Abstract
Medical students are a population at risk for the development of stress-related risk states (e.g. burnout) and manifest mental disorders (e.g. depression). Still the learning of coping mechanisms against stress is not an integral part of the medical curriculum. In a pilot study we developed an elective course for learning relaxation techniques (Relacs) which was geared to the clinical practice of autogenic training (AT) with psychiatric patients. The course focussed on an innovative and mostly communicative transfer of knowledge about AT, progressive muscle relaxation and medical hypnosis and stressed the principle of repeated and supervised exercises in small student groups alongside self-administered exercise. 42 students took part in this course and showed a very high acceptance for the topic and positive evaluation. Moreover, we found a distinct improvement of the participants’ mental parameters (burnout, anxiety) and a good knowledge about the course’s contents within the final exams at the end of the semester. The structure and realisation of the course is easily adaptable and very effective regarding the improvement of the students’ mental health. Due to our results and the commonly known prevalence of stress-related disorders in medical students we postulate the integration of courses on relaxation strategies in the medical curriculum.
Similar content being viewed by others
References
Antonovsky, A. (1985). The life cycle, mental health and the sense of coherence. Israel Journal of Psychiatry and Related Sciences, 22(4), 273–280.
Arigoni, F., Bovier, P. A., Mermillod, B., Waltz, P., & Sappino, A. P. (2009). Prevalence of burnout among Swiss cancer clinicians, paediatricians and general practitioners: who are most at risk? Supportive Care in Cancer, 17(1), 75–81. doi:10.1007/s00520-008-0465-6.
Arigoni, F., Bovier, P. A., & Sappino, A. P. (2010). Trend of burnout among Swiss doctors. Swiss Medical Weekly, 140, w13070. doi:10.4414/smw.2010.13070.
Beck, A. T, Steer, R. A., Brown, G. K., Hautzinger, M., Keller, F., & Kühner, C. (2009). BDI-II beck depressions inventar revision manual. Harcourt Test Services GmbH, 2. Auflage (Pearson Assessment and Information GmbH).
Beddoe, A. E., & Lee, K. A. (2008). Mind-body interventions during pregnancy. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 37(2), 165–175. doi:10.1111/j.1552-6909.2008.00218.x.
Bramness, J. G., Fixdal, T. C., & Vaglum, P. (1991). Effect of medical school stress on the mental health of medical students in early and late clinical curriculum. Acta Psychiatrica Scand., 84(4), 340–345.
Brennan, J., & McGrady, A. (2015). Designing and implementing a resiliency program for family medicine residents. International Journal of Psychiatry in Medicine, 50(1), 104–114. doi:10.1177/0091217415592369.
Bruce, C. T., Thomas, P. S., & Yates, D. H. (2005). Burnout and psychiatric morbidity in new medical graduates. Medical Journal of Australia, 182(11), 599. author reply 599.
Buddeberg-Fischer, B., Stamm, M., Buddeberg, C., & Klaghofer, R. (2009). Anxiety and depression in residents—Results of a Swiss longitudinal study. Zeitschrift fur Psychosomatische Medizin und Psychotherapie, 55(1), 37–50.
Burger, P. H., & Scholz, M. (2014). The learning type makes the difference—The interrelation of Kolb’s learning styles and psychological status of preclinical medical students at the University of Erlangen. GMS Zeitschrift für Medizinische Ausbildung, 31(4), Doc42. doi:10.3205/zma000934.
Burger, P. H., Tektas, O. Y., Paulsen, F., & Scholz, M. (2014). From freshmanship to the first “Staatsexamen”–Increase of depression and decline in sense of coherence and mental quality of life in advanced medical students. Psychotherapie, Psychosomatik, Medizinische Psychologie, 64(8), 322–327. doi:10.1055/s-0034-1374593.
Busch, M. A., Maske, U. E., Ryl, L., Schlack, R., & Hapke, U. (2013). Prevalence of depressive symptoms and diagnosed depression among adults in Germany: Results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 56(5–6), 733–739. doi:10.1007/s00103-013-1688-3.
Conrad, A., & Roth, W. T. (2007). Muscle relaxation therapy for anxiety disorders: It works but how? Journal of Anxiety Disorders, 21(3), 243–264. doi:10.1016/j.janxdis.2006.08.001.
Dahlin, M. E., & Runeson, B. (2007). Burnout and psychiatric morbidity among medical students entering clinical training: A three year prospective questionnaire and interview-based study. BMC Medical Education, 7, 6. doi:10.1186/1472-6920-7-6.
Dobkin, P. L., & Hutchinson, T. A. (2013). Teaching mindfulness in medical school: Where are we now and where are we going? Medical Education, 47(8), 768–779. doi:10.1111/medu.12200.
