Mindfulness-based intervention helps preclinical medical students to contain stress, maintain mindfulness and improve academic success

Sustainable benefits of mindfulness training in health professions education

BACKGROUND

Healthcare work and even studies towards a healthcare profession is associated with a high prevalence of distress. According to recent meta-analyses, half of the medical students worldwide suffer from burn out prior to residency, and 34% of nursing students suffer from depression. The aim of this study was to investigate healthcare students' long-term experiences of mindfulness training, and whether, how and why students were continuing their mindfulness practice after graduation. Further, to assess if background characteristics were associated with continuing mindfulness practice.

METHODS

A mixed method survey study based on predetermined and open-ended questions. Qualitative and quantitative data were analysed concurrently to assess effects on, and a deepened understanding of stress management, use of mindfulness in relation to patients, oneself and others, and continued practice of mindfulness.

RESULTS

Two hundred one of the 380 (52,8%) students completing the mindfulness based stress management course (MBSM) answered the questionnaire. Of all, 175 (87,1%) students also answered free text questions. The qualitative analysis identified five themes: "Positive" Experiences, "Negative" Experiences, "Origin and development of interest in mindfulness" and "Continuing practice of mindfulness". A considerable proportion of the participants experienced increased acceptance, relaxation, ability to face difficulties, self-compassion and better interaction with patients, but some participants also experienced negative experiences such as aversiveness and ineffectiveness of the course. Those continuing to practice mindfulness after graduation were more likely (85.3%) to say that the gained competence helped in their relationship with patients, compared to those who did not continue to practice (57.1%); (chi2 = 18.13; df = 2; p < 0.001). Among those who had previous mindfulness or similar experience, 84% continue to practice mindfulness after the course, compared to 50% of those who had no previous experience (chi2 = 26; df = 1; p < 0.001).

CONCLUSION

The long-term follow-up of mindfulness training for healthcare students shows that participants maintain a sustained capability to handle stressful work situations in their professional practice and develop a more compassionate relationship with themselves. We argue that skills to care for one's inner environment, such as learning mindfulness as a student, can contribute to a sustainable future professional life. However, further research is needed to confirm the transferability of the results.

Developing and evaluating a Portuguese-language meditation App for medical students: motivation, adherence, and emotional effects

The well-being of medical students is affected by high stress levels. The relevance of a mindfulness mediation app (Med@Med) specifically produced to help medical students at a Portuguese medical school cope with stress was evaluated. The app, consisting of 21 short meditations, was totally developed in Portuguese to fulfill with the needs of some of the students. The motivations to use the app, adherence to it, and its emotional benefits were evaluated. A total of 147 medical students were enrolled in the study. Students completed questionnaires related to emotional regulation (Emotion Regulation of Others and Self) and emotional thermometers before the first meditation and at the end of the project. Before and after each meditation, the students were invited to identify their basic emotion (joy, fear, disgust, anger, or sadness), no perceived emotion, or no reply. Participants received daily motivational messages (scientific or in lay language) or no message during the first 7 days of the project and the retention was registered. The main motivations to use the Med@Med app were to experience meditation (33%), decrease stress/anxiety (25%), or implement a daily meditation routine (16%). The remaining motivations of the students were sleep improvement or enhancement of academic performance. The self-motivation to use the app was high (7.3 ± 3.2 on a 1-10 scale). Participants that received daily messages in lay language, which summarized scientific findings about the benefits of meditation, were more likely to continue to use the app. The emotions changed from pre- to post-practice, with an increase in self-identification with joy and decrease of fear and sadness. An improvement in the intrinsic emotional regulation subscale (p < 0.01) was detected. In comparison with age-matched students that did not use the Med@Med app, the students that used the app presented less emotional distress and anxiety as evaluated by emotional thermometers. This study shows that medical students are motivated to use a meditation app. The improvement of emotion-related parameters after the use of the Med@Med app is a promising result. The benefits of using the Med@Med meditation app prepared in Portuguese keeping in mind the needs of medical students should be evaluated in other Portuguese-speaking medical schools.

