Randomized controlled pilot study of feasibility and effectiveness of peer led remote Mindfulness‐Based Art Workshops on stress, anxiety, and depression in medical students
Authors: Wang Chaoyang , Darbari Isha , Tolaymat Mazen , Quezada Sandra , Allen John , Cross Raymond K. 
Published: September 2022

Medical students report high levels of psychological distress compared to the general population, yet they also underutilize mental health services. Our Mindfulness‐Based Art Workshops (MBAW) combine two established, formal interventions: (a) Mindfulness‐Based Stress Reduction, an 8‐week group series teaching mindfulness practices, shown to reduce self‐reported measures of stress, and (b) art therapy, the use of art exercises guided by certified therapists, shown to reduce stress and anxiety in hospitalized patients and students. The goal of our study was to determine if a peer‐led, virtual workshop series designed specifically for and by medical students may be a feasible and effective method of adapting these models to improve student well‐being. We hypothesized that virtual, medical student led MBAW are effective in reducing measures of stress, anxiety, and depression in medical students and improving well‐being scores. In 2020, 24 University of Maryland School of Medicine first‐ and second‐year medical students were randomized to either the MBAW or no‐intervention control group. Primary outcomes included (a) short‐term change in State Trait Anxiety Inventory (STAI) scores and (b) difference in the perceived stress scores between intervention and control group immediately after, and 2, 4, and 6 weeks after a 6‐session intervention. At specific time points, participants completed questionnaires, which included STAI and National Institutes of Health (NIH) Toolbox Perceived Stress survey. We compared the percentage of intervention participants who had clinically significant anxiety before and after MBAW for each session using a generalized estimating equations methodology and compared change from baseline scores between intervention and control groups using a mixed‐effects model for repeated measures analysis. In the intervention group, post‐MBAW STAI scores decreased by 16.2 (p = .0001), 5 (p = .1544), 13.7 (p = .0002), 13.6 (p = .0006), 12.1 (p = .0009), and 11.9 (p = .0011) points after sessions 1, 2, 3, 4, 5, and 6, respectively. Intervention group perceived stress scores decreased from baseline by 5.9 (p = .07) and 4.7 (p = .09) points more than the control group immediately after, and 2 weeks after the 6‐session intervention. MBAW sessions are effective at significantly reducing short‐term anxiety, and a 6‐session MBAW workshop intervention shows trends toward decreasing levels of perceived stress lasting 2 weeks following the intervention, although these findings were not statistically significant. Future studies should evaluate a larger population to confirm the positive findings of this pilot study, which we hope will encourage medical schools to consider integrating and supporting such programs as a method of addressing the urgent need to aid student well‐being, within logistical, time, and cost constraints of students and administrators.