Mindfulness and self-compassion are increasingly recognized as valuable tools in healthcare education, offering substantial benefits for both personal and professional development. Considering the link between mindfulness and self-compassion, along with the positive impact of mindfulness on mental health and well-being, integrating mindfulness intervention into healthcare curricula is crucial. This is particularly important for occupational therapy (OT) students to cope with their fieldwork during their studies and the demands of their future professions.
Mindfulness is defined as “the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment” (Kabat-Zinn, 2003, p.145). It is comprised of two components: self-regulation of attention, involving nonjudgmental awareness of sensations and thoughts; and how one responds to experiences (Oró et al., 2021). Mindfulness aims to help people live each moment fully, even the painful ones (Kabat-Zinn, 1993). The practice of mindfulness includes both formal and informal structured interventions (Oró et al., 2021), and is crucial for developing the skill of mindfulness (Kabat-Zinn, 2002). Mindfulness has been incorporated into healthcare interventions for people with various health conditions, such as serious illness and chronic pain, depression, and borderline personality disorder (Linehan, 2014; Williams et al., 2007). Research confirms that mindfulness improves brain function and cognitive abilities, including attention, problem-solving, working memory, and organizational capacities; as well as psychological indices such as well-being, stress, and anxiety (Lomas et al., 2018; Tang et al., 2012). As mindfulness supports mental health, self-compassion, a related concept, involves turning nonjudgmental kindness inward, especially during challenging moments.
Self-compassion is defined as being warm, kind and nonjudgmental towards oneself during hardships, and accepting suffering or unpleasant experiences as they are (Neff, 2003b). The Self-Compassion Scale (SCS; Neff, 2003a; 2003b) uses six components that assess positive aspects (self-kindness, common humanity, and mindfulness) and negative aspects (self-judgment, isolation, and over-identification) of self-compassion. Being self-compassionate helps individuals to face their thoughts and emotions in a healthier way (Neff, 2016), leading to greater well-being, healthy psychological functioning, and emotional resilience; all of which are generally related to mindfulness (Biehler & Naragon-Gainey, 2022; Neff et al., 2018).
Given the close connection between mindfulness and self-compassion, it is not surprising that previous studies have found mindfulness programs to positively influence self-compassion in both anxious and depressed patients (Proeve et al., 2018), as well as in nonclinical populations, including students and healthcare professionals (Centeno & Fernandez, 2020; Erkin & Aykar, 2021; Halamová et al., 2018; Orosa-Duarte et al., 2021; Wasson et al., 2020). For example, Wasson et al. (2020) found that mindfulness-based interventions improve self-compassion in healthcare professionals.
Considering the link between mindfulness and self-compassion, it is crucial to examine how mindfulness-based interventions are being implemented in educational settings. Various mindfulness-based interventions have been incorporated into universities and colleges, via techniques such as yoga, meditation, body scanning, conscious movements, and breathing exercises. These techniques can be practiced individually or in groups, and can be taught either frontally or virtually online (Gutman et al., 2020; Orosa-Duarte et al., 2021; Pavlovic, 2021; Zollars et al., 2019). Studies that examined the impacts of curricula which incorporate mindfulness practices for students across all disciplines, including healthcare, indicated that these practices improved students' health and well-being, self-efficacy, cognitive ability, and academic measures (Howarth et al., 2019; Kaisti et al., 2024; Kinsella et al., 2018; Luberto et al., 2014). Mindfulness training helped students to learn stress-coping strategies, reduce symptoms of depression and anxiety, and develop emotional regulation, empathy, and self-compassion (Centeno & Fernandez, 2020; Erkin & Aykar, 2021; Halladay et al., 2019; McConville et al., 2017). These courses were also found to be useful for preventing stress and insomnia, and for providing support while waiting for more comprehensive professional assessments (e.g., for anxiety disorders) or other therapeutic services (Halladay et al., 2019). The acceptability and feasibility of these self-help mindfulness practices, as well as the students' levels of involvement and preservation of the outcomes, were also examined (Parsons et al., 2022).
