Reduced burnout and higher mindfulness in medical students after a self-care program during the COVID-19 pandemic.

BACKGROUND: Medical students experience high levels of psychological stress during clinical training. However, most medical curricula do not teach self-care skills. The COVID-19 pandemic has disrupted medical education causing increased distress among students. AIM: To report the implementation and impact of an eight-week multifaceted mindfulness-based self-care program on medical students' distress and well-being during the COVID-19 pandemic. MATERIAL AND METHODS: One hundred twenty-three fourth-year medical students attended the program as part of a mandatory course from April to May 2020, during the rising phase of COVID-19 in Chile. They were evaluated using validated tests before and immediately after the program. The measures included burnout, dispositional mindfulness, perceived stress, traumatic stress reactions, general well-being, resilience, and stress coping strategies. RESULTS: Burnout prevalence decreased from 48% to 24%, whereas students with high dispositional mindfulness increased from 25% to 44%. Burnout reduction was mostly due to decreased emotional exhaustion. Additionally, students reported lower levels of stress, self-blaming, and traumatic stress reactions alongside an increased use of active coping strategies and resilience levels after the program. CONCLUSIONS: A formal educational intervention, teaching self-awareness and self-regulation skills can help reduce medical students' distress and promote their well-being even amidst a pandemic.

[Concern for residents' wellbeing, an issue discussed at the latin american conference on resident education (LACRE) 2017]. / Preocupación por el bienestar de residentes, un tema presente en la Conferencia Latinoamericana en Educación de Residentes (LACRE) 2017.

At the end of May 2017, the third version of the Latin American Conference on Resident Education, LACRE, was held in Chile; it convened 433 people from 14 regional countries. Chronic stress and emotional exhaustion of residents was one of the topics discussed. Reports from different countries documented that about half of residents suffer from burnout. This is, they are emotionally drained, indifferent towards their patients and with a sense of low personal fulfillment at work. This article describes the contributions presented in LACRE about interventions or institutional programs designed to reduce burnout and promote self-care of residents. The relevance of these initiatives is discussed in the current global context, considering the available evidence on the effectiveness of interventions to promote well-being among residents. International experts are making renewed and eloquent calls to medical educators and organizations to get involved in the solution of the erosion of resident wellbeing during the residence.

Reduced burnout and higher mindfulness in medical students after a self-care program during the COVID-19 pandemic / Reducción del agotamiento en estudiantes de medicina mediante auto-cuidado durante la pandemia COVID-19

ABSTRACT Background: Medical students experience high levels of psychological stress during clinical training. However, most medical curricula do not teach self-care skills. The COVID-19 pandemic has disrupted medical education causing increased distress among students. Aim: To report the implementation and impact of an eight-week multifaceted mindfulness-based self-care program on medical students' distress and well-being during the COVID-19 pandemic. Material and Methods: One hundred twenty-three fourth-year medical students attended the program as part of a mandatory course from April to May 2020, during the rising phase of COVID-19 in Chile. They were evaluated using validated tests before and immediately after the program. The measures included burnout, dispositional mindfulness, perceived stress, traumatic stress reactions, general well-being, resilience, and stress coping strategies. Results: Burnout prevalence decreased from 48% to 24%, whereas students with high dispositional mindfulness increased from 25% to 44%. Burnout reduction was mostly due to decreased emotional exhaustion. Additionally, students reported lower levels of stress, self-blaming, and traumatic stress reactions alongside an increased use of active coping strategies and resilience levels after the program. Conclusions: A formal educational intervention, teaching self-awareness and self-regulation skills can help reduce medical students' distress and promote their well-being even amidst a pandemic.

