How to reduce empathic distress and increase emotional skills in medical training? Experience of a Mindfulness-Based stress reduction class vs. control group in France

Background: Improving student wellness through curricular activities is a topic of interest in medical school. Both distress and well-being are related to medical student empathy. Numerous data suggest that learning mindfulness skills help to reduce anxiety, stress and overall psychological distress. Moreover, there are still poor data on the impact of MBSR on medical students' empathy and emotional skills. Methods : We designed a controlled study including an intervention group (MBSR) and a wait-list control group. We aimed to explore the impact of an MBSR training in medical students on (1) empathy (2) emotional skills (identification, understanding, acceptance) and (3) self-care. Online assessments occurred at baseline and post intervention. We analyzed pre-post changes and explored intervention effects using a generalized mixed model. Results : Fifty-one medical students were included. 80% of students attended all MBSR classes. When compared with the control group, Personal Distress (PD) of the empathy subscale decreased significantly in the MBSR group (β=-3.55 [95%CI -5.09, -1.40], p<0.005 ). No other significant change was observed as for the empathy subscales. Students in the MBSR group increased their emotional skills as the ability to identify ( p <.005, Cohen’s d=0,52) and understand ( p =.02, Cohen’s d=0.62) one’s own emotion. The total Self-Compassion score (SCS) increased significantly in the MBSR group (β=-25.5 [95%CI 18.16, 32.86], p<0.001 ) assesses the ability to self-care. Conclusion: Results suggest that MBSR develops medical students' interpersonal resources and reduces empathy distress. Indeed, PD assesses the tendency to feel distress and discomfort in response to the distress of others and corresponds to a challenge in medical training. MBSR could be beneficially combined with other educational modalities to enhance each component of empathy.