Walach H, Buchheld N, Buttenmüller V, et al. Empirische Erfassung der Achtsamkeit - Die Konstruktion des Freiburger Fragebogens zur Achtsamkeit (FFA) und weitere Validierungsstudien. In: Heidenreich T, Michalak J, editors. Achtsamkeit und Akzeptanz in der Psychotherapie. Tübingen: dgvt; 2004. p. 727–65. van Vliet M, Jong M, Jong MC. Long-term benefits by a mind-body medicine skills course on perceived stress and empathy among medical and nursing students. Med Teach. 2017;39(7):710–9. MBM courses have been evaluated in studies using various self-reported quantitative scores, qualitative surveys, and stress biomarkers. While it was generally found to reduce stress and promote empathy, self-care, and well-being [ 1, 13, 14, 22, 23, 29, 33], results for respective quantitative measures, such as the Perceived Stress Scale (PSS), were not always consistent across studies [ 7, 13, 33]. Qualitative findings corroborate the quantitative results of increased mindfulness, self-reflection, and empathy, providing a narrative that relates these three outcome values. Students’ accounts of their course experience link their exposure to mindfulness and other MBM practices to increased self-reflection, empathy, and recognition of self in the other. An interdependence between individual and group experiences constitutes the core of these findings, present on three levels. (see Fig. 1): Hsieh H-F, Shannon SE. Three Approaches to qualitative content analysis. Qual Health Res. 2005;2005(11/01):1277–88.

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Hilger-Kolb J, Diehl K, Herr R, et al. Effort-reward imbalance among students at german universities: associations with self-rated health and mental health. Int Arch Occup Environ Health. 2018;91(8):1011–20.

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Neumann M, Edelhäuser F, Tauschel D, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Acad Med. 2011;86(8):996–1009.

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Klein EM, Brähler E, Dreier M, et al. The german version of the perceived stress scale - psychometric characteristics in a representative german community sample. BMC Psychiatry. 2016;16:159. All models pictured nude on Body in Mind were at least 18 years old and of legal age when photographed. After completing an MBM course, students reported reduced perceived stress, increased self-efficacy, mindfulness, empathy and positive engagement with integrative concepts of doctor–patient relationships. Further research with larger randomized confirmatory studies is needed to validate these benefits.Learning about MBM and CIM as disciplines of modern medicine was reported as a primary motivation for course enrollment. Some participants sought to acquire proficiency in MBM techniques as tools for their future patient care. Students reported increased knowledge of MBM techniques as a main benefit of the course, emphasizing the value of practical experience. New perspectives on the value of MBM and CIM gained through the course led to what students described as a broader, “more holistic” view of the scope of medical practice and the relationship between healthcare professionals and their patients. Triangulation—experiences of self and the other Participants showed improvement across most quantitative measures, including mindfulness, self-reflection, self-efficacy, and perceived stress. However, there were no changes in participant-reported QoL. Empathy, as an ability to take others’ perspective, showed improvement, as did the sense of distress at experiencing empathy. These outcomes were corroborated by focus groups reporting increases in students’ ability to self-regulate stressful experiences and improve their relationships with themselves and others. Participants also recognized the importance of MBM values in the doctor–patient relationship, patient care, and a more holistic view of medicine. During 2012–2019, uncontrolled quantitative and qualitative data were gathered from 112 student participants. Outcomes including changes in perceived stress (PSS), mindfulness (FMI/MAAS), self-reflection (GRAS), self-efficacy (GSE), empathy (SPF), and health-related quality of life (SF-12) were measured between the first (T0) and last sessions (T1). Qualitative data were obtained in focus groups at course completion and triangulated with quantitative data.

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Quantitative data were collected through printed and online questionnaires. Participants were asked to complete them before the first and after the last course session. Due to the exploratory nature of this study, no primary or secondary outcomes were predefined; furthermore, no sample size calculation was performed. Ware J, Kosinski M, Turner-Bowker D, et al. How to score version 2 of the SF-12 Health Survey. Lincoln, US: Quality Metric Incorporated; 2002. This study hasn’t shown a meaningful change in MBM course participants’ mental or physical health QoL, as assessed by the SF-12, whereas Esch et al. showed an improvement for mental QoL SF-12 levels in MBM group compared to control [ 13]. Yet it is possible that the SF-12 is not suitable for use in a sample of generally healthy medical students. The SF-36, and its short version SF-12, were originally developed to assess QoL changes in patients with reduced health [ 5, 35] and when tested within a sample of healthy patients, the original SF-36 sub-scales, MCS and PCS, were not always found to be independent [ 27]. Potential MCS changes in our healthy population sample may therefore have been masked. Chen AK, Kumar A, Haramati A. The effect of mind body Medicine course on medical student empathy: a pilot study. Med Educ Online. 2016;21: 31196. Kraemer KM, Luberto CM, O’Bryan EM, et al. Mind-body skills training to improve distress tolerance in medical students: a pilot study. Teach Learn Med. 2016;28(2):219–28.

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Our qualitative findings indicate that the effects of MBM intervention are deeply embedded in the social framework, discourse, and perspective of its practitioners. Consequently, MBM interventions not only affect measurable outcomes, such as mindfulness, perceived stress, and empathy, but may also influence how students relate to themselves and others, the medical field, and their role as doctors. This supports previous qualitative research conducted by Saunders et al. (2017) at GUSOM, who reported meaningful social connections, self-discovery, and an increased valuing of the doctor-patient relationship as central themes of their study. In this study, data triangulation located a central dynamic of these findings in a reciprocative process between self and the other (see Fig. 1) fostered by meaningful encounters between individual participants and the group. BiMGirls | Eraudica | PhotoDromm | Superbe.com | Gallery of Nudes | A-M-O-C | OnlyTease | This Year's Model | Zishy.com | Emily Bloom

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Hojat M, Vergare MJ, Maxwell K, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med. 2009;84(9):1182–91. Schwartz CE, Rapkin BD, et al. Reconsidering the psychometrics of quality of life assessment in light of response shift and appraisal. Health Qual Life Outcomes. 2004;2(1):16. Maclaughlin BW, Wang D, Noone AM, et al. Stress biomarkers in medical students participating in a mind body medicine skills program. Evid Based Complement Alternat Med. 2011;2011:950461. Dyrbye LN, Harper W, Durning SJ, et al. Patterns of distress in US medical students. Med Teach. 2011;33(10):834–9.Brinkhaus B, Witt C. Making better doctors - using mind-body medicine skills as a self-care element in medical education at the Charite University Medical School. Forsch Komplementmed. 2012;19(1):4–6.