Enhancing the health of medical students: outcomes of an integrated mindfulness and lifestyle program

Abstract

Medical students experience various stresses and many poor health behaviours. Previous studies consistently show that student wellbeing is at its lowest pre-exam. Little core-curriculum is traditionally dedicated to providing self-care skills for medical students. This paper describes the development, implementation and outcomes of the Health Enhancement Program (HEP) at Monash University. It comprises mindfulness and ESSENCE lifestyle programs, is experientially-based, and integrates with biomedical sciences, clinical skills and assessment. This study measured the program's impact on medical student psychological distress and quality of life. A cohort study performed on the 2006 first-year intake measured effects of the HEP on various markers of wellbeing. Instruments used were the depression, anxiety and hostility subscales of the Symptom Checklist-90-R incorporating the Global Severity Index (GSI) and the WHO Quality of Life (WHOQOL) questionnaire. Pre-course data (T1) was gathered mid-semester and postcourse data (T2) corresponded with pre-exam week. To examine differences between T1 and T2 repeated measures ANOVA was used for the GSI and two separate repeated measures MANOVAs were used to examine changes in the subscales of the SCL-90-R and the WHOQOL-BREF. Follow-up t-tests were conducted to examine differences between individual subscales. A total of 148 of an eligible 270 students returned data at T1 and T2 giving a response rate of 55%. 90.5% of students reported personally applying the mindfulness practices. Improved student wellbeing was noted on all measures and reached statistical significance for the depression (mean T1 = 0.91, T2 = 0.78; p = 0.01) and hostility (0.62, 0.49; 0.03) subscales and the GSI (0.73, 0.64; 0.02) of the SCL-90, but not the anxiety subscale (0.62, 0.54; 0.11). Statistically significant results were also found for the psychological domain (62.42, 65.62; p \ 0.001) but not the physical domain (69.11, 70.90; p = 0.07) of the WHOQOL. This study is the first to demonstrate an overall improvement in medical student wellbeing during the pre-exam period suggesting that the common decline in wellbeing is avoidable. Although the findings of this study indicate the potential for improving student wellbeing at the same time as meeting important learning objectives, the limitations in study design due to the current duration of follow-up and lack of a control group means that the data should be interpreted with caution. Future research should be directed at determining the contribution of individual program components, long-term outcomes, and impacts on future attitudes and clinical practice.

Percepção da qualidade de vida e fatores associados aos escores de qualidade de vida de alunos de uma escola de medicina

“…Ao ingressar na faculdade de medicina, há inúme-ros aspectos positivos, como a compensação pelo enorme esforço despendido na preparação para o vestibular, a alegria pela conquista e o imenso prestígio familiar e social que contribuem para elevar a autoestima e sensação de vitória, que certamente contribuem para elevar os indicadores de qualidade de vida no primeiro ano do curso, sobretudo no aspecto psicológico [15][16][17][18] , entretanto, com o decorrer do curso e o aumento da carga de trabalho e responsabilidades, tais efeitos vão se reduzindo. 22 mostrou resultados semelhantes entre estudantes locais e estrangeiros na Noruega, exceto para estudantes de origem africana.…”

Health habits of medical students during operating room rotations

“…Increased levels of student stress have also been associated with reduced academic performance and professionalism during medical school [7][8][9][10]. Existing research examining the health habits of medical students structured around health guidelines is dated and was done in schools outside of Canada and the USA making its relevance to contemporary Canadian and American medical school education uncertain [11]. Research has shown that healthy lifestyle programs are well received by students and are effective in improving health and well-being [12,13].…”

Motivation to Learn, Quality of Life and Estimated Academic Achievement: Medical Students Studying in New Zealand

“…2 The well-being of medical students is well researched, and some links have been made between students" quality of life and their motivation to learn, and scholastic achievement. 1,[3][4][5][6][7][8][9][10][11] Nevertheless, research in this area is often ad hoc and more research is required to determine the relationships between QoL and MtL using theoretical paradigms and established robust research tools such as those developed by the World Health Organization and prominent motivational theorists. [12][13][14][15][16] Numerous studies have documented QoL issues amongst the medical student population.…”