On becoming a mindful practitioner : a mixed methods study of students' perceptions and their psychological changes through mindfulness training in a medical humanities curriculum

Abstract

Objectives: The objective of this mixed methods study was to examine the outcomes of a compulsory yet very brief type of mindfulness practice training newly introduced for the medical students in the medical humanities curriculum at The University of Hong Kong. The changes in both their psychological conditions and their personal experiences as a result of going through the training were investigated. The design and interpretation of the results were guided by both the scientific understanding of the motivation to engage in mindfulness practice and the traditional Buddhist teachings on mindfulness. Methods: The embedded mixed methods approach was used for the current study. Quantitative data were collected from the control group and three sets of data were collected from the intervention group. Questionnaires were used to assess the changes in the psychological conditions of the two groups of students across a one-year period as they progressed from year two to year three of the medical training. Changes in perceived stress, mindfulness level, self-compassion and sense of coherence were assessed. Individual interviews were conducted and reflection notes from the intervention group were reviewed to obtain the qualitative data necessary to achieve a better understanding of the quantitative results. Results: The changes in perceived stress were significant for both groups. A significant reduction was found for the intervention group and a significant increase was found for the control group. The results also showed that mindfulness training sustained the mindfulness level and self-compassion of the intervention group and while these two dependent variables for the control group were significantly reduced. No significant change in sense of coherence was found for both groups. Four themes emerged from the qualitative data from the individual interviews: awareness, personal experiences with mindfulness, mindfulness for medical practice and mindfulness in medical training. Additional themes related to their personal experiences were identified from the reflection notes, including their proactive coping, reflection on and regulation of experiences and ability to observe. Findings from these three data sources were integrated to ensure an in-depth interpretation of the outcomes through self-determination theory and the traditional Buddhist teachings in the Satipatthana Sutra. Discussion and conclusion: The results led to a comprehensive description of the outcomes of the compulsory mindfulness training offered to the medical students in the new curriculum. Both the positive results and the constraints of the training were identified. This helped not only to identify the medical students’ needs, but also to articulate how mindfulness could help their personal and professional development directly from the students’ perspectives. The results generated transferrable experiences for medical educators interested in introducing mindfulness practice within the formal medical training field.