The Impact of a Required Longitudinal Stress Management and Resilience Training Course for First-Year Medical Students

Background: Although psychological distress is common among medical students, little remains known about effective interventions. One promising individual-focused approach is mindfulness-based stress management interventions; however, studies to date have relied on volunteers. Objective: To determine whether a required longitudinal stress management and resilience course improves well-being among first-year medical students. Design: A quasi-experimental study. Participants: Two cohorts of medical students who participated in a required stress management and resilience course and completed pre and post questionnaires. Main Measures: Validated instruments were used to examine the effects on burnout, quality of life (QOL), stress, resilience, happiness, and empathy. Paired analysis was conducted to explore changes from baseline. Key Results: On paired analysis of individual students, mean mental QOL and happiness declined (mental QOL: −5.63 [P < 0.001] and −5.15 [P = 0.015] and happiness: −0.31 [P = 0.02] and −0.4 [P = 0.01], cohorts 1 and 2, respectively) over the course of the year. Similarly, stress scores increased by 4.22 (P < 0.0001) and 3.62 (P = 0.03) in cohorts 1 and 2, respectively. Cognitive and emotive empathy declined in both cohorts but was only statistically significant for cohort 1 (−1.64 and −2.07, P < 0.01). No statistically significant differences in burnout or resilience were seen. Conclusions: The required longitudinal mindfulness-based stress management course tested in first-year medical students did not lead to measurable improvements in medical student well-being or empathy. These findings contrast with those of studies using volunteer medical students or physicians, which suggested a reduction in burnout and stress using a similar curriculum. Medical schools should consider offering a variety of effective options so that students can select activities they want to engage in.