Dyrbye, L. N., Thomas, M. R., Massie, F. S., Power, D. V., Eacker, A., Harper, W., & Shanafelt, T. D. (2008). Burnout and suicidal ideation among U.S. medical students. Annals of Internal Medicine, 149(5), 334–341.
Ludwig, D. S., & Kabat-Zinn, J. (2008). Mindfulness in medicine. JAMA, 300(11), 1350–1352. doi:10.1001/jama.300.11.1350.
Mache, S., Vitzthum, K., & Groneberg, D. A. (2015). Prevention of study-related stress symptoms: Health-promoting behavior among dental students. Wiener Medizinische Wochenschrift, 165(5–6), 100–106. doi:10.1007/s10354-014-0341-6.
Mache, S., Vitzthum, K., Groneberg, D., & Klapp, B. F. (2012). How to stay mentally healthy during medical education. Stress coping and relaxation behaviour of female and male students. Medical Teacher, 34(10), 867. doi:10.3109/0142159X.2012.716187.
McCraty, R., Atkinson, M., Lipsenthal, L., & Arguelles, L. (2009). New hope for correctional officers: An innovative program for reducing stress and health risks. Applied Psychophysiology and Biofeedback, 34(4), 251–272. doi:10.1007/s10484-009-9087-0.
McGrady, A., Brennan, J., Lynch, D., & Whearty, K. (2012). A wellness program for first year medical students. Applied Psychophysiology and Biofeedback, 37(4), 253–260. doi:10.1007/s10484-012-9198-x.
Miller, G. E. (1990). The assessment of clinical skills/competence/performance. Academic Medicine, 65(9 Suppl), S63–S67.
Morone, N. E., & Greco, C. M. (2007). Mind-body interventions for chronic pain in older adults: A structured review. Pain Medicine, 8(4), 359–375. doi:10.1111/j.1526-4637.2007.00312.x.
Pereira, M. A., & Barbosa, M. A. (2013). Teaching strategies for coping with stress—The perceptions of medical students. BMC Medical Education, 13, 50. doi:10.1186/1472-6920-13-50.
Scholz, M., Neumann, C., Steinmann, C., Hammer, C. M., Schroder, A., Essel, N., & Burger, P. H. (2015). Development and correlation of work-related behavior and experience patterns, burnout and quality of life in medical students from their freshmanship to the first state examination. Psychotherapie, Psychosomatik, Medizinische Psychologie, 65(3–4), 93–98. doi:10.1055/s-0034-1375630.
Schreiber, E. H. (1997). Use of group hypnosis to improve college students’ achievement. Psychological Reports, 80(2), 636–638.
Singer, S., & Brähler, E. (2007). Die “Sense of Coherence Scale” Testhandbuch zur deutschen Version. Göttingen: Vandenhoeck & Ruprecht GmbH & Co KG.
Song, Q. H., Xu, R. M., Zhang, Q. H., Ma, M., & Zhao, X. P. (2013). Relaxation training during chemotherapy for breast cancer improves mental health and lessens adverse events. International Journal of Clinical and Experimental Medicine, 6(10), 979–984.
Sreeramareddy, C. T., Shankar, P. R., Binu, V. S., Mukhopadhyay, C., Ray, B., & Menezes, R. G. (2007). Psychological morbidity, sources of stress and coping strategies among undergraduate medical students of Nepal. BMC Medical Education, 7, 26. doi:10.1186/1472-6920-7-26.
Thomas, K. (2006). Praxis des Autogenen Trainings Selbsthypnose nach I.H. Schultz: Grundstufe/Formelhafte Vorsätze/Oberstufe. TRIAS-Verlag.
Warnecke, E., Quinn, S., Ogden, K., Towle, N., & Nelson, M. R. (2011). A randomised controlled trial of the effects of mindfulness practice on medical student stress levels. Medical Education, 45(4), 381–388. doi:10.1111/j.1365-2923.2010.03877.x.
Wild, K., Scholz, M., Ropohl, A., Brauer, L., Paulsen, F., & Burger, P. H. (2014). Strategies against burnout and anxiety in medical education—Implementation and evaluation of a new course on relaxation techniques (Relacs) for medical students. PLoS One, 9(12), e114967. doi:10.1371/journal.pone.0114967.
Williams, D., Tricomi, G., Gupta, J., & Janise, A. (2015). Efficacy of burnout interventions in the medical education pipeline. Academic Psychiatry, 39(1), 47–54. doi:10.1007/s40596-014-0197-5.
Acknowledgments
The authors would like to thank Mr. Michael Beall for editing the English text.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Rights and permissions
About this article
Cite this article
Scholz, M., Neumann, C., Wild, K. et al. Teaching to Relax: Development of a Program to Potentiate Stress—Results of a Feasibility Study with Medical Undergraduate Students. Appl Psychophysiol Biofeedback 41, 275–281 (2016). https://doi.org/10.1007/s10484-015-9327-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10484-015-9327-4