[Surgeon well-being and mindfulness-A narrative review on how come, for what reason, why in times of surgeon shortage]

In the Anglo-American world the field of surgeon well-being is already very prominent, while in Germany it is still underrepresented. In this article, we aim to analyze the challenges and factors that affect the well-being of surgeons, including stress, burnout, workload, job satisfaction, autonomy, leadership, teamwork and work-life integration. Additionally, we discuss the connection between surgeon well-being and the shortage of new talent in surgery, which is currently being exacerbated by increasing treatment and physician demands, the age development of specialists and an overall high turnover. Finally, we propose several solutions that can be implemented at individual, institutional and systemic levels to promote and maintain the well-being of surgeons. These include improving working conditions, providing resources and support, promoting resilience and mindfulness and recognizing and appreciating achievements.

Twelve tips for supporting medical learners through high-stakes assessment challenges

Learners across the medical education continuum will encounter numerous high-stakes exams and assessments. Effectively preparing for and performing well on these types of assessments can be challenging for learners for a wide variety of reasons. It is imperative that medical educators provide appropriate support for learners who experience challenges with high-stakes exams, particularly given the complexity of factors like life circumstances of individual learners and the significance of these assessments for career advancement/progression. Grouped into areas including educator mindset, information-gathering, and developing and executing a study plan, the following 12 tips will help medical educators be better prepared to meaningfully support learners in need of assessment remediation and guidance.

A holistic approach to sustain and support lifelong practices of wellness among healthcare professionals: generating preliminary solid steps towards a culture of wellness

BACKGROUND

The COVID-19 pandemic has served as a catalyst for recognizing the challenging environments in which healthcare workers operate, underscoring the urgent need to enhance their wellness to better support themselves and others. The implementation of a culture of wellness within the context of healthcare education, with a particular emphasis on individual-level strategies, allows for the realization of its intrinsic value and significance as a foundation for broader organizational strategies. This approach facilitates the establishment of a sustainable culture of wellness that benefits both current and subsequent generations of healthcare professionals.

METHODS

We implemented our wellness program using a pragmatic pre-post study design for different settings. Our wellness intervention program was tested in three ways by creating combinations of different intensities (high, moderate, or low), delivery methods (face-to-face vs. virtual), different motivations (incentive, mandatory, or volunteer participation), and different timings (during medical programs or before entering into healthcare programs) among medical and nursing students. The effects of the wellness program were measured on quality of life, emotional intelligence, and efficacy scores among healthcare students. Statistical methods included repeated measures analysis of variance and paired t-tests.

RESULTS

A total of 224 students (13 in high, 145 in moderate, and 66 in low-dose interventions) participated in our study program. Most scores were significantly improved except for a few factors in the high-dose face-to-face Well-Teach intervention cohort. Among quality of life components, the average psychological scores were markedly increased after high (13.2 vs. 14.7, p = .018), moderate (13.9 vs. 14.8, p < .001), and low (12.8 vs. 13.4, p < .001) intensity intervention cohorts. The moderate and low intensity of wellness intervention cohorts had the highest impact on the total emotional intelligence scores (mean difference = 3.021, 95%CI:0.553-5.488, p = .008) and (mean difference = 5.197, 95%CI:3.057-7.337, p = < 0.001), respectively. The low-dose healthcare intervention program yielded improvements in all components of all scores to a greater extent than moderate-dose or high-dose with face-to-face intervention programs.

CONCLUSIONS

This study demonstrates that our multifaceted Well-Teach model can be used to improve the quality of life, emotional intelligence, and self-efficacy of healthcare students. Low- or moderate-intensity intervention programs integrated into the curriculum may be more practical in health sciences education to sustain and promote lifelong wellness practices as solid steps toward attaining a "culture of wellness". Our model should be considered to be beneficial, sustainable, cost-effective, comprehensive, and effective for current and future generations of healthcare providers.

Can positive emotional writing improve the emotional health level of international medical students? Evidence from a randomized controlled trial

BACKGROUND

Depression and anxiety are common psychological issues among international medical students in universities, which have serious negative impacts on their learning and life. The present study aimed to evaluate the efficacy of positive emotional writing in alleviating symptoms of anxiety and depression, as well as enhancing subjective well-being among this population.

METHOD

This study was conducted at an international college of a comprehensive university in central China. A total of ninety-two participants who met the inclusion criteria were recruited to participate in a single-blind randomized controlled trial, in which participants were not aware that there was an experimental group and a control group. Participants in control received daily psychological care weekly for 8 weeks (n = 46). Correspondingly, participants in experimental group received the positive emotional writing intervention on the basis of daily psychological care. Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and General Well-being Scale (GWB) were used to evaluate the effect of the intervention. Data from 89 students who completed the entire study (experimental group, n = 44; control group, n = 45) were analyzed.

