A semester-long mind – body course for medical students had a statistically significant positive effect on students’ self-regulation and self-compassion. There was also a favorable change in empathy and perceived stress, but these changes did not reach statistical significance. Our study also suggests there are subjective benefits to Embodied Health which overlap to a great extent with the psychological measures we measured, particularly self-regulation and self-compassion.
Students’ self-regulation scores before and after the course fall within the ‘moderate’ self-regulation capacity range. Regarding self-compassion, previous studies have found mean scores for undergraduates to be 3.04 (11
). Thus, our study showed students initially tended to be less self-compassionate than the average undergraduate student, whereas after the course, their self-compassion was greater than average. Previous research has found the average empathy score among first-year medical students to be 5.93, whereas it was 5.91 among second-year medical students (17
). Thus, we found that students in the course had lower empathy scores both before and after the course than previously published data on medical students.
Students’ baseline perceived stress scores indicate that medical students are more stressed than their gender- or age-matched peers. The mean population-based perceived stress scale, based on a 1988 national area-probability sample of 2,387 non-institutionalized adults in the United States, was found to be 1.21 on a scale of 0 – 4 (18
). The same study found the average for women was 1.37 (18
). In addition, the national average among 645 test-takers aged 18 – 29 was found to be 1.42 (18
Common themes found in students’ end-of-course essays included increased mindfulness and its positive effect on self-regulation; a feeling of community in an otherwise competitive environment with an increase in empathy for others; positive effects of increased mindfulness as reflected by increased self-regulation; a decrease in stress level; and increased competency and interest in suggesting mind – body practices that could benefit patients. These themes overlapped significantly with the measures that were affected by the course – that is, self-regulation and self-compassion.
Previous studies have shown yoga and other mind – body practices, such as MBSR, increase self-regulation and self-compassion. However, the subjects of these studies were not medical students (7
). Rosenzweig et al. examined the effects of MBSR in medical students and found decreased tension, anxiety, and total mood disturbance compared to a control group attending didactic seminars on complementary medicine (19
). Other research found that an eight-week meditation-based course decreased stress and increased empathy levels in premedical and medical students (20
Contrary to our results, some research has shown yoga to reduce perceived stress among medical students and in non-medical student populations (19
). For example, a three-month intensive yoga program was shown to decrease stress among distressed women (21
). However, the study entailed twice-weekly 90-min Iyengar yoga classes. Thus, our program's one hour of yoga weekly may have been too little to significantly reduce stress. It is also possible that any potential stress-alleviating benefits were offset by the escalating stress over the course of the spring semester, during which there is an increasingly heavy academic load for both first- and second-year students. In particular, students in their second year face the impending United States Medical Licensing Exam – Step 1, a stressful exam considered highly important for residency applications. However, without a control group, determination of any specific effect by Embodied Health is not possible.
BUSM's Embodied Health course is among only a few in the United States teaching medical students yoga and mind – body medicine both didactically and experientially (22
). Participant knowledge of the science behind mind – body practice, not typically taught as part of the medical school curriculum, is enhanced. It also offers opportunities for students to learn new skills that they can pass on to their future patients. One other mind – body course for medical students found five central themes to students’ responses to the course – connections, self-discovery, stress relief, learning, and medical education (22
). A mindfulness program for primary care physicians has also been found to improve measures of psychological well-being, such as by improving mood and decreasing burnout (23
). In addition, given that almost 40% of US adults reported in 2007 that they had used some form of complementary or alternative therapies within the past year, scientific and experiential knowledge of these practices is valuable to students’ future capacity to counsel patients on the appropriate use of complementary therapies (24
There are several important limitations to this research. First, there was no control group. Without a control group, it is not possible to ascertain whether observed changes were due to the course or to other factors. In addition, a small sample size limited the statistical power of the study. Students in the study were fairly high in empathy at baseline, suggesting a possible ceiling effect for this measure. In addition, we lack long-term follow-up data regarding students’ psychological well-being, as the study was short-term (one semester) only. Another limitation of the study is generalizability; students enrolled themselves in the study and course voluntarily and were therefore self-selected. Thus, students taking the course may have possessed certain interests and traits that other students do not.
Future studies should examine the long-term effects of a mind – body practice on medical student well-being, even after finishing medical school and entering residency and clinical practice. In addition, larger and longer studies are needed to better assess the quantitative effects of a mind – body course on medical students.