The Body in Mind: Understanding Cognitive Processes (Cambridge Studies in Philosophy)

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Hojat M, Vergare MJ, Maxwell K, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med. 2009;84(9):1182–91.

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An analysis of course motivation revealed that students’ desire for improved well-being and reduced perception of everyday life stress was a main motivator for participation. Anxiety was commonly reported among participants, brought on by exam periods, feelings of falling behind on academic achievement in a competitive environment, even causing strain on students’ personal lives. Some students complained of experiencing physical symptoms, such as nausea, tinnitus, high blood pressure, and insomnia. Ishak W, Nikravesh R, Lederer S, et al. Burnout in medical students: a systematic review. Clin Teach. 2013;10(4):242–5. High stress during medical education and its detrimental effects on student health is well documented. This exploratory evaluation study assesses a 10-week Mind-Body-Medicine student course, created to promote student self-care at Charité Universitätsmedizin Berlin, Germany.After completing an MBM course, students reported reduced perceived stress, increased self-efficacy, mindfulness, empathy and positive engagement with integrative concepts of doctor–patient relationships. Further research with larger randomized confirmatory studies is needed to validate these benefits.

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This study included quantitative and qualitative data, each gathered from 11 MBM courses conducted between October 2012 and February 2019. However, between 2013 and 2014, quantitative and qualitative data collection was not upheld for two consecutive courses. Demographic characteristics and SF−12 scores were introduced from October 2015 onwards. A total of 112 medical students were included in the quantitative data analysis. Since the first evaluation of demographic characteristics in 2015, there were 48 female (70.1%) and 20 male (29.9%) participants with a mean age of 26.2 years (range = 19–42, SD = 4.9). Qualitative data were collected from 11 focus groups comprising 87 participants (62 females, 25 males), with an average interview duration of 52.8 min. Relating to the patient from your own experience] creates a completely different impression than working from book [knowledge].(FGWS16.F1). Well-being & stress reductionWare J Jr, Kosinski M, Keller SD. A 12-Item short-form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33. Schwarzer R, Jerusalem M. Measures in Health psychology: a user’s portfolio. Causal and control beliefs. Causal and Control Beliefs. 1995;01(011):35–7. Greeson JM, Toohey MJ, Pearce MJ. An adapted, four-week mind-body skills group for medical students: reducing stress, increasing mindfulness, and enhancing self-care. Explore (NY). 2015;11(3):186–92.

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Ann Dutton M, Arun P, Talley J, et al. Mind–body skills training for improving emotional well-being in medical students. Explore. 2013;9(5):328. MBM courses have been evaluated in studies using various self-reported quantitative scores, qualitative surveys, and stress biomarkers. While it was generally found to reduce stress and promote empathy, self-care, and well-being [ 1, 13, 14, 22, 23, 29, 33], results for respective quantitative measures, such as the Perceived Stress Scale (PSS), were not always consistent across studies [ 7, 13, 33]. In her paper on problems with psychometric evaluation of health based QoL, Güthlin [ 15] expands on the confounding effect of “response shift”. Outcomes of QoL measurements may reflect real changes or they may be the consequence of “response shift” - a cognitive change in the reference system of the patient or changes in the values and concepts held about health and disease [ 15, 30]. After course participation students reported an increased awareness of the connection between stress, well-being, and self-care practices. However, they also described their difficulties to implement and sustain MBM practices both personally and in the face of a wider academic and medical system often perceived as largely uncaring about self-care practices. Thus, while both qualitative data and a reduction in quantitative stress measure (PSS) support a beneficial effect of course participation on students’ well-being, the overall experience may also have resulted in a shift of values and views that adversely affected QoL appraisal.Walach H, Buchheld N, Buttenmüller V, et al. Empirische Erfassung der Achtsamkeit - Die Konstruktion des Freiburger Fragebogens zur Achtsamkeit (FFA) und weitere Validierungsstudien. In: Heidenreich T, Michalak J, editors. Achtsamkeit und Akzeptanz in der Psychotherapie. Tübingen: dgvt; 2004. p. 727–65. Chen AK, Kumar A, Haramati A. The effect of mind body Medicine course on medical student empathy: a pilot study. Med Educ Online. 2016;21: 31196. BiMGirls | Eraudica | PhotoDromm | Superbe.com | Gallery of Nudes | A-M-O-C | OnlyTease | This Year's Model | Zishy.com | Emily Bloom

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Dyrbye LN, Thomas MR, Huntington JL, et al. Personal life events and medical student burnout: a multicenter study. Acad Med. 2006;81(4):374–84. All models pictured nude on Body in Mind were at least 18 years old and of legal age when photographed. Qualitative findings corroborate the quantitative results of increased mindfulness, self-reflection, and empathy, providing a narrative that relates these three outcome values. Students’ accounts of their course experience link their exposure to mindfulness and other MBM practices to increased self-reflection, empathy, and recognition of self in the other. An interdependence between individual and group experiences constitutes the core of these findings, present on three levels. (see Fig. 1): Shiralkar MT, Harris TB, Eddins-Folensbee FF, et al. A systematic review of stress-management programs for medical students. Acad Psychiatry. 2013;37(3):158–64.Dyrbye LN, Harper W, Durning SJ, et al. Patterns of distress in US medical students. Med Teach. 2011;33(10):834–9. Hilger-Kolb J, Diehl K, Herr R, et al. Effort-reward imbalance among students at german universities: associations with self-rated health and mental health. Int Arch Occup Environ Health. 2018;91(8):1011–20.