According to research published in the American Journal of Medicine, one in three physicians experiences burnout, which can lead to treatment errors as well as impact the quality of a physician-patient relationship, the overall health of the patient and the physicians’ work and life satisfaction.
Additional research shows that in four years of medical school, the measure of empathy in students decreases alarmingly due to stress and burnout, and increased rates of depression occur.
This is why Sian Cotton, PhD, UC associate professor of family and community medicine and director of the UC Center for Integrative Health and Wellness and UC Health Integrative Medicine, along with Keith Wilson, MD, associate professor of otolaryngology and medical director of UC Health Integrative Medicine, decided to receive official mind-body skills training in April and pass these effective methods along to UC medical students.
"By proactively teaching them these skills, we show them ways to better manage stress in constructive, effective ways,” says Cotton, who with Wilson completed an intensive three-day workshop, titled "Educating for Enhanced Self-Awareness and Self-Care: An Experiential Faculty Training in Mind-Body Medicine,” in Queenstown, Md.
The workshop was hosted by the Institute for Integrative Health.
Now, Cotton and Wilson will use what they have learned to develop an elective course as part of the College of Medicine curriculum to teach students the application and benefits of these skills.
"The purpose of the program is to provide faculty at health professional schools with the necessary training, tools, materials and strategic thinking to implement mind-body medicine skills groups at their institutions,” Cotton says, adding that she and Wilson were introduced to a variety of mind-body techniques like meditation, deep breathing and guided imagery to experience the approach first-hand. "These methods help alleviate stress and foster self-awareness and self-care—Keith and I definitely saw their impact in our three days.”
Aside from the didactic presentations, those at the workshop participated in daily yoga or tai chi, and each of the sessions took place at a table with flowers, a candle, dark chocolate and tissues—appealing to the senses.
"All exercises centered on recognizing the importance of social support and realizing that everyone is in the same boat, which will be key for medical students,” Cotton says. "These students are in a pressure cooker type of environment. We need to teach them these skills in order for them to deal with stress early for their wellness and the success of their careers.”
Cotton says she and Wilson are planning the 11-week elective which will be offered for the first time in the fall to second-year medical students. They will assess the program using validated surveys and stress scales to see how it is working and how it might need to change to optimally benefit students.
She also hopes to send additional faculty members to similar mind-body skills training, further passing along the knowledge to students and others at UC.
"Our goal is for students to see their faculty mentors investing time in this, so that they truly see that self-care is important,” she says. "We need to see a culture change throughout the university and to place emphasis on this method as a valuable and valid asset to the campus community.”
Wilson, also surgeon at UC Medical Center, agrees.
"Our medical system is perfectly designed to produce the results that it gets,” he says. "We are producing physicians lacking in empathy and physicians prone to burnout. We need to provide our physicians in training with the skills necessary to deal with stress and hopefully prevent burnout."
Integrative Medicine Clinical Trial Receives Funding
Sian Cotton, PhD, and her research team received a $15,000 Center for Clinical & Translational Science & Training (CCTST) grant to conduct a school-based randomized controlled trial of breathing retraining interventions to improve asthma control, lung function and anxiety or stress in African-American adolescents with asthma at Cincinnati Public Schools.
This clinical trial, which is a partnership between CPS, UC and Cincinnati Children’s Hospital Medical Center, is evaluating a cost-effective intervention for adolescents with asthma to use in addition to conventional treatments.
"Asthma is a major public health problem and is the most common chronic illness in adolescents; it disproportionately affects urban African-American adolescents,” Cotton says, adding that stress and anxiety are both triggers and consequences of asthma. "Breathing retraining exercises, which involve mindful, diaphragmatic breathing, have been shown to be effective in improving asthma and related psychological symptoms in adults; additionally, we did a preliminary study with seven urban African-American adolescents with asthma and found improved trends for asthma control and anxiety reduction for those receiving the intervention.
"In this trial, we will test the feasibility and efficacy of these interventions versus an education usual control group for improving their asthma control and lung function.”
Both groups of students will receive traditional care in addition to the interventions; the study will be used to submit for a federal grant aimed at further evaluation and dissemination of the intervention throughout the CPS system.