A Targeted Mindfulness Curriculum for Medical Students During Their Emergency Medicine Clerkship Experience

Abstract

IntroductionDespite high rates of burnout in senior medical students, many schools provide the majority of their wellness training during the first and second preclinical years. Students planning a career in emergency medicine (EM) may be at particularly high risk of burnout, given that EM has one of the highest burnout rates of all the specialties in the United States We developed an innovative, mindfulness-based curriculum designed to be integrated into a standard EM clerkship for senior medical students to help students manage stress and reduce their risk of burnout.MethodsThe curriculum included these components: (1) four, once-weekly, 60-minute classroom sessions; (2) prerequisite reading assignments; (3) individual daily meditation practice and journaling; and (4) the development of a personalized wellness plan with the help of a mentor. The design was based on self-directed learning theory and focused on building relatedness, competence, and autonomy to help cultivate mindfulness.ResultsThirty students participated in the curriculum; 20 were included in the final analysis. Each student completed surveys prior to, immediately after, and six months after participation in the curriculum. We found significant changes in the self-reported behaviors and attitudes of the students immediately following participation in the curriculum, which were sustained up to six months later.ConclusionAlthough this was a pilot study, our pilot curriculum had a significantly sustained self-reported behavioral impact on our students. In the future, this intervention could easily be adapted for any four-week rotation during medical school to reduce burnout and increase physician wellness.

Stimulating Intrinsic Motivation in Millennial Students: A New Generation, a New Approach

“…The importance of providing meaningful feedback is underscored by the fact that millennial students are very focused on their own goals (Rogers and Tutty, ; Tai et al, ). They feel a strong urge to continuously grow and identify effective feedback as a means toward this goal (Luthar, ; Chung et al, ; Mestdagh et al, ). Complementary studies have corroborated that providing effective feedback enabled students to experience a greater sense of volitional (Joshi et al, ; Oommen et al, ; Mestdagh et al, ) and psychological freedom (Cubi‐Molla et al, ), an increased sense of fulfillment of personal effectiveness (Holaday et al, ; Mahoney et al, ) and improved social relatedness (Fond et al, ), and interpersonal relationships (Ottenberg et al, ; Hill et al, ).…”

“…As these students commence health care studies, some are unable to sustain their college lifestyle due to the burgeoning rigor of health care studies (Hallin et al, 2015;Tomassini et al, 2016;Sahoo and Mohammed, 2018). This combination of academic (Luthar, 2017;Chung et al, 2018;Raza et al, 2018) and social stressors (Croffoot et al, 2010) can combine to erode the psychological well-being of students (Oommen et al, 2017;Mestdagh et al, 2018) and weaken their resilience (Palmen et al, 2015;Joshi et al, 2017;Haque et al, 2018;Rowland and Kumagai, 2018). Consequently, as their educational performance declines maladaptive personalities emerge (Dyrbye et al, 2006;Omigbodun et al, 2006;Yates et al, 2008;Garrud and Yates, 2012;Delany et al, 2015), leading to a vicious cycle of poor grades, stress, self-doubt, and decreased efficacy in these students (Schubert, 2016;McConville et al, 2017;Yan et al, 2017;McLuckie et al, 2018;Rotenstein et al, 2016).…”

“…Millennial students think (Brass et al, 2017;Mabel and Britton, 2018) and react differently (Kong et al, 2014;de Paiva et al, 2017;Ciliberto et al, 2018) due to their upbringing (Tanaka et al, 2009;Palmen et al, 2015), and the influences of the rapid advancements in technology (Budden et al, 2017;Luthar, 2017). They differ from previous generations of students in that monetary gains are not their primary motivation for studies (Wilkinson et al, 2014;Shatto and Erwin, 2017), and personal development (Keister et al, 2017;Burch et al, 2018;Chung et al, 2018), and study/life balance are equally important to them (Chung et al, 2018;Sahoo and Mohammed, 2018). Millennial students are driven to succeed (Lowe et al, 2016;Fond et al, 2018), and hence appreciate constructive criticism (Igde and Sahin, 2017;Oommen et al, 2017;Tackett et al, 2018), and require frequent assessments of their performance to stay on course.…”

“…Cumulative evidence derived from various health care disciplines clearly demonstrates that accurate and early identification of learning styles can directly improve executive functions such as working memory (Cerasoli and Ford, 2014;Jacobs et al, 2015;Pape et al, 2018), cognitive flexibility (Hallin et al, 2015;Tomassini et al, 2016;Raza et al, 2018), and adaptive (Woolley and Fishbach, 2018) and autonomous problemsolving skills (Ezell et al, 2013;Bhagat et al, 2015;Gauer and Jackson, 2018). The recognition of individual learning styles in medical and dental students, has been particularly beneficial during the teaching of anatomy, where students were able to function with lesser instructions (Palmen et al, 2015;Joshi et al, 2017;Oommen et al, 2017;Chung et al, 2018;Mestdagh et al, 2018) and develop effective (Wilkinson et al, 2014;Tai et al, 2016) and self-regulated (Gurpinar et al, 2010;Haro et al, 2014) study habits. In addition, present-day health care students have rated that instructions directed toward their learning styles have been one of the foremost approaches that led to consolidated learning (Sahoo and Mohammed, 2018) and better academic performance (Croffoot et al, 2010;Luthar, 2017;Haque et al, 2018;Rowland and Kumagai, 2018;Sahoo and Mohammed, 2018).…”

“…This provides students an insight into how each task and instruction has a purpose that aligns with their ultimate professional training in health care (Bernstein and Bhugra, 2011;Fryer et al, 2016;Nuffer et al, 2017). Hence, backward curriculum design is being increasing applied in the health sciences (Puertas et al, 2013;Hallin et al, 2015;Rosenman et al, 2015;Luthar, 2017;Tetenbaum-Novatt et al, 2018), as it has also been reported to directly stimulate the desire for exploration (Graf et al, 2007;Chung et al, 2018) and enhance IM during task engagement (Lysak et al, 2018;Streilein et al, 2018).…”