RESULTS

After the intervention, the scores of SDS and SAS in the experimental group significantly decreased, while the subjective well-being score significantly increased. Although the SAS score of the control group after intervention was significantly lower than before, the decrease in SDS and SAS scores, as well as the increase in GWB score, were significantly greater in the experimental group than in the control group.

CONCLUSION

The findings suggest that positive emotional writing can effectively reduce the depression and anxiety of international medical students, and significantly enhance their subjective well-being, providing ideas for management to solve the psychological problems of international medical students.

TRIAL REGISTRATION NUMBER

ChiCTR2400087815. Registered at Chinese Clinical Trial Registry.

The impact of mindfulness on academic achievement of students with the mediating role of adaptability: a structural equation modeling approach

INTRODUCTION

Examining the factors influencing students' academic achievement can lead to improved educational planning and enhanced teaching and learning outcomes. The aim of this study was to investigate the impact of mindfulness on academic achievement with the mediating role of adaptability among students at Jiroft University of Medical Sciences in southern Iran in 2024.

METHODS

This descriptive-analytical cross-sectional study was conducted on 290 students from various fields at Jiroft University of Medical Sciences in southern Iran from January to April 2024. To select these 290 individuals, a stratified sampling proportional to size was first carried out based on the year of university entry and field of study. After the sample size was determined for each entry year and field of study, students were randomly selected using their student numbers and a random number table. The data collection instruments were the standard mindfulness, academic achievement, and adaptability questionnaires. Descriptive tests and structural equation modeling using the Partial Least Squares (PLS) method were employed for data analysis, utilizing Smart PLS3 and SPSS26 software.

RESULTS

The findings indicate that students' mindfulness positively affects their academic achievement (p < 0.001, β = 0.59). Additionally, mindfulness positively influences students' adaptability (p < 0.001, β = 0.65). The results also show adaptability positively impacts students' academic achievement (p = 0.001, β = 0.57). Finally, students' mindfulness has a significant positive effect on their academic achievement through the mediating role of adaptability (p < 0.001).

DISCUSSION

According to the results, a favorable state of mindfulness and adaptability among students can improve academic achievement. Therefore, it is recommended that university administrators facilitate the enhancement of students' mindfulness and adaptability by organizing relevant courses and workshops. This approach can contribute to their academic progress.

Workplace learning: the bidirectional relationship between stress and self-regulated learning in undergraduates

The present study focused on the relationships between various aspects of self-regulated learning (SRL) and stress among undergraduate health science students in workplace settings. Although both constructs are associated with academic achievement (Ahmady Set al., in J Educ Health Promotion 10:32, 2021, Cho KK et al., in BMC Med Educ 17:112, 2017), it is still unclear how they influence each other. Employing a longitudinal diary design, the aim of the present study was to examine whether perceived stress in the previous week impacts SRL-aspects in the current week and, conversely, whether SRL-aspects in the previous week impacts stress in the current week. Subjects were 192 undergraduate health sciences students in their workplace placements. SRL-aspects and stress were assessed using scales and previously tested single-item measures. The 21 SRL-aspects used in this study included cognition (learning strategies), motivation, emotion, perception of the learning environment, and regulation of these areas on a metalevel (monitoring and control). Data collected over 15 weeks were analyzed using multilevel vector autoregressive models, with the data nested within weeks and one model dedicated to each SRL-aspect and its relationship with stress. Among the 21 path estimates assessing the impact of prior stress on individual SRL-aspects, 10 were statistically significant. For individual SRL-aspects impacting stress, 7 out of 21 paths were statistically significant (p < .05). Notably, no model showed statistical significance of effects in both directions. Except for two results, cross-lagged relationships were negative, indicating that better SRL-aspects from the previous week resulted in reduced stress in the current week and vice versa. The effects for the cross-lagged paths from SRL-aspects to stress were predominantly of medium size, whereas the influence of stress on individual SRL-aspects was predominantly small. The present study highlights a potentially causal and mostly negative relationship between stress and various aspects of SRL, but also that the individual relationships require differentiated consideration. The results can be used to develop targeted interventions in the practical part of the training of health science students to reduce stress and improve specific aspects of SRL. Furthermore, these findings underscore assumptions regarding connections between anxiety and increased stress, negative relationships between stress and motivation, and the importance of effective time management strategies for stress reduction.