These implementations highlight the increasing recognition of the need to incorporate mindfulness programs into the curriculum for healthcare students, as emphasized by the literature. This includes disciplines, such as nursing, medicine, psychology, physiotherapy, and social work. It was suggested that healthcare students continue practicing mindfulness and integrate it into their daily work to mitigate burnout and perceived stress (Braun et al., 2023; Repo et al., 2022). Mindfulness practice as well as self-compassion can help these students to become more aware of their emotions, and improve their ability to deal with challenging situations with patients in the therapeutic environment (Raab, 2014). Moreover, mindfulness practice was found to improve the healthcare practitioners' ability to be present and empathetic with clients, less judgmental, and more focused and attentive during treatment (Gockel et al., 2013), all of which are crucial for effective therapy.
While both mindfulness and self-compassion are needed for various healthcare students, it's important to identify the unique benefits of mindfulness programs for different professions with distinct roles. Specifically, studies among OT students found that mindfulness exercises, including deep breathing, journaling, self-reflection, and self-awareness, are effective coping mechanisms for students (Henton et al., 2021). Additionally, increased mindfulness helped these students to reduce negative attitudes towards people with disabilities (Akyurek et al., 2018), whom they might meet as clients in their roles as occupational therapists.
However, only a few studies have examined mindfulness training among these students. Reid (2013) found that an eight-week online mindfulness program significantly improved “Attention” and “Awareness” scores in 15 first-year OT students. Mattila et al. (2020) found that a 10-week mindfulness intervention program, once a week for 15–30 min, showed significant improvements in “grit”, “gratitude”, self-regulation and therapeutic interactions, although “growth mindset” showed no significant change among the 24 OT students. Gutman et al. (2020) reported that an 8-week mindfulness program, with weekly in-person group sessions and four online meditations, significantly improved perceived stress and stress management, along with better sleep quality, energy levels, and life-work balance, compared to the control group. Finally, Vogtmann and Provident (2021) showed a significant reduction in perceived stress levels among OT students following a seven-week mindfulness program that combining stress reduction strategies and coping techniques.
The purpose of this study was to assess a mandatory mindfulness course designed for a large number of first-year OT students, focusing on enhancing mindfulness skills and self-compassion. This study aimed to fill the gaps left by previous studies conducted among OT students, which focused on various outcomes but did not specifically address self-compassion. Moreover, these studies involved small, self-selected samples (15–36) and varied in program length (8–12 weeks). This study sought to determine the effectiveness of a mandatory mindfulness course in fostering critical mindfulness and self-compassion skills, which are vital for students’ personal and professional development, particularly during their clinical fieldwork and future practice. We hypothesized that it is essential to incorporate a mandatory mindfulness course into the curricula, and we expected to measure its effectiveness in enhancing students’ mindfulness and self-compassion skills.
The specific study questions were: (a) Are there positive changes in mindfulness skills and self-compassion among the OT students who completed the mindfulness course? (b) Are the changes in students' mindfulness skills and self-compassion (before and after participating in the mindfulness course) correlated?
Method
Participants
Over a period of three academic years, 210 students completed the course and were invited to participate in the study. Out of these, 133 students completed either the pre-course or post-course questionnaires, and 106 students completed both. Based on Wasson et al. (2020), the sample size calculation using G-power software, with 90% power, a 0.05 type-I error, and a moderate effect size (0.3), determined that a minimum of 97 participants was needed.
All 106 participants were between the ages of 20–30 years (Mage = 23.03 years, SD = 1.45) and were studying at the]Concealed] University School of Occupational Therapy in]Concealed]. Of these, 94.3% were females (due to the high proportion of female students in this field). Data were gathered at two time points, before and after completion the course, for each of three academic years. It is important to note that 24 participants attended the course during the COVID-19 pandemic, while adhering to health instructions like wearing masks and maintaining physical distance. No significant differences were found in the study variables between these students and those who attended before the pandemic (p > 0.05).
Procedure
This study employed a cross-sectional comparison and correlative design. The study was approved by the institutional research board of the]Concealed] University and was conducted over a consecutive three-year period (2019–2021). At the beginning of each semester before the students started the mindfulness course, the researchers entered the classroom, explained the purpose of the study, and asked students to participate. Students were informed that participation in the study was voluntary and anonymous. Those who were interested were asked to sign a consent form and complete the questionnaires; these were placed in an envelope that was left in the classroom for this purpose, which was later collected by the researchers. Students completed the questionnaires in the same way at the end of the semester. Students were informed that they could opt out of the study while still participating in the course.
