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Meditation, Empathy, and Stress in Osteopathic Medical Students: An Interventional Pilot Study
Balentine, J. [3]
Goldfinger, M. [2]
Blazey, W. [3]
Jung, M.K. [7]
Krishnamachari, B. [4]

Journal: Journal of Osteopathic Medicine Date: 2017/11, 117(11):Pages: e132-e133. doi: Subito , type of study: randomized controlled trial

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

Keywords:

empathy [50]
medical students [402]
meditation [8]
osteopathic medicine [1540]
pilot study [104]
randomized controlled trial [710]
stress [82]
USA [1086]

Abstract:

Research Questions/Hypotheses: Physician and medical student burnout is a major problem that negatively affects both patient and physician well-being. High stress levels may be one of the most important factors that contribute to burnout. Additionally, higher levels of burnout may be associated with lower empathy. Empathy is a major factor in attaining positive clinical outcomes for patients. Thus, solutions to lessen empathy drain and decrease stress are crucial. Meditation may be one such avenue to promote positive student attitudes, though very few studies have examined this idea through empirical research. The specific aim of this study was to use validated measures to investigate whether use of a guided meditation app would be associated with higher levels of self-rated empathy and lower stress levels. We hypothesized that osteopathic medical students who participated in a program using a meditation app would have higher levels of empathy and lower stress levels than those who did not participate. Osteopathic Significance: Fostering empathy and decreasing stress in osteopathic medical students is particularly important, as they are the future of the health care workforce, and a trend of declining empathy and increasing stress during medical education may lead to decreased health care quality outcomes. Methods: This pilot study was IRB approved. First-, second-, and third-year osteopathic medical students were recruited into the study. The study was initiated in January 2017, at the beginning of the semester. Students were randomly assigned to an intervention group (use of the Headspace meditation app) or control group (no use of the app). The study included 19 students in the intervention group and 21 controls. Students in the intervention groups used the app 3 days a week, 10 minutes each session. Empathy and stress were measured before study initiation and after 3 months. The Jefferson Scale of Empathy (JSPE) was used to measure empathy. Higher scores on this scale indicate higher empathy. The perceived stress scale (PSS) was used to measure stress levels. Higher scores on this scale indicate higher stress. Data Analysis:t tests were used to compare the intervention group and control groups on age. χ2 tests were used to compare the 2 groups on sex. Generalized linear regression was run to estimate the mean difference in empathy and stress scores between those who did and did not receive the intervention. Results: The mean (SD) age was 24.6 (3.3) years in the intervention group and 24.4 (3.7) years in the control group. 68.4% (n=13) of the intervention group and 47.6% (n=10) of the control group were female. Age and sex were not significantly different between the intervention and control groups. The mean empathy score in the total study population differed between males and females (P=.04). Specifically, the mean (SD) JSPE score in males was 110.9 (12.4) and in females was 118.6 (10.1). Because the scores were significantly different, all analyses were stratified by sex. In males, there was no statistically significant difference in empathy scores between the intervention and control groups before the study initiation or after 3 months. Similarly, in females, there was no statistically significant difference in empathy scores between the intervention and control groups before the study initiation or after 3 months. In males, there was also no statistically significant difference in stress scores between the intervention and control groups before the study initiation or after 3 months. However, in females, there was a statistically significant difference in stress scores between the intervention and control groups after 3 months (P=.01). Specifically, before study initiation, the intervention group had a mean (SD) score of 19.33 (5.03), and the control group had a score of 18.5 (4.79). After 3 months of meditation, the intervention group has a score of 16.09 (5.30) and the control group had a score of 24.20 (2.86). Conclusion: This pilot study found that meditation is effective for reducing stress in females. It is unclear why the same effect was not seen in males. It is possible that the study sample size was too small to detect a difference in this group. Repeating the study on a larger scale might detect a difference in males as well. Conversely, males and females may process stress differently and may need different tools to assist in decreasing stress. In the JSPE scale analysis, meditation was not associated with an increase in the empathy score. A lack of detected effect could be due to small sample size. We did find that males and females had a significantly different baseline empathy score. This is consistent with previous research that found a difference in baseline performance on the JSPE scale between males and females. An additional factor to consider when interpreting the results is the timing of the project. Students were first assessed at the beginning of the spring semester. As classes would not yet have started, this may be associated with lower stress. The second measurement was taken at 3 months, in the middle of the academic semester, when we would expect higher stress levels. Given the expected rise in stress levels over the course of the study, the decreased stress seen in females who used meditation is promising. A larger study will be conducted that can look at the effects of meditation on stress and empathy over a longer period. Future studies should consider the impact of timing in the school year. Additionally, it will be important to analyze the effects separately in students based on school year. If future research shows that student empathy increases and stress decreases with use of a meditation app, osteopathic medical schools may choose to incorporate this feature in their curricular programs.

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