Siobhan Lynch

Dialectics of mindfulness: implications for western medicine

Mindfulness as a clinical and nonclinical intervention for a variety of symptoms has recently received a substantial amount of interest. Although the application of mindfulness appears straightforward and its effectiveness is well supported, the concept may easily be misunderstood. This misunderstanding may severely limit the benefit of mindfulness-based interventions. It is therefore necessary to understand that the characteristics of mindfulness are based on a set of seemingly paradoxical structures. This article discusses the underlying paradox by disentangling it into five dialectical positions - activity vs. passivity, wanting vs. non-wanting, changing vs. non-changing, non-judging vs. non-reacting, and active acceptance vs. passive acceptance, respectively. Finally, the practical implications for the medical professional as well as potential caveats are discussed.

Mindfulness Interventions Delivered by Technology Without Facilitator Involvement: What Research Exists and What Are the Clinical Outcomes?

New cost-effective psychological interventions are needed to contribute to treatment options for psychiatric and physical health conditions. This systematic review aims to investigate the current literature on one potentially cost-effective form of mindfulness-based therapy, those delivered through technological platforms without any mindfulness facilitator input beyond the initial design of the programme. Three electronic databases (Ovid Medline, PsychINFO and Embase) were searched for relevant keywords, titles, medical subject headings (MeSH) and abstracts using search terms derived from a combination of two subjects: ‘mindfulness’ and ‘technology’. Overall, ten studies were identified. The majority of studies were web-based and similar in structure and content to face-to-face mindfulness-based stress reduction courses. Clinical outcomes of stress (n = 5), depression (n = 6) and anxiety (n = 4) were reported along with mindfulness (n = 4), the supposed mediator of effects. All eight studies that measured significance found at least some significant effects (p < .05). The highest reported effect sizes were large (stress d = 1.57, depression d = .95, both ps > .005). However, methodological issues (e.g. selection bias, lack of control group and follow-up) which reflect the early nature of the work mean these largest effects are likely to be representative of maximal rather than average effects. Whilst there are important differences in the construction, length and delivery of interventions, it is difficult to draw firm conclusions about the most effective models. Suggestions of key characteristics are made though, needing further investigation preferably in standardised interventions. Given the existing research and the speed at which technology is making new platforms and tools available, it seems important that further research explores two parallel lines: first, refinement and thorough evaluation of already established technology-based mindfulness programmes and second, exploration of novel approaches to mindfulness training that combine the latest technological advances with the knowledge and skills of experienced meditation teachers.

Enhancing Student Engagement in Student Experience Surveys: A Mixed Methods Study.

Abstract Background Measuring the student experience is becoming increasingly important in higher education in the UK. Student experience surveys are used as indicators of quality and form the basis of rankings of higher education institutions. They are also used by them as tools to assist their quality enhancement initiatives. However, these surveys frequently suffer from low response rates, which can reduce the reliability and usefulness of their data. The UK Postgraduate Taught Experience Survey (PTES) is a relatively new survey and suffers from a low response rate. As this survey is new, little is known about why students do not respond to it. Purpose This study aimed to explore the reasons why postgraduate students do not respond to the PTES. Sample Three hundred and fifty-five postgraduate taught students from four health faculties in one UK higher education institution completed an online survey. Of these, seven participated in one of two focus groups. Design and methods The online survey was completed both by students who completed the PTES in 2011 and those who did not. This provided us with cross-sectional data to compare both groups’ knowledge of PTES and their reasons for completing or not completing it. We used multivariate regression analysis to explore which variables were associated with response to PTES. We led two focus groups to explore the themes that emerged from the survey in more depth. This data was analysed by two researchers using thematic analysis. Results The cross-sectional data found that students who were not clear about the purpose of PTES were less likely to respond, independent of other potential predictor variables. Focus group data indicated that if postgraduate students felt a stronger connection to the university community they may be more likely to respond to PTES. Conclusions This study suggests that higher education institutions may wish to review their strategies for advertising student experience surveys to focus more on their purpose rather than their impact.

Medical Student Resilience: a symposium approach

There is growing evidence that the psychological well-being of medical students is in decline. 1 Many of us involved in medical education recognise that training can be challenging and can result in signifi cant psychological morbidity, including stress, depression and burnout. 1 Burnout is a state of emotional exhaustion, depersonalisation and reduced sense of personal accomplishment that appears to be growing in prevalence among medical and other health care students, 2 both in the UK and internationally. 3,4

Mindfulness-Based Coping With University Life: A Randomized Wait-List Controlled Study:

The benefits of mindfulness for a variety of clinical and nonclinical populations are well established and there is growing interest in the potential of mindfulness in higher education. This article reports on the results from a randomized wait-list controlled study of Mindfulness-Based Coping With University Life (MBCUL), an adaption of Mindfulness-Based Stress Reduction (MBSR) for university students. MBCUL is an 8-week program, which aims to help students bring mindful awareness to their academic work, stress management, approach to communication and relationships, and health. Participants were recruited from the general student body at the University of Northampton (United Kingdom) and were randomized into mindfulness or control groups. The mean age for students in the combined MBCUL group was M = 25.07, SD = 8.25 (18-50), and M = 28, SD = 7.26 (20-41) in the control group. A significant decrease in anxiety, F(1, 21) = 7.82, p = .01; depression, F(1, 22) = 4.15, p = .05; and perceived stress, F(1, 22) = 9.65, p = .01, was found in the MBCUL group compared with controls. Similarly, a significant increase in mindfulness was found in the MBCUL, F(1, 20) = 16.32, p = .001, compared with controls. Attrition was high, and the small numbers limit the generalizability of the data. However, the results suggest that MBCUL is an acceptable, useful mindfulness program for university students, which warrants further investigation with larger samples.

REFRAME : resilience training for GPs

We need more GPs in the UK if we are to manage our ageing and increasingly multi-morbid population. However, there is a manpower crisis in NHS primary care, with GP recruitment falling and older doctors taking early retirement. Although there has been considerable research into medical staff stress, there are relatively few studies of coping and resilience in doctors. However, there is some evidence that intensive, brief resilience training can be beneficial. Our aim was to establish if REFRAME could help GPs develop skills that improve their well-being and resilience and to establish whether participants feel the outcome measures employed capture their experience.

Participation in postgraduate surveys: Barriers and obstacles - the students’ perspective

© 2013 S.P. Forrest, The Higher Education Academy Low response rates to the UK Postgraduate Taught Experience Survey (PTES) reduce the reliability and usefulness of the data it provides. This project aimed to explore students’ reasons for nonresponse. Cross-sectional data from 355 postgraduate taught students in health faculties of one university found that non-responders were less clear about the purpose of PTES than those who responded. Students suggested that if they felt more connected to the university community they may be more likely to respond to PTES. This project recommends that universities may wish to try to engage postgraduate taught students more in their quality enhancement activities.