The mindfulness course was based on the Mindfulness-Based Stress Reduction protocol (MBSR; Santorelli et al., 2017). The MBSR program was initially developed and implemented in 1979 by Jon Kabat-Zinn at the University of Massachusetts Medical Center, as a systematic and intensive training in mindfulness meditation and mindful hatha yoga. This protocol is a curriculum designed to guide participants in the “how” of learning to practice, integrate, and apply mindfulness in their everyday lives. The primary intention of the MBSR curriculum is to create a structured pathway to relieve suffering and increase wellbeing for people facing a host of challenges, which may arise from a wide range of medical and psychological conditions and the demands and stressors inherent in the everyday lives of human beings.
In the course, theoretical studies are combined with self-awareness and practice methods. Students engage in formal mindfulness practices (e.g., guided breathing exercises and guided body-awareness exercises), as well as informal practices (e.g., aware eating and conscious walking). The theoretical studies include eight subjects formulated by Kabat-Zinn (e.g., from automatic action to presence, being and doing, and stress mechanisms; Santorelli et al., 2017). Each subject includes current information from relevant brain research, which is related to the students' own challenges in clinical practice. The mindfulness course is intended for all first-year students, with the goal of facilitating the evolution of a “conscious use of self” by offering tools and language for self-reflection. These include the acceptance of “what is” as a way to facilitate well-being and self-compassion; and attentiveness to body sensations as ways to deepen one's inner listening. Inner listening is an important skill to support involvement, engagement, and presence in the “here and now”.
The course used in our study lasted nine weeks and included weekly sessions of 2.5 hr in small groups (15–20 students each) during the first academic semester (see Table 1 for more details). The mindfulness course is part of the first-year curriculum for occupational therapy students pursuing a Bachelor's degree. The course was approved by the University's teaching committee, which recognized that participation would enhance the students' personal and professional development as future occupational therapists. Students received two academic credits for completing this course.
Table 1
Content outline of mindfulness course with integrated MBSR principles
Sessions | Topic | Principles of MBSR |
|---|---|---|
1 | Introduction to Mindfulness | “From automatic to choice” (Introduction to the definition of mindfulness, basic concepts, body scan, and mindful eating) |
2 | The "guests" | “The guests: It's not simple to be simple” (Identifying the challenge in building a practice routine. Familiarization and practice of encountering "guests" in consciousness) |
3 | Attention to the body | “From story to experience” (Attention to the body as a foundation of awareness and presence. Physical practice and mindful walking.) |
4 | Stress | “Stress mechanisms” (Brain research insights, physiological aspects of stress, coping methods and breathing practice.) |
5 | Managing unpleasant emotions | “Like a mountain- practice, RAIN” (Proactivity in relation to unpleasant emotions.) |
6 | Addressing cognitive patterns and biases | “Thoughts are not facts” (Introduction to "cognitive biases," patterns of consciousness operation. "Open Space" practice.) |
7 | Practice | A practice session (Integrating all practices learned and practiced so far.) |
8 | "Source of Nourishment" | “What Nourishes Me” (Discussion and identification of "nourishment" sources. Practice of cultivating heart qualities.) |
9 | Summary | “Concluding meeting” (Including "My Contract with Myself".) |
During the mindfulness course, the students sat in a circle on chairs or on mattresses on the floor, a setting which enabled inner attentiveness, personal expression, and significant group processes. The course was led by an occupational therapist who is also a certified mindfulness practitioner and teacher. As part of the course, the students were required to put their experiences and processes into words. Each student was also required to keep a written journal that included their course activities and their personal experiences during the home practice. Each student submitted two written self-reflection assignments, enabling them to deepen their observations and allowing the teacher to follow their journey. In a final paper, they were required to present an integrative perspective related to mindfulness practice and language, based on academic research and their clinical practice in a student community project. Students expressed overall satisfaction with the course. In their final papers, they shared positive experiences, such as stating, “The course was very interesting and helped me to better know myself”; and, “I realized that in order to be empathetic towards others, I must first know and understand myself and accept my feelings as they are without judging them and myself”.
