg016

Lases, S. S., Lombarts, M. J. M. H., Slootweg, I. A., Arah, O. A., Pierik, E. G. J. M., & Heineman, E. (2016). Evaluating mind fitness training and its potential effects on surgical residents’ well-being: A mixed methods pilot study. World Journal of Surgery, 40(1), 29–37. https://doi.org/10.1007/s00268-015-3278-z

Lemkau, J. P., Purdy, R. R., Rafferty, J. P., & Rudisill, J. R. (1988). Correlates of burnout among family practice residents. Journal of Medical Education, 63(9), 682–691. https://doi.org/10.1097/00001888-198809000-00003

Mangione, S., Kane, G. C., Caruso, J. W., Gonnella, J. S., Nasca, T. J., & Hojat, M. (2002). Assessment of empathy in different years of internal medicine training. Medical Teacher, 24(4), 370–373. https://doi.org/10.1080/01421590220145725

Martini, S., Arfken, C. L., Churchill, A., & Balon, R. (2004). Burnout comparison among residents in different medical specialties. Academic Psychiatry, 28(3), 240–242. https://doi.org/10.1176/appi.ap.28.3.240

McCue, J. D., & Sachs, C. L. (1991). A stress management workshop improves residents' coping skills. Archives of Internal Medicine, 151(11), 2273–2277. https://doi.org/10.1001/archinte.1991.00400110117023

National Physician Survey. (2012). 2012 national physician survey. http://nationalphysiciansurvey.ca/surveys/2012-survey/

Nguyen, M. C., Gabbe, S. G., Kemper, K. J., Mahan, J. D., Cheavens, J. S., & Moffatt-Bruce, S. D. (2020). Training on mind-body skills: Feasibility and effects on physician mindfulness, compassion, and associated effects on stress, burnout, and clinical outcomes. The Journal of Positive Psychology, 15(2), 194–207. https://doi.org/10.1080/17439760.2019.1578892

Polack, E. P., Avtgis, T. A., Rossi, D. C., & Shaffer, L. (2010). A team approach in communication instruction: A qualitative description. Journal of Surgical Education, 67(3), 125–128. https://doi.org/10.1016/j.jsurg.2010.02.004

Prasad, K., Wahner-Roedler, D., Cha, S. S., & Sood, A. (2011). Effect of a single-session meditation training to reduce stress and improve quality of life among health care professionals: A “dose-ranging” feasibility study. Alternative Therapies, 17(3), 46–49.

Prins J. T., Gazendam-Donofrio S. M., Tubben B. J., van der Heijden F. M. M. A., van de Wiel H. B. M., & Hoekstra-Weebers J. E. H. M. (2007). Burnout in medical residents: A review. Medical Education, 41(8), 788–800. https://doi.org/10.1111/j.1365-2923.2007.02797.x

Prins, J. T., van der Heijden, F. M., Hoekstra-Weebers, J. E. H. M., Bakker, A. B., van de Wiel, H. B. M., Jacobs, B., & Gazemdam-Donofrio, S. M. (2009). Burnout, engagement and resident physicians’ self-reported errors. Psychology, Health & Medicine, 14(6), 654–666. https://doi.org/10.1080/13548500903311554

Raper, S. E., Resnick, A. S., & Morris, J. B. (2014). Simulated

disclosure of a medical error by residents: Development of a course in specific communication skills. Journal of Surgical Education, 71(6), e116–e126. https://doi.org/10.1016/j.jsurg.2014.06.020

Ratanawongsa, N., Wright, S. M., & Carrese, J. A. (2008). Well-being in residency: Effects on relationships with patients, interactions with colleagues, performance, and motivation. Patient Education and Counseling, 72(2), 194–200.

https://doi.org/10.1016/j.pec.2008.04.010

Real, K., Fields-Elswick, K., & Bernard, A. C. (2017). Understanding resident performance, mindfulness, and communication in critical care rotations. Journal of Surgical Education, 74(3), 503–512. https://doi.org/10.1016/j.jsurg.2016.11.010

Ripp, J., Fallar, R., Babyatsky, M., David, R., Reich, L., & Korenstein, D. (2010). Prevalence of resident burnout at the start of training. Teaching and Learning Medicine, 22(3), 172–175. https://doi.org/10.1080/10401334.2010.488194

Shanafelt, T. D., Bradley, K. A., Wipf, J. E., & Back, A. L. (2002). Burnout and self-reported patient care in an internal medicine residency program. Annals of Internal Medicine, 136(5), 358–367. https://doi.org/10.7326/0003-4819-136-5-200203050-00008

Tuccitto, D. E., Giacobbi, P. R., Jr., & Leite, W. L. (2010). The internal structure of positive and negative affect: A confirmatory factor analysis of the PANAS. Educational and Psychological Measurement, 70(1), 125–141. https://doi.org/10.1177/0013164409344522

Wang, J.-N., Sun, W., Chi, T.-S., Wu, H., & Wang, L. (2010). Prevalence and associated factors of depressive symptoms among Chinese doctors: A cross-sectional survey. International Archives of Occupational and Environmental Health, 83(8), 905–911. https://doi.org/10.1007/s00420-010-0508-4

Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063–1070. https://doi.org/10.1037/0022-3514.54.6.1063

West, C. P., Huschka, M. M., Novotny P. J., Sloan, J. A., Kolars, J. C., Habermann, T. M., & Shanafelt, T. D. (2006). Association of perceived medical errors with resident distress and empathy: A prospective longitudinal study. JAMA, 296(9), 1071–1078. https://doi.org/10.1001/jama.296.9.1071

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Published

2020-12-01

How to Cite

Carsley, D., Sadowski, I., Heath, N., Montoro, R., & Miller, S. (2020). Acceptability and perceived effectiveness of a single-session mindfulness intervention for medical residents. Focus on Health Professional Education: A Multi-Professional Journal, 21(3), 15–29. https://doi.org/10.11157/fohpe.v21i3.399

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