Antecedentes: Los estudiantes de medicina experimentan altos niveles de estrés y burnout durante la formación clínica. Sin embargo, la mayoría de los planes de estudios médicos no enseñan habilidades de autocuidado. La pandemia de COVID-19 ha conmocionado la educación médica provocando mayor distrés entre los estudiantes. Objetivo: Informar sobre la implementación y el impacto de un programa multifacético de autocuidado -basado en mindfulness (atención consciente)-sobre el distrés y el bienestar de los estudiantes de medicina durante la pandemia de COVID-19. Material y Métodos: Ciento veintitrés estudiantes de medicina de cuarto año asistieron al programa como parte de un curso obligatorio de abril a mayo de 2020, durante la fase ascendente de COVID-19 en Chile. Fueron evaluados mediante pruebas validadas antes e inmediatamente después del programa. Las medidas incluyeron burnout, mindfulness disposicional, estrés percibido, reacciones de estrés traumático, bienestar general, resiliencia y estrategias de afrontamiento del estrés. Resultados: La prevalencia del burnout disminuyó del 48% al 24%, mientras que los estudiantes con alto mindfulness aumentaron del 25% al 44%. La reducción del burnout se debió principalmente a la disminución del agotamiento emocional. Además, los estudiantes informaron niveles más bajos de estrés, autoinculpación y reacciones de estrés traumático junto con un mayor uso de estrategias activas de afrontamiento y mayores niveles de resiliencia, después del programa de autocuidado. Conclusiones: Una intervención educativa formal que enseñe habilidades de autoconciencia y autorregulación puede ayudar a reducir el burnout de los estudiantes de medicina y promover su bienestar incluso en medio de una pandemia.

Revisión de la educación médica en Chile: logros y desafíos / Review of medical education in Chile: achievements and challenges

La educación médica en Chile ha tenido un importante desarrollo en las últimas décadas. El esfuerzo de distintas instituciones, universidades, sociedades científicas y organizaciones públicas y privadas ha empujado su avance y la han posicionado en un alto estándar de funcionamiento. Esto permite a estudiantes de pre y posgrado el acceso a la formación en salud acorde a un país que quiere avanzar en dar a su población la mejor atención posible. Los avances en áreas de formación con nuevos currículos, el uso de evaluación docente, la acreditación nacional e internacional de los programas, el uso de simulación, la innovación docente y el liderazgo en iniciativas regionales auguran un futuro prometedor y los desafíos se centran en el desarrollo de nuevas estrategias para mejorar el acceso desde una red de instituciones aún dispar en su progreso y de una planificación que regule y potencie el trabajo de la red de educación médica en el ámbito nacional e internacional. El objetivo de este trabajo es detallar el estado actual de la formación médica en Chile y las áreas de trabajo que tienen las más importantes entidades de educación médica del país, destacando las áreas de mayor proyección para articular un proyecto de formación para las futuras generaciones de médicos en Chile

Chilean medical education has developed greatly in the last decade. Different institutions, such as universities, scientific societies and private and public organizations have pushed this development forward, and have allowed and encouraged the high standards at which Chilean medical education is now working. As a consequence undergraduate and postgraduate students have access to health related training that continues to raise the country's medical standard, and goes hand in hand with the country's aim of delivering the best possible health care to its population. Improved training standards, the development of new curricula, regular faculty assessment, national and international accreditation, the use of simulation, teaching innovation and leadership in regional initiatives hold a promising future. Future challenges center on the development of new strategies that allows a network of institutions, at dissimilar stages of progress, improved access to training. And a plan that regulates and enhances the work of the medical education network at a national and international level. The purpose of this paper is to detail the state medical education in Chile, as well as highlighting the most promising areas of development that the best regarded institutions in medical education in Chile are working on, thus articulating a training project for the future generations of medical doctors in Chile

Preocupación por el bienestar de residentes, un tema presente en la Conferencia Latinoamericana en Educación de Residentes (LACRE) 2017 / Concern for residents' wellbeing, an issue discussed at the latin american conference on resident education (LACRE) 2017

At the end of May 2017, the third version of the Latin American Conference on Resident Education, LACRE, was held in Chile; it convened 433 people from 14 regional countries. Chronic stress and emotional exhaustion of residents was one of the topics discussed. Reports from different countries documented that about half of residents suffer from burnout. This is, they are emotionally drained, indifferent towards their patients and with a sense of low personal fulfillment at work. This article describes the contributions presented in LACRE about interventions or institutional programs designed to reduce burnout and promote self-care of residents. The relevance of these initiatives is discussed in the current global context, considering the available evidence on the effectiveness of interventions to promote well-being among residents. International experts are making renewed and eloquent calls to medical educators and organizations to get involved in the solution of the erosion of resident wellbeing during the residence.