Feasibility and effectiveness of stress management skill training in medical students

Background

There is limited literature on stress management interventions targeting Indian medical undergraduates. With this background, the study aimed to evaluate the feasibility and effectiveness of stress management intervention on perceived stress, coping and burnout amongst first-year medical undergraduates.

Methods

It was a quasi-experimental study assessing the effect of "Comprehensive Stress Management Skill Training Program". This intervention emphasized on self-awareness of early warning signs of stress, adopting a healthy lifestyle, developing assertiveness at work, maintaining work-life balance. The stress reduction techniques mainly consisted of deep breathing exercises, progressive muscular relaxation and visualization. It was delivered by a team of a psychiatrist and a nurse to hundred first year medical undergraduate students. Medical Students Stressor Questionnaire, Brief COPE Questionnaire and Maslach Burnout Inventory-Student Survey were applied for assessment of perceived stress, burn out, and coping, respectively, at baseline, finish of one and three months of intervention.

Results

Significant improvement was noted in academic stress, interpersonal-related stress, teaching learning-related stress, and total stress scores, emotional exhaustion, and emotion-focused coping at the end of the three months of intervention. Positive feedback about the intervention was given by majority of the students.

Conclusion

Stress management intervention was found to be feasible and effective in improving stress, coping, and emotional exhaustion in first year medical students.

Enhancing self-care education amongst medical students: a systematic scoping review

BACKGROUND

Reports of emotional, existential and moral distress amongst medical students witnessing death and suffering of patients during their clinical postings have raised awareness on the need for better psycho-emotional support during medical school. Furthermore, the stress experienced by medical students stemming from the rigours of their academic curriculum underlines the need for greater awareness on mental health issues and better self-care practices across medical training. With such programmes lacking in most medical schools, we propose a systematic scoping review (SSR) to map and address our research question, "what is known about self-care education interventions amongst medical students?".

METHODS

We adopted the Systematic Evidence-Based Approach to guide a systematic scoping review (SSR in SEBA) of relevant articles published between 1st January 2000 and 30th June 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles were independently and concurrently thematically and content analysed, with complementary categories and themes combined using the Jigsaw Approach. The domains created from the Funnelling Process framed the discussion.

RESULTS

A total of 6128 abstracts were identified, 429 full-text articles evaluated, and 147 articles included. The 6 domains identified were definition, topics, pedagogy, influences, outcomes and assessment. Most interventions were promising, though peer-led mindfulness-based interventions showed most promise in enhancing engagement, positively impacting personal wellbeing, and improving patient care. Overall, however, self-care education was poorly recognized, adopted and integrated into curricula.

CONCLUSION

Greater dedicated time and conducive practice environments within medical school curricula is required to enhance medical student wellbeing. Host organizations must ensure faculty are appropriately selected to instil the importance of self-care, be trained to assess and personalize self-care interventions and provide longitudinal assessment and support. Further study into assessing self-care capabilities is required.

Measuring wellbeing: A scoping review of metrics and studies measuring medical student wellbeing across multiple timepoints

PURPOSE

Studies have demonstrated poor mental health in medical students. However, there is wide variation in study design and metric use, impairing comparability. The authors aimed to examine the metrics and methods used to measure medical student wellbeing across multiple timepoints and identify where guidance is necessary.

METHODS

Five databases were searched between May and June 2021 for studies using survey-based metrics among medical students at multiple timepoints. Screening and data extraction were done independently by two reviewers. Data regarding the manuscript, methodology, and metrics were analyzed.

RESULTS

221 studies were included, with 109 observational and 112 interventional studies. There were limited studies (15.4%) focused on clinical students. Stress management interventions were the most common (40.2%). Few (3.57%) interventional studies followed participants longer than 12 months, and 38.4% had no control group. There were 140 unique metrics measuring 13 constructs. 52.1% of metrics were used only once.

