Journal of Contextual Behavioral Science (JCBS)
Volume 30, October 2023, Pages 20-30
Authors
Takafumi Watanabe, Masaki Kondo, Mie Sakai, Tatsuo Akechi
Abstract
Physicians are likely to experience burnout early in their medical education, and it only accelerates as their clinical and academic responsibilities expand and they begin clinical practice. However, effective burnout interventions for clinical-year medical students are lacking. Avoidance of unpleasant internal experiences and decreased engagement in value-based behaviors are associated with burnout. This study, an open-label pilot research with a single-center, before-and-after comparative study design and without a control group, aimed to examine the feasibility and effectiveness of brief acceptance and commitment training (ACT) in reducing burnout during psychiatric clinical clerkships at a medical school. The feasibility proved to be good, with all the participants (n = 56) completing the training. There were no significant differences in the emotional exhaustion (EE) and depersonalization (DP) scores of burnout as measured by the Maslach Burnout Inventory (MBI) at the end of the ACT and two months following the intervention. A comparison was made with scores recorded before the intervention, and significant differences were observed. A subsample of medical students with moderate or greater burnout at T0 manifested significant burnout score reductions. The same subsample revealed a significant increase in psychological flexibility as indicated by the progress factor score on the Valuing Questionnaire (VQ) at T1 compared to T0 and a significant reduction in reaction latency to negative words as indicated by the DIRAP score of the Implicit Relational Assessment Procedure (IRAP) for anxiety. We argue that short-term ACT during clinical clerkships of medical students in psychiatry and palliative care is feasible and potentially effective, and a multi-site comparative study using more direct behavioral measures is warranted to further investigate its effectiveness.