By Erica Benedicto, PA-C, MPH, YT

Founder, Shiny Healthy People, Austin, TX

Ms. Benedicto reports no financial relationships relevant to this field of study.

SYNOPSIS: This pilot study shows that a peer-led mindfulness program during medical school enhances self-compassion, altruism, and mental wellness and decreases levels of stress.

SOURCE: Danilewitz M, Bradwejn J, Koszycki D. A pilot feasibility study of a peer-led mindfulness program for medical students. Can Med Educ J 2016;7:e31-e37.

SUMMARY POINT

  • Peer-led mindfulness programs may contribute to improving medical student mental health as well as their future practice as physicians.

Medical school is a challenging experience from even before matriculation, one that stems from both internal and external psychological and cultural pressures. This has led to increased risk of depression throughout the training, sometimes leading to suicide.1 A 1977 study showed that society loses the equivalent of one small medical school to suicide per year.2 Depression, isolation, and anxiety have led to decreased quality of care, reduced empathy, and increases in medical errors.3 Although medical schools are attempting to make student wellness a priority, mental health services use is low among students. Addressing this monumental issue requires a shift in the culture as well as creative ways to engage students to utilize the few resources that are available.

Danilewitz et al looked at the effect of a peer-led mindfulness program on student wellness and professionalism. Participants were recruited from first- and second-year medical students at the University of Ottawa. The study was a randomized waitlist (WL) control design. The first 30 students to reply were chosen and were asked to undergo an eight-week intervention. The study was considered feasible if 75% of participants completed four or more sessions, and compliance with homework was higher than 70%. The study also looked at self-reported psychological distress, empathy, self-compassion, mindfulness, and altruism.

Outcomes also included program satisfaction, which was found to be high, although compliance was suboptimal. The Mindfulness Medication Program (MMP) was adapted from the mindfulness-based stress reduction program and designed specifically for medical students. Paired t-tests showed the MMP group had changes in levels of stress (P = 0.019), self-compassion (P = 0.024), and altruism (P = 0.0333) from baseline to post-study. The WL group did not have a significant pre-to post-test change. Academic and clinical performance were affected positively, at 88% and 69%, respectively, in those who received the MMP.

According to a study by Durning and Ten Cate, there is a shift in medical school curriculum toward more peer education.4 Research has shown that since medical students are reluctant to seek mental health care from professionals, a peer-led program may be one solution toward achieving medical student wellbeing. According to this pilot study, a peer-led MMP is feasible. Further research in the realm of medical student mental health is imperative to the future of our healthcare system and its clinicians.

REFERENCES

  1. Goebert D, Thompson D, Takeshita J, et al. Depressive symptoms in medical students and residents: A multischool study. Acad Med 2009;34:236-241. doi: 10.1097/ACM.ob013e31819391bb.
  2. Sargent DA, Jensen VW, Petty TA, Raskin H. Preventing physician suicide. The role of family, colleagues, and organized medicine. JAMA 1977;237:143-145. doi:10.1001/jama.1977.03270290043024.
  3. Thomas MR, Dyrbye LN, Huntington JL, et al. How do distress and well-being relate to medical student empathy? A multicenter study. J Gen Intern Med 2007;22:177-183. doi: 10.1007/s11606-006-0039-6.
  4. Durning SJ, Ten Cate OT. Peer teaching in medical education. Med Teach 2007;29:523-524doi/full/10.1080/01421590701683160