Mindfulness program for doctors

A team of researchers in Freiburg has investigated if a mindfulness program can help young doctors in training – residents – reduce stress and experience a greater sense of leisure, also known as otium.

Photo: Blue Planet Studio / Stock.adobe.com

Major on-the-job challenges together with high self-expectation can trigger stress. Prolonged periods of heavy stress not only reduce quality of life, but they can also cause illness as well. Burnout or depression are possible consequences. Occasional stress is taken as a given in most careers today. Add to that the hectic environment of a hospital and the enormous responsibilities, especially for residents, and a potential for chronic stress is there. That’s why the team working with University of Freiburg Professor Anja Göritz of the Department of Economic Psychology and Prof. Dr. Stefan Schmidt of the Faculty of Medicine and the Systemic Health Research Section of the Department of Psychosomatic Medicine and Psychotherapy at Freiburg University Medical Center have developed a mindfulness program tailored to residents’ needs. In a study funded within a Freiburg Collaborative Research Center 1015 of the German Research Foundation (DFG) called “Otium. Societal Resource - Critical Potential.” the researchers examined whether the perceived stress burden of the residents could be reduced and if moments of leisure could be felt during daily clinic routine.

A tailor-made program

Mindfulness is a state of consciousness characterized by openness and curiosity, during which attention is focused on the present moment and the individual perceives their own surroundings and feelings without judgment. Schmidt explains, “In order to suit the program to residents’ needs, the concept of leisure takes on a key role.” He continues, “Leisure is a target state in which people – even during stressful periods – feel that they are free and autonomous. At the same time, it forms the antithesis of striving toward self-perfection.” In a performance-oriented hospital environment, that should ensure that mindfulness is viewed only as a means for achieving well-being and not misinterpreted as an additional performance demand. To train the study subjects in mindfulness, the program consisted of eight weekly and one all-day session. These were led by experienced specialists in psychosomatic medicine who are also qualified mindfulness instructors. Attention was focused on transferring mindfulness practice from the seminar room to daily clinic activities.

Mindfulness as a chance

The team examined the efficacy of the program in a study funded by the DFG. In it, 147 residents were divided into a practice or a control group. The control group was provided solely with theoretical information on mindfulness. The test subjects were given a targeted survey before and after the program – one after six and another after twelve months. Clear differences in efficacy were observed when results were compared of those who actually practiced mindfulness as opposed to those who were only given theoretical information. Subjects who took part in the program showed significantly fewer signs of stress and suffered from fewer negative moods directly after the course. After six months, the program participants reported clearly fewer burnout symptoms. Compared to the control group, they also said they felt more leisure and self-compassion. Superiors, colleagues, and patients also perceived those who took part in the program as more empathetic and present. Analysis of hair for the stress hormone cortisol, however, did not indicate differences between the groups.

“Many residents benefited demonstrably from taking part in the program. But of course, that doesn’t mean that in future, residents should deal with their stress just by practicing mindfulness,” Schmidt emphasized. He went on, “What’s far more important is to discover stress factors from different sides and reduce them. Lawmakers and employers are under an obligation to ensure healthy working conditions.”

In June 2022 starts the next training course for certified MBSR/MBCT teachers who would like to apply and teach the method "Mindfulness-based stress reduction".

Publications on the study:
Fendel, J. C., Aeschbach, V. M., Schmidt, S., & Göritz, A. S. (2021): The impact of a tailored mindfulness-based program for resident physicians on distress and the quality of care: A randomized controlled trial. In: Journal of Internal Medicine, 290(6), 1233–1248. https://doi.org/10.1111/joim.13374 

Aeschbach, V. M., Fendel, J. C., Schmidt, S., & Göritz, A. S. (2021): A tailored mindfulness-based program for resident physicians: A qualitative study. In: Complementary Therapies in Clinical Practice, 43, 101333. https://doi.org/10.1016/j.ctcp.2021.101333

Fendel, J. C., Aeschbach, V. M., Göritz, A. S., & Schmidt, S. (2020): A Mindfulness Program to Improve Resident Physicians’ Personal and Work-Related Well-being: A qualitative study. In: Mindfulness, 11(6), 1511–1519. https://doi.org/10.1007/s12671-020-01366-x

Contact:
Prof. Dr. Anja Göritz
Department of Economic Psychology
University of Freiburg
E-Mail: goeritz@psychologie.uni-freiburg.de
Telephone:  +49 (0)761/203 5686

Prof. Dr. Stefan Schmidt
Systemic Health Research Section
Clinic for Psychosomatic Medicine and Psychotherapy
Freiburg University Medical Center
E-Mail: stefan.schmidt@uniklinik-freiburg.de
Telephone: +49 (0)761/270 69280