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Engaging in “Mind, Body, Spirit”—A Student Perspective on Incorporating Mindfulness in Osteopathic Medical Education Through the Wellness, Academic, Resilience and Mindfulness (WARM) Curriculum
Hu, H. [1]
Khorsand, M. [1]
Anand, R. [1]
Hendriksz, T. [6]
Velasco, H. E. [1]

Journal: Journal of Osteopathic Medicine Date: 2017/11, 117(11):Pages: e134-e135. doi: Subito , type of study: pretest posttest design

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2017.141/html)

Keywords:

curriculum [229]
medical students [402]
mindfulness [18]
osteopathic medicine [1540]
pretest posttest design [108]
USA [1086]

Abstract:

Background: At osteopathic medical schools, the medical education should emphasize the unity of mind, body, and spirit. While the medical curriculum does apply this concept to patient care, the wellness of medical students is often overlooked. Today, 14 medical schools offer formal mindfulness training courses to their students. However, none of these schools are osteopathic medical schools. This past academic year, TUCOM piloted the Wellness, Academic, Resilience, and Mindfulness (WARM) curriculum. One of the core goals of the WARM curriculum is to provide means for the students to learn and practice the principle of mind, body, and spirit interrelationship in their personal and professional development. The curriculum integrates and streamlines school-sponsored curricular and student-directed extracurricular activities that incrementally and sequentially teach the importance of mindfulness and resilience in medical training and in the medical profession. Hypothesis and Research Question: We proposed that osteopathic medical students’ personal and professional development in wellness, academics, and resiliency training may center around their understanding of mindfulness. We aimed to establish baseline values of students’ mindfulness and other WARM parameters using validated instruments to establish future directions of the WARM curriculum. Methods: An element paramount to the WARM curriculum is student involvement. Through a student-directed survey at the beginning of the academic year, the WARM curriculum student representatives gathered data on the specific needs of first- and second-year medical students. The survey (response rate=53.5%, n=266) showed that over 90% of respondents were interested in learning about mindfulness during their medical education, and over half of the respondents saw the need for school-sponsored mindfulness workshops, meditation retreats, and an on-campus meditation garden, among other means. After establishing that the WARM curriculum met the student needs, over the academic year faculty members of TUCOM integrated mindfulness and resiliency principles into the curriculum, and WARM student representatives delivered mindfulness-related activities on campus, including the building of a new meditation garden on campus. Through an IRB-approved, voluntary, and anonymous survey at the end of the academic year (response rate=53.4%, n=266), we administered the Five-Facet Mindfulness Questionnaire (short-form) (FFMQ-SF) to establish baseline values of preclinical students. We also administered Health Promoting Lifestyle Profile II (HPLP-II), John Hopkins Learning Environment Scale (JHLES), and Perceived Stress Scale (PSS) to measure performance in the Wellness, Academics, and Resilience components, respectively. Finally, we administered a student-directed qualitative survey where preclinical students commented on their perceived impact of the WARM curriculum on their understanding of the first osteopathic tenet. Data Analysis: Two-sample t tests performed between OMS I and OMS II baseline values showed that there was no significant difference between the 2 classes in their composite scores in the 4 WARM parameters. Linear regression analysis was performed to demonstrate possible relationships between the students’ scores on FFMQ-SF and their scores in HPLP-II, JHLES, and PSS. Results: Analysis suggested that there is a significant relationship between students’ mindfulness and their self-care behaviors, thus suggesting that the more mindful medical students tend to have better wellness habits. We also found that there is a plausible protective factor of mindfulness to perceived stress, as demonstrated by the inverse correlation between the students’ scores in the FFMQ-SF and the PSS. There was no significant relationship observed between mindfulness and students’ satisfaction with their learning environment, as scored by the JHLES. The qualitative data suggest that a number of students found mindfulness to be a useful additional tool in understanding the unity of mind, body, and spirit. Potential limitations of this study are voluntary participation. Conclusion: We established baseline data of the preclinical students’ behavior in the WARM parameters. Future longitudinal research will observe the progressive impact of the WARM curriculum. According to our data analysis, mindfulness may be the mediating factor for achieving better wellness habits and resilience to stress in medical school. This factor is particularly important for osteopathic medical students, who are expected to embody the osteopathic tenets in their personal lives. Future projects of the WARM curriculum will be informed by and tailored accordingly to these data. Our immediate aim is to further strengthen and integrate mindfulness and resilience into our preclinical curriculum.

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