Measures
The Kentucky Inventory of Mindfulness Skills (KIMS; Baer et al., 2004)
The Kentucky Inventory of Mindfulness Skills (KIMS) is a 39-item self-report questionnaire that assesses the tendency to be mindful in everyday life. It includes a Likert scale ranging from 1 (“never” or “very rarely” true) to 5 (“almost always” or “always” true). High scores reflect more mindfulness and indicate a greater use of each mindfulness skill. This questionnaire assesses four different mindfulness facets: (1) Observing (e.g., “I notice when my moods begin to change.”); (2) Describing (e.g., “I can easily put my beliefs, opinions, and expectations into words.”); (3) Acting with Awareness (e.g., “When I'm doing something, I'm only focused on what I'm doing, nothing else.”); and (4) Accepting without Judgment (e.g., “I criticize myself for having irrational or inappropriate emotions.”). The KIMS shows adequate to good test–retest reliability (range 0.65–0.86), good internal consistency (Cronbach's α = 0.83–0.91), and good construct validity (Baer et al., 2004; Luberto et al., 2014). The internal consistency of the KIMS in this research was sufficient (McDonald's omega = 0.65–0.89; Cronbach's α = 0.71–0.90). Items were reversed for data analysis according to the tool's guidelines.
The Self-Compassion Scale (SCS; Neff, 2003a)
The Self-Compassion Scale (SCS) is a self-report questionnaire that measures the characteristics of natural self‐compassion. The 26-item scale is composed of 6 subscales: (1) Self-kindness (5 items; e.g., “I'm kind to myself when I'm experiencing suffering.”); (2) Self-judgment (5 items; e.g., “When I see aspects of myself that I don't like, I get down on myself.”); (3) Common Humanity (4 items; e.g., “I try to see my failings as part of the human condition.”); (4) Isolation (4 items; e.g., “When I fail at something that's important to me, I tend to feel alone in my failure.”); (5) Mindfulness (4 items; e.g., “When something upsets me, I try to keep my emotions in balance.”); and (6) Over-identification (4 items; e.g., “When something upsets me, I get carried away with my feelings.”). These items were designed to capture how respondents perceive their actions toward themselves during difficult times. Items are rated using a 5-level Likert scale ranging from 1 (almost never) to 5 (almost always). High scores indicate high levels of the characteristic being measured by that subscale. The scoring is done separately for each subscale. When calculating the total score (overall self‐compassion), the scores of the negative subscales (“Self‐judgment,” “Isolation,” and “Over-identification”) are inverted and the mean scores of all six subscales are summed to obtain the mean final score. Scores between 1 and 2.5 show a low level of self‐compassion, scores between 2.5 and 3.5 show a moderate level, and scores between 3.5 and 5 indicate a high level. The SCS shows adequate to good test–retest reliability (r = 0.65–0.86), good internal consistency (Cronbach's α = 0.77–0.78), and good construct validity (Neff, 2003a). The internal consistency of the total score in this study was good (McDonald's omega = 0.90), with sufficient internal consistency for the subscales (McDonald's omega = 0.65–0.81; Cronbach's α = 0.91). Items were reversed for data analysis according to the tool's guidelines.
Data Analyses
Statistical analysis was performed using the SPSS version 27.0 (Statistical Package for the Social Sciences; Wagner III, 2019), with a significance level of 0.05. Descriptive statistics were used to describe means and standard deviations. The one-way repeated measures MANOVA was used to examine the changes in mindfulness skills and self-compassion before and after completion of the mindfulness course. Partial eta-squared effect sizes were also calculated, with η2 = 0.01 considered a small effect size, 0.06 a medium effect size, and 0.14 a large effect size (Cohen, 2013). Correlations between the changes, before and after the course, in students' mindfulness skills and self-compassion were analyzed using Pearson's correlations. To address the issue of multiple comparisons and control the False Discovery Rate (FDR), we employed the Benjamini–Hochberg procedure (Benjamini & Hochberg, 1995). This method is particularly well-suited for controlling the expected proportion of false positives (Type I errors) among the rejected hypotheses when conducting multiple tests, such as correlations in our analysis.
Results
To examine the first study question if there are positive changes in mindfulness skills and self-compassion among the OT students who completed the mindfulness course, one-way repeated measure MANOVAs were used to assess the changes in the mindfulness skills and self-compassion. These analyses included only the students who answered the questionnaires both before and after the course (n = 106). As seen in Table 2, the mean scores of all the KIMS facets, except for “Acting,” were higher after completing the course. There was a significant multivariate effect on the combined dependent variables as a result of participating in the course: Wilks' Lambda = 0.85, F(4, 102) = 4.65, p = 0.002, partial η2 = 0.15. Significant improvement following completion of the mindfulness course was found in the “Observing” skill as well as in the “Accepting” skill with small-to-medium effect sizes.
