Mindfulness in pharmacy education: a national mixed-methods study
University College Cork
Introduction: Stress is growing in prevalence and severity in the university setting, particularly in undergraduate health and social care education. High levels of stress within the pharmacy degree have also been demonstrated. Stress has a detrimental effect on physical and mental health if left to progress, ultimately negatively impacting upon students’ future performance as healthcare professionals, and the quality of patient care provided. Calls have been made to determine the best way to teach self-care as well as patient care as part of the pharmacy degree. Mindfulness-based interventions (MBIs) have been shown to be of benefit in clinical and non-clinical settings, specifically in the areas of stress and distress reduction. Hence, the overarching aim of this thesis was to develop and assess the effectiveness of a mindfulness intervention to reduce pharmacy student stress and distress levels, and aid their personal development. Methods: A mixed-methods approach to this research guided our study design. Firstly, quantitative and qualitative systematic reviews were conducted to determine the effectiveness of MBIs in the improvement of undergraduate health and social care students’ stress and related outcomes. These reviews also identified the types of intervention designs and measurement tools employed in such studies to date. Secondly, a qualitative focus group study was conducted with pharmacy students across the island of Ireland, to explore students’ current experiences of the pharmacy degree, the challenges they face, and whether there could be a role for mindfulness as part of their pharmacy education. Finally, these findings were used to inform the design, delivery and analysis of two interventions; a face-to-face MBI for undergraduate pharmacy students in UCC, and an online MBI for undergraduate pharmacy students in the other four pharmacy schools on the island of Ireland. These interventions were wait-list controlled, and were assessed using validated quantitative measures for stress, distress, burnout, empathy and mindfulness levels, as well as thematic analysis of semi-structured interviews and free-text answers to open-ended questions. Results: Despite the systematic reviews showing that MBIs were being used successfully in medical, nursing, midwifery, psychology and social care education, there was as yet no intervention available that aimed to improve pharmacy student stress and distress through the use of an MBI. Our focus group study showed that pharmacy students were experiencing high levels of stress, often due to perfectionistic tendencies, and would welcome an MBI as part of the pharmacy degree. The face-to-face intervention that was designed based on these findings produced a statistically significant reduction in distress, as well as increases in observing and describing scores when delivered face-to-face. The online version of the intervention increased participants’ professional efficacy, as well as their observation levels. Thematic analysis of the qualitative data provided insights into students’ reasons for taking part, their experience of the course, and how best to implement any future intervention. Limitations of the study included high dropout rates, and lack of long-term follow-up. Conclusions: This thesis has made a significant contribution to the knowledge available regarding the use of MBIs in undergraduate health and social care education, and has achieved promising progress in the development of an MBI for use in the undergraduate pharmacy education setting. While preliminary mixed-methods investigations into the effectiveness of this novel intervention have been promising, further research and larger studies are required to improve and refine the approach, and increase the quality and generalisability of findings.
Pharmacy education , Mindfulness , Mindfulness-based stress reduction
O'Driscoll, M. 2018. Mindfulness in pharmacy education: a national mixed-methods study. PhD Thesis, University College Cork.