CONCLUSIONS

Unique guidance is needed to address gaps in study design as well as unique challenges surrounding medical student wellbeing surveys. Metric use is highly variable and future research is necessary to identify metrics specifically validated in medical student samples that reflect the diversity of today's students.

Student academic performance in non-lecture physiology topics following the abrupt change from traditional on-site teaching to online teaching during COVID-19 pandemic

BACKGROUND

During the COVID-19 pandemic, pre-clerkship medical education, including all physiology classes, was obliged to change to online teaching due to limitations of on-site (face-to-face) classes. However, the effectiveness of online teaching in non-lecture physiology topics during the COVID-19 pandemic has not been thoroughly investigated.

METHOD

We conducted a prospective study to evaluate the students' academic achievement and opinions on online teaching during the COVID-19 academic year. Academic achievement of 312 students in the COVID-19 year was compared with that of 299 students in the pre-COVID-19 year. Student opinions regarding social interactions and the preferred learning method were also collected.

RESULTS

We found that student academic achievement in the non-lecture physiology topics, assessed by summative scores, was 4.80±0.92 percent higher in the pre-COVID-19 year than in the COVID-19 year (P < 0.01, Cohen's d = 0.42). Students rated that online classes tended to reduce their interactions with peers and teachers; however, students preferred online learning over traditional on-site learning.

CONCLUSIONS

This study pointed out that students' academic performance related to the physiology topics taught by online non-lecture methods during the COVID-19 pandemic was lower than their performance when the topics were taught by the traditional (on-site) methods, although students reported that they preferred the online teaching. Hence, we suggest that medical teachers should deliberately plan and utilise a variety of tools and techniques when developing online non-lecture classes to preserve the interactivity of the classes, which might overcome this gap in students' academic performance.

The effect of mindfulness interventions on stress in medical students: A systematic review and meta-analysis

BACKGROUND

Medical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students.

PURPOSE

The purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included.

METHODS

A comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics.

RESULTS

Mindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239-0.501, p < .001) and one-arm pre-post studies (d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127-0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress.

CONCLUSIONS

This study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.

Combination of EEG-Guided Adaptive Neurostimulation with Resonance Scanning in Correction of Stress-Induced States and Cognitive Rehabilitation of University Students

The correction of stress-induced states and cognitive rehabilitation were carried out during the examination session in three university student groups comparable in the number, sex, and age. In the experimental group, a combination of EEG-guided adaptive neurostimulation with preliminary resonance scanning was used. In control group 1, only EEG-guided adaptive neurostimulation was used. In control group 2, musical-acoustic stimuli were presented without feedback from the subject's EEG. Experiments with preliminary resonance scanning revealed the maximum positive effects compared to the two control types of stimulation. A significant increase in the power of EEG rhythms, especially in the alpha range, was accompanied by a significant increase in subjective indicators of the functional state and cognitive activity. These results can be explained from the standpoint of the progressive involvement of the resonant, integrative, and neuroplasticity mechanisms of the brain into the processes of normalization the functional state of the body under the influence of combined stimulation procedures.

Understanding students' motivations for participating in a mindfulness course: a qualitative analysis of medical students' views

OBJECTIVES

Improving medical students' wellbeing and empowerment through curricular activities is a topic of interest worldwide. Mindfulness-based interventions (MBIs) are increasingly implemented in medical education often as part of elective courses. To better understand training outcomes and adjust curriculum to students' needs, we will explore why will medical students participate in meditation-based education?

METHODS

We analyzed 29 transcripts from the first session of an 8-week MBSR program offered to medical students in French. Transcripts were coded and analyzed using a qualitative content thematic analysis and the constant comparison method.

RESULTS

Analyses resulted in three themes describing students' motivation: (1) Medical education and the physician's role, i.e. improving interpersonal skills, acquiring skills oriented toward a more integrative medicine, being more productive in a highly competitive context. (2) Caring for my health i.e. aiming at stress reduction, emotion regulation, and improving self-compassion. (3) A quest for meaning, i.e. optimizing meaning of care, and meaning of life.

CONCLUSION

The results highlight the congruence between the perceived motivations and the evidence on the effect of mindfulness on self-care, the development of humanistic medical skills, and the meaning of care. Some findings raise the issue of the limits of using mindfulness to enhance one's productivity. Notably, participants articulated the need for self-care as in mindfulness training, with the ability to care for others.

