Strengths, limitations, and future directions
depression, burnout syndrome, anxiety
Our study shows certain strengths in that we have tried to overcome major limitations in this field [Our study shows certain limitations. First, as a pilot study, the sample size was moderate, although it is in line with previous studies on CCT in medical students [In view of the above, future studies should replicate our results with a larger sample size to extrapolate information about the efficacy of the program, an active control condition (e.g., a mindfulness training or a relaxation program), and measurements of biological variables (e.g., cortisol levels, heart-rate variability, and brain activity). Furthermore, some post-intervention changes persisted at follow-up (i.e., self-kindness, observing, non-reactivity, anxiety, emotional exhaustion, and some emotional-regulation factors), whereas others had vanished. Thus, future research should include longer longitudinal designs (e.g., one-year follow-up) while exploring the role of continued meditation practice after completion of the program as a mediator of follow-up effects. Future research should also compare our results with other compassion-based interventions (e.g., Compassion Focused Therapy), in order to examine whether other compassion programs could enhance the measures that did not improve with CCT. It would be informative also to analyze the effectiveness of the program in physicians working at hospitals as well as in medical students diagnosed with anxiety, depression, and/or burnout syndrome. Furthermore, given that universities are also responsible for sustainable human-resource development, these kinds of programs could also be applied to other university employees in order to improve their skills related to well-being. Finally, there could be cross-cultural differences in the importance of compassion in the medical curriculum, so futures studies should explore these potential differences.