University of Louisville School of Medicine, Undergraduate Medical Education, 500 South Preston Street, Louisville, KY, 40202, USA.
Department of Medicine, University of Louisville School of Medicine, 530 S Jackson Street, Louisville, KY, 40202, USA.
BMC Med Educ. 2019 May 10;19(1):139. doi: 10.1186/s12909-019-1546-6.
Compassionate health care is associated with positive patient outcomes. Educational interventions for medical students that develop compassion may also increase wellness, decrease burnout, and improve provider-patient relationships. Research on compassion training in medical education is needed to determine how students learn and apply these skills. The authors evaluated an elective course for medical students modeled after the Compassion Cultivation Training course developed by the Stanford Center for Compassion and Altruism Research and Education. The elective goals were to strengthen student compassion, kindness, and wellness through compassion training and mindfulness meditation training modeled by a faculty instructor. The research objectives were to understand students' applications and perceptions of this training.
Over three years, 45 students participated in the elective at the University of Louisville School of Medicine. The course administered a pre/post Kentucky Inventory of Mindfulness Skills that measured observing, describing, acting with awareness, and accepting without judgment. Qualitative analyses of self-reported experiences were used to assess students' perceptions of compassion training and their application of skills learned through the elective.
The mindfulness inventory showed significant improvements in observing (t = 3.62, p = 0.005) and accepting without judgment skills (t = 2.87, p = 0.017) for some elective cohorts. Qualitative data indicated that students across all cohorts found the elective rewarding, and they used mindfulness, meditation, and compassion skills broadly outside the course. Students described how the training helped them address major stressors associated with personal, academic, and clinical responsibilities. Students also reported that the skills strengthened interpersonal interactions, including with patients.
These outcomes illuminate students' attitudes toward compassion training and suggest that among receptive students, a brief, student-focused intervention can be enthusiastically received and positively influence students' compassion toward oneself and others. To underscore the importance of interpersonal and cognitive skills such as compassion and mindfulness, faculty should consider purposefully modeling these skills to students. Modeling compassion cultivation and mindfulness skills in the context of patient interactions may address student empathy erosion more directly than stress management training alone. This pilot study shows compassion training could be an attractive, efficient option to address burnout by simultaneously promoting student wellness and enhanced patient interactions.
富有同情心的医疗保健与积极的患者预后相关。对医学生进行培养同情心的教育干预,也可能会提高他们的健康水平,减少倦怠感,并改善医患关系。需要对医学教育中的同情心培训进行研究,以确定学生如何学习和应用这些技能。作者评估了一门仿照斯坦福同情心与利他主义研究与教育中心开发的“同情培养培训”课程的医学生选修课程。该选修课程的目标是通过同情培训和正念冥想培训,由一名教师来增强学生的同情心、善良和健康。研究目标是了解学生对这种培训的应用和看法。
在三年的时间里,路易斯维尔大学医学院的 45 名学生参加了该选修课程。该课程采用了肯塔基州正念技能问卷的前后测,该问卷测量了观察、描述、有意识地行动和不带评判地接纳。对自我报告经验的定性分析用于评估学生对同情培训的看法,以及他们通过选修课程应用所学技能的情况。
对于一些选修课程,正念量表显示出观察(t=3.62,p=0.005)和不带评判地接纳(t=2.87,p=0.017)技能的显著提高。来自所有选修课程的学生的数据表明,学生普遍认为该选修课程很有价值,他们在课程之外广泛地运用正念、冥想和同情技能。学生们描述了培训如何帮助他们应对与个人、学术和临床职责相关的主要压力源。学生们还报告说,这些技能增强了他们的人际互动,包括与患者的互动。
这些结果阐明了学生对同情培训的态度,并表明在接受培训的学生中,简短的、以学生为中心的干预措施可以受到热烈欢迎,并对学生对自己和他人的同情心产生积极影响。为了强调同情和正念等人际和认知技能的重要性,教师应该考虑有针对性地向学生展示这些技能。在与患者互动的背景下培养同情心和正念技能,可能比单独进行压力管理培训更直接地解决学生同理心的侵蚀问题。这项初步研究表明,同情培训可以通过同时促进学生的健康水平和增强患者互动,成为一种有吸引力、高效的方法来应对倦怠。