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Acad Med. 2017 Jul;92(7):1012-1021. doi: 10.1097/ACM.0000000000001546.

Effects of Mindfulness-Based Stress Reduction on the Mental Health of Clinical Clerkship Students: A Cluster-Randomized Controlled Trial.

Author information

I. van Dijk is psychiatrist, MoleMann Mental Health, Amersfoort, the Netherlands, and PhD candidate, Department of Psychiatry and Department of Primary and Community Care, Radboudumc, Nijmegen, the Netherlands. P.L.B.J. Lucassen is general practitioner and senior researcher, Department of Primary and Community Care, Radboudumc, Nijmegen, the Netherlands. R.P. Akkermans is statistician, Department of Primary and Community Care, Radboudumc, Nijmegen, the Netherlands. B.G.M. van Engelen is neurologist and professor of neuromuscular disorders, Department of Neurology, Radboudumc, Nijmegen, the Netherlands. C. van Weel is emeritus professor of general practice, Department of Primary and Community Care, Radboudumc, Nijmegen, the Netherlands, and honorary professor of primary health care research, Department of Health Services Research and Policy, Australian National University, Canberra, Australia. A.E.M. Speckens is professor of psychiatry, Department of Psychiatry, Radboudumc, Nijmegen, the Netherlands.



To examine the effect of mindfulness-based stress reduction training (MBSR) on the mental health of medical students during clinical clerkships.


Between February 2011 and May 2014, the authors conducted a cluster-randomized controlled trial of clerkships as usual (CAU) and clerkships with additional MBSR in medical students during their first year of clinical clerkships at a Dutch university medical center. MBSR consisted of eight weekly two-hour sessions, comprising didactic teaching, meditation exercises, and group dialogues. Students completed online assessments at baseline and after 3, 7, 12, 15, and 20 months. Outcome measures were psychological distress, positive mental health, life satisfaction, physician empathy, mindfulness skills, and dysfunctional cognitions as measured by validated tools.


Of 232 eligible students, 167 students (72%) participated and were randomized by clerkship group into MBSR (n = 83) or CAU (n = 84). The MBSR group reported a small reduction of psychological distress (P = .03, Cohen's d = 0.20) and dysfunctional cognitions (P = .05, Cohen's d = 0.18) and a moderate increase of positive mental health (P = .002, Cohen's d = 0.44), life satisfaction (P = .01, Cohen's d = 0.51), and mindfulness skills (P = .05, Cohen's d = 0.35) compared with CAU during the 20-month follow-up. The authors detected no significant effect on physician empathy (P = .18, Cohen's d = 0.27).


MBSR appeared feasible and acceptable to medical clerkship students and resulted in a small to moderate improvement of mental health compared with CAU over the 20-month follow-up.

[Indexed for MEDLINE]

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