Table 2
Mean scores (M), standard deviations (SD), and one-way repeated measures MANOVA results regarding differences in mindfulness skills before and after the mindfulness course (n = 106)
KIMSa | Pre | Post | |||
|---|---|---|---|---|---|
M (SD) | M (SD) | F(1,105) | p | η2 | |
Observing | 3.36 (0.50) | 3.50 (0.42) | 8.86 | 0.004 | 0.08 |
Describing | 3.51 (0.70) | 3.58 (0.70) | 2.07 | 0.153 | 0.01 |
Acting | 2.93 (0.50) | 2.88 (0.45) | 1.30 | 0.257 | 0.01 |
Accepting | 3.33 (0.60) | 3.47 (0.49) | 6.07 | 0.015 | 0.06 |
Total | 3.27 (0.33) | 3.35 (0.31) |
Examining the changes in the self-compassion scale before and following completion of the mindfulness course revealed significant improvement in the combined dependent variables: Wilks' Lambda 0.81, F(6, 100) = 4.02, p = 0.001, partial η2 = 0.19. As seen in Table 3, the mean scores of all the SCS components were higher after completing the course. The changes in the “Isolation” and “Self-judgment” components were the largest, with large effect sizes.
Table 3
Mean scores (M), standard deviations (SD), and one-way repeated measures MANOVA results regarding differences in self-compassion before and after the completion of the mindfulness course (n = 106)
SCSa | Pre | Post | |||
|---|---|---|---|---|---|
M (SD) | M (SD) | F(1, 105) | p | η2 | |
Self-kindness | 3.11 (0.65) | 3.30 (0.69) | 8.60 | 0.004 | 0.08 |
Self-judgment | 3.03 (0.72) | 3.31 (0.75) | 17.16 | < 0.001 | 0.14 |
Common Humanity | 3.22 (0.69) | 3.27 (0.68) | 0.34 | 0.561 | 0.003 |
Isolation | 2.95 (0.91) | 3.27 (0.86) | 18.82 | < 0.001 | 0.15 |
Mindfulness | 3.23 (0.64) | 3.38 (0.62) | 5.08 | 0.026 | 0.05 |
Over-identification | 2.71 (0.71) | 2.84 (0.70) | 3.63 | 0.060 | 0.03 |
Total | 3.04 (0.52) | 3.23 (0.52) |
To examine the second study question if the changes, before and after the course, in students' mindfulness skills and self-compassion correlate, Pearson's correlations were calculated. As seen in Table 4, significant positive moderate-to-strong correlations were found between the changes in the total score of KIMS and the subscales of the SCS as well as the changes in the total score of SCS and subscales for KIMS. Increased levels of mindfulness skills were associated with a significant increase in self-compassion.
Table 4
Pearson correlations between the changes in scores of mindfulness skills (KIMS) and the changes in scores of self-compassion (SCS) before/after the mindfulness course (n = 106)a
Changes in KIMS-Mindfulness skills | ||||||
|---|---|---|---|---|---|---|
Observing | Describing | Acting | Accepting | Total | ||
Changes in SCS -Self-compassion | Self-kindness | 0.33*** | 0.41*** | 0.26** | 0.27** | 0.49*** |
Self-judgment | 0.26** | 0.28** | 0.27** | 0.41*** | 0.48*** | |
Common Humanity | 0.15 | 0.35*** | 0.21* | 0.31** | 0.39*** | |
Isolation | 0.45*** | 0.14 | 0.21* | 0.31** | 0.46*** | |
Mindfulness | 0.36*** | 0.27** | 0.12 | 0.24* | 0.40*** | |
Over-identification | 0.17 | 0.21* | 0.24* | 0.31** | 0.36*** | |
Total | 0.41*** | 0.40*** | 0.31** | 0.44*** | 0.61*** | |
In summary, the results indicated significant positive changes in both mindfulness skills and self-compassion among OT students following the completion of a mindfulness course. Specifically, students demonstrated significant improvements in the “Observing” and “Accepting” subscales of mindfulness, as well as notable enhancements in the “Isolation” and “Self-judgment” components of self-compassion. Additionally, the changes in mindfulness were significantly correlated with self-compassion.
Discussion
This study is unique in adding new knowledge to the small number of studies about the efficacy of mindfulness courses for health profession students, particularly OT students (Gutman et al., 2020; Reid, 2013; Vogtmann & Provident, 2021). The current study investigated the effects of a mandatory mindfulness course on the mindfulness skills and self-compassion of a large group of first-year undergraduate OT students.
