Long-term follow-up of mind-body medicine practices among medical school graduates.

INTRODUCTION: We sought to determine the long-term use of mind-body medicine (MBM) skills after graduation from medical school. METHODS: An online survey was sent to Georgetown University School of Medicine (GUSOM) graduates who completed at least one semester of a MBM skills training course. Using a quantitative-qualitative mixed-methods approach, we assessed the personal and professional practices of graduates, and identified factors that may influence practice/training after graduation. RESULTS: Current personal practices were positively related to the level of the course completed and amount of home practice during medical school (N = 112). Over half the sample indicated they currently practice MBM and refer patients to MBM. Moreover, physician specialty and awareness of home institution MBM training was associated with MBM patient training and referral. Participants reported a dearth of MBM training at their home institutions, and provided qualitative insights about the personal and professional impact of MBM training as well as barriers to continued MBM practice. CONCLUSIONS: The results provide preliminary evidence that MBM training during medical school may be related over time to physician trainee self-care and patient care. Rigorous tests of these relationships should be conducted in future work.

The impact of mind-body medicine facilitation on affirming and enhancing professional identity in health care professions faculty.

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.

Stress biomarkers in medical students participating in a mind body medicine skills program.

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 well-being 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, dehydroepiandrosterone-sulfate (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.

Using complementary and alternative medicine curricular elements to foster medical student self-awareness.

PURPOSE: To determine the value that the National Center for Complementary and Alternative Medicine (NCCAM)-funded Education Project leaders placed on self-awareness objectives among their curricular activities, to identify projects' rationales for inclusion of self-awareness activities, and to describe curricular elements used to teach self-awareness. METHOD: A survey was distributed to the NCCAM Education Project grantees in October 2006. Survey items sought to identify project directors' perceived importance of self-awareness activities in complementary and alternative medicine (CAM) curricula, rationales for inclusion of self-awareness activities, and activities to foster self-awareness. Invited reports described in more depth the specific activities in three of the projects. RESULTS: Fourteen of 15 reporting NCCAM educational projects rated activities to promote self-awareness as highly or very highly valued components, and all projects incorporated numerous strategies to enhance self-awareness. Learning objectives ranged from basic knowledge about mind-body relationships and psychoneuroimmunology, to evidence and indications for mind-body interventions, to training in self-application, to training for intervention with patients. Specific strategies that increase students' self-awareness included evidence-based CAM activities to help students recognize personal biases that may impair critical thinking; personal health experiences to expand definition of health beliefs; and mind-body medicine skills groups to personally integrate the use of mind-body techniques for wellness and stress management. CONCLUSIONS: Incorporating some of these CAM curricular activities, didactically or experientially, may be a unique way to foster student self-awareness and personal growth.

Promoting self-awareness and reflection through an experiential mind-body skills course for first year medical students.

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.