Discussions
reduced difficulties, anxiety
MAY, SECONDARY
Medical students have a significantly higher stress level than general populationThe present study was performed on a large sample of medical students from Italian different universities recruited in two different cohorts and randomized to treated or control group. The treated group underwent a comprehensive MBI whose core element consisted of 10 online IM classes, given twice a week via Zoom videoconferencing platformThe main analysis was performed on the whole recruited sample of 362 medical students by also adjusting the model for all the measured confounding variables statistically significant different between the two cohorts and which were included in a Propensity Score (PS).Our intervention showed a statistically significant effect, except for STAI-X1, in all the investigated endpoint, confirming our hypothesis of the beneficial effect of our MBI. Specifically, the intervention emerged as effective in: (Given the presence of statistically significant differences between the two cohorts in many informative background variables collected at baseline, indicating that the samples were quite different, although both belonging to the population of medical students, we further performed a secondary analysis separately on the two cohorts. The differences between the two cohorts, also considering those unmeasured, could have affected the effectiveness of our MBI. Furthermore, students in the two cohorts were recruited and attended the intervention in two different time periods: the first cohort in March–April and the second in May–June, this latter close to the exam session. The pandemic situation, whose restrictive measures have been greatly relaxed over the months, may have played an important role with a consequent benefit for the social lives of the students. Being these factors numerous and difficult to formalize, since many of them were probably not observed and even unknown, we could not have included all the possible confounding variables in the statistical models or in the creation of the PS in our main analysis. In addition, our administered background questionnaire, albeit enriched with questions related to different characteristics (from personal data to lifestyle), is not exhaustive of all possible variables describing the single subject, and hence not able to capture all the sources of variation between the two cohorts.This secondary analysis showed that the students belonging to the first cohort were positively affected by our intervention, in almost all areas of experimentation, confirming our hypothesis of the beneficial effect of our MBI. Specifically, compared to the control group, the intervention group had reported lower scores on measures of perceived stress, anxiety, and higher scores on different measures of positive affect, resilience, mental well-being, and emotion regulation. On the contrary, students from the second cohort seem not to have benefited from our MBI and this could depend by unknown differences between the two sample, other than the confounding variables included in the model.We also performed a multiple mediation post-hoc analysis to investigate if changes in emotional regulation, attentional control and attentional shift could mediate the effect of our intervention on increasing participants’ psychological well-being. We found a significant indirect effect of our intervention on psychological well-being mediated by reduced difficulties in emotional regulation, while no indirect effect for attentional control and attentional shift was found. These results support the idea that MBIs could improve medical students’ well-being through different paths: increasing the well-being itself but also improving other aspects that lead to an increased well-being, such as difficulties in emotional regulation. Our results are in line with what is reported by Tang et al.In this study we observed a gender difference, more females than males, in reaching out to the program as also found in literatureThe limitations of our study were: (i) given the voluntary nature of the participation, we were unable to extrapolate the benefits of the program to the general population. So, the inference can only be extended to those students who decide to attend meditation classes if offered. It should be emphasized that to benefit from a program like MBI, individuals must be really determined to meditate, therefore participation must necessarily be on a voluntary basis; and (ii) the solely use of self-report measures: the reliability of self-report measures may have influenced our findingsDespite the reported limitation the strength of our papers resides in the large sample recruited and in the randomized assignment to the treated and control group. Furthermore, as to our knowledge, this is the first study aimed at investigating the effect of a MBI, as easily accessible and low-cost intervention, on a broad range of psychological indicators in medical students and during the Covid-19 pandemic time.In addition, the high percentages of students with irregular sleep (over 30%) and with a recent psychological consultation (approximately 25%) that we found in this study highlight the need for preventive intervention addressing medical students’ health, and mindfulness meditation seems to be an optimal candidate to cover such a role.In conclusion, taken all together, the results obtained show a general improvement of well-being at the end of the treatment program therefore confirming the positive effects of practices of mindfulnessFor all these reasons we are confident in concluding the MBI it is a practice that it is worthwhile adopting also to improve students’ well-being and quality of life.