The mindfulness course described in this study aligns with similar courses emerging over the last decade (Linehan, 2014; Williams et al., 2007), which aim to help health profession students to cope with the pressures and challenges they encounter during their academic journey. The mindfulness course presented in this study provides OT students with valuable tools that can assist them in better integrating their knowledge and skills during their fieldwork experiences, and later in their professional careers. However, the course can be relevant to other healthcare professions as well. The common factor of studying to become therapists creates the need to have compassion for themselves along with others, and at the same time to be aware of their surroundings.
This study results revealed that following completion of the course, there were significant improvements in the total mindfulness skills score, and in two subscales (“Observing” and “Accepting”); as well as in the total self-compassion skills score and its subscales (“Self-kindness,” “Self-judgment,” “Isolation,” and “Mindfulness”).
Mindfulness has been shown to potentially elevate an individual's self-compassion levels (Neff, 2003b) through the cultivation of feelings of love, compassion, and forgiveness; consequently, reducing susceptibility to negative emotional states (Erkin & Aykar, 2021). A previous study found that students who participated in mindfulness courses exhibited increased self-compassion scores following their completion (Centeno & Fernandez, 2020). Self-compassion is an important ability for healthcare students, including occupation therapy students (Henton et al., 2021; Kotera et al., 2022).
Changes, before and after, the mindfulness course between the mindfulness and self-compassion scores were found to be significantly correlated in the current study, which strengthens the theoretical choice of mindfulness skills and self-compassion as the main outcome measures of the mindfulness course, increased levels of mindfulness skills were associated with a significant increase in self-compassion (Centeno & Fernandez, 2020). Furthermore, studies found that mindfulness can increase self-compassion in general (Neff, 2003b), and specifically for healthcare students (Centeno & Fernandez, 2020). The results of a systematic review, which focused on the effect of mindfulness on empathy and self-compassion, indicated that mindfulness training was effective in improving self-compassion (Kotera et al., 2022).
The current study results also showed improvement in the mindfulness scale scores after participating in the mindfulness course. These results are consistent with other studies that revealed improvement in total mindfulness scores (Biehler & Naragon-Gainey, 2022; Whitesman & Mash, 2015). In the current study, the scores of “Describing” and “Acting” in the KIMS questionnaire (Baer et al., 2004) did not significantly improve. These results are different from other studies, (Moore & Malinowski, 2009; Whitesman & Mash, 2015).
The results of the current study can be explained by differences in the settings and participants of the respective studies. In studies other than ours, most participants were not Bachelor-degree students and were not obligated to take the mindfulness course (Kabat-Zinn, 2009; Sanko et al., 2016). Additionally, previous studies have discussed the use of the KIMS subscales and suggested using the total score of the KIMS instead of the sub scales to assess integrative concepts such as mindfulness (Baer et al., 2004; Luberto et al., 2014). Furthermore, Baer et al. (2014) indicated an overlap between the KIMS subscales of “Observing” and “Accepting”.
Upon reviewing the items in the “Acting” subscale, it became evident that they require a high level of awareness. To successfully perform these actions, one must be attentive and fully engaged in the current activity. For example: “When I am engaged in a task, I am solely focused on that task, disregarding everything else;” and “I become completely absorbed in my activities and lose track of everything else around me.” First-year students often experience significant stress related to their academic success, financial management, and social adjustments (McLean et al., 2023; Ribeiro et al., 2018). Consequently, we can hypotized that during their first year of studies, students may struggle to maintain complete awareness and attention while engaging in various activities. A similar assumption could also explain why the “Acting” subscale score decreased; it may be challenging for students to achieve the required level of focus amidst their concerns and responsibilities (Dontre, 2021; Firth et al., 2019).
Similar to the mindfulness scores, self-compassion scores in this study also showed improvement, as measured by the SCS (Neff, 2003a). These results support the findings of previous studies that assessed the enhancement of self-compassion following participation in a mindfulness course. Such studies have been conducted among various populations, including teachers (Roeser et al., 2022), college students (Taylor et al., 2022), and healthcare professionals (Raab, 2014). In the current study, significant improvements were noted in all the self-compassion subscales except for “Common Humanity.” Self-compassion is an important ability for health profession students, due to its role in protection from stress, early burnout at work, anxiety, and lack of mental wellbeing (Dev et al., 2020; Kotera et al., 2022). Self-compassion allows people to be kind to themselves and seek better ways of facing difficult situations and failures. Being self-compassionate helps the individual to face inner thoughts and emotions in a healthier manner (Neff, 2015). All these abilities are crucial in order for OT students to eventually become competent professionals.