Resonance Scanning as an Efficiency Enhancer for EEG-Guided Adaptive Neurostimulation

Electroencephalogram (EEG)-guided adaptive neurostimulation is an innovative kind of non-invasive closed-loop brain stimulation technique that uses audio–visual stimulation on-line modulated by rhythmical EEG components of the individual. However, the opportunity to enhance its effectiveness is a challenging task and needs further investigation. The present study aims to experimentally test whether it is possible to increase the efficiency of EEG-guided adaptive neurostimulation by pre- strengthening the modulating factor (subject’s EEG) through the procedure of resonance scanning, i.e., LED photostimulation with the frequency gradually increasing in the range of main EEG rhythms (4–20 Hz). Thirty-six university students in a state of exam stress were randomly assigned to two matched groups. One group was presented with the EEG-guided adaptive neurostimulation alone, whereas another matched group was presented with the combination of resonance scanning and EEG-guided adaptive neurostimulation. The changes in psychophysiological indicators after stimulation relative to the initial level were used. Although both types of stimulation led to an increase in the power of EEG rhythms, accompanied by a decrease in the number of errors in the word recognition test and a decrease in the degree of emotional maladjustment, these changes reached the level of significance only in experiments with preliminary resonance scanning. Resonance scanning increases the brain’s responsiveness to subsequent EEG-guided adaptive neurostimulation, acting as a tool to enhance its efficiency. The results obtained clearly indicate that the combination of resonance scanning and EEG-guided adaptive neurostimulation is an effective way to reach the signs of cognitive improvement in stressed individuals.

Mindfulness and Academic Performance of College and University Students: A Systematic Review

Higher education's expectations place demands on students' attainment, leading them to experience stress and anxiety, which negatively affect their academic improvement and life satisfaction. The aim of this systematic review was to investigate (a) if mindfulness as an inner ability is related to academic attainment, through dependent variables, including compassion, engagement, stress or anxiety state, depression, self-efficacy, mindfulness's facets (non-reactivity, acting with awareness) and (b) if mindfulness-based interventions positively affect the academic performance of college and university students. The systematic review was conducted in accordance with the PRISMA statement. PubMed, Web of Science, and Cochrane Library Wiley were screened to identify studies published relevant to the topic. In total, 568 papers were retrieved in the initial search. Five papers met the eligibility criteria and were included in the systematic review: a randomized controlled trial, a non-randomized controlled trial, a quasi-experimental study, a quantitative exploratory pilot study, and a longitudinal randomized controlled study. Most interventional studies revealed a non-significant direct effect of practicing mindfulness technique on academic attainment. Further research, especially randomized controlled trials are necessary to clarify the effect of mindfulness on academic performance of college and university students.

Mindfulness practice correlates with reduced exam-induced stress and improved exam performance in preclinical medical students with the "acting with awareness", "non-judging" and "non-reacting" facets of mindfulness particularly associated with improved exam performance

BACKGROUND

Medical students demonstrate higher levels of psychological distress compared with the general population and other student groups, especially at exam times. Mindfulness interventions show promise in stress reduction for this group, and in the reduction of cortisol, an established clinical marker of the body's stress response. This study investigated the relationship of mindfulness to exam-induced stress, salivary cortisol and exam performance in undergraduate medical students.

METHODS

A controlled pre-post analysis design with within-groups comparisons. 67 medical students completed the five facet mindfulness questionnaire (FFMQ) and provided saliva samples, from which cortisol was extracted, during group work (control/baseline) and immediately prior to end of year 2 examinations (experimental). Academic performance data was extracted for comparison with measures.

RESULTS

Exam-induced salivary cortisol concentration showed a significant negative relation with exam performance. Total FFMQ score showed a significant positive relation with exam performance and a significant negative relation with exam-induced salivary cortisol. The specific mindfulness facets of acting with awareness, non-judging and non-reacting also showed a positive correlation with exam performance.

CONCLUSIONS

This study suggests that there exists an important relationship between mindfulness and the physiological biomarker of stress, cortisol, and this manifests into improved assessment outcomes potentially through healthier, more adaptive coping and stress management strategies. In particular, this study identifies the acting with awareness, non-judging and non-reacting facets of mindfulness to be significantly associated with exam performance suggesting that these may be important facets for clinical educators to target when helping students with mindfulness practice.