The finding indicating no significant improvement in the “Common Humanity” subscale differs from previous studies that reported significant improvements in that subscale (Chang et al., 2017; Taylor et al., 2022). A possible explanation is that the other studies correlated the improvement of the “Common Humanity” subscale with emotional and mental health indicators, such as stress and suicide (Chang et al., 2017; Taylor et al., 2022); and/or with health promotion, such as lifestyle (Gedik, 2019). In contrast, our study centered on enhancing self-compassion and mindfulness skills without explicitly targeting common humanity as a developmental focus. This distinction is crucial because the mindfulness course in our study was designed to cultivate self-compassion, which, while related to common humanity, does not necessarily enhance this subscale directly. Therefore, the lack of significant change in the “Common Humanity” subscale in our results aligns with the course’s specific objectives.
Occupational therapists in particular use everyday activities to help people engage more fully in their daily lives, integrating the act of doing with the state of being. These concepts are central to the profession, which must address the intersection of body and mind when considering health conditions on functioning (American Occupational Therapy Association, 2020; Hitch et al., 2014). Mindfulness fosters a deep and ongoing awareness of the importance of listening to the body and its sensations, both inwardly and outwardly.
The mindfulness techniques that the students learned in the course can enable students to foster a more successful and fulfilling transition into real work settings (Centeno & Fernandez, 2020; Halladay et al., 2019; Howarth et al., 2019; McConville et al., 2017; Wasson et al., 2020). Our study's findings demonstrated improvements essential abilities that foster self-awareness and enhance the capacity to connect with others, which underscores the importance of this course for OT students. These findings support previous study suggesting that a mindfulness course teaches the students to be more attentive to themselves and others during the process of becoming therapists (Gockel et al., 2013).
Limitations and Future Research
This study has certain limitations. The mindfulness course described in this paper was mandatory, which raises some issues worthy of discussion. Given that the students did not choose to participate, their motivation to engage in the course and apply the techniques taught was not necessarily high. Furthermore, universities attempt to improve the personal well-being of students by providing a mindfulness course to all, instead of addressing the root causes of a student's difficulties, which negatively affect their well-being (Lee et al., 2024). Some researchers also highlight the concern of requiring students to interact with course material drawn from the religious tenets of Buddhism (Lee et al., 2024). However, it is important to emphasize that the course used in this study is designed to teach students mindfulness techniques without religious interpretations. Moreover, the course teacher encourages open dialogue, questions, and critique. Through the course the students developed self-reflective abilities and read professional articles on mindfulness. As evidenced by the results of this study and others (Dev et al., 2020; Halladay et al., 2019; Kotera et al., 2022), the students received tools enabling them be become more self-compassionate and mindful, which can help them manage stress and improve their well-being.
Furthermore, the study focused solely on assessing mindfulness and self-compassion skills, without considering the potential effects of the course on participants' stress levels, emotional abilities, and health-promotion measures. Future studies should aim to examine the emotional-behavioral aspects of participants enrolled in the mindfulness course. In addition, future studies should also include comparisons to a control group who did not participate in a mindfulness course, as well as comparison to similar programs among other healthcare students. Also recommended are qualitative studies, including interviews and focus groups with the participants. Further follow-up studies would be useful to investigate the use of mindfulness skills and self-compassion later in their program and professional careers.
In summary, this study adds unique insights to the limited body of research examining the efficacy of mindfulness courses for health profession college students. The investigation of the effects of a mandatory mindfulness course for a large group of first-year undergraduate OT students demonstrated significant improvements in mindfulness and self-compassion skills. The results underscore the importance of integrating mindfulness training into the curriculum for health profession students, particularly OT students.
Acknowledgements
We are grateful to the occupational therapy students who participated in this study.
Declarations
Ethical Approval
This study was approved by the Ethics Committee of the Hebrew University of Jerusalem (No. 2211201).
Informed Consent
Informed consent was obtained from all subjects involved in the study.
Use of Artificial Intelligence
AI was not used.
Conflict of Interest
The authors declare no conflict of interest.
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