Mechanisms of change in compassion-based programs for medical students

Medical practice exposes physicians to numerous stressors, leading to high rates of psychological distress and burnout, a problem that begins during medical school. Scientific evidence suggests that promoting compassion among physicians could improve their well-being and promote patient-centered care. However, the mechanisms underlying these benefits remain unclear. This study aimed to examine the mediators and moderators of changes in psychological distress and well-being following Compassion Cultivation Training (CCT) among medical students. A randomized controlled trial with 40 medical students assigned to an 8-week CCT program or a waitlist control group was conducted. Participants were assessed at pre-intervention, post-intervention, and a 2-month follow-up on measures of psychological distress, well-being, mindfulness, compassion, emotion regulation, and burnout. Results indicated that CCT led to significant reductions in stress and anxiety immediately after the program, mediated by improvements in emotion regulation and mindfulness skills. Gender moderated changes in stress, anxiety, depression, and well-being at post-intervention, with women benefiting more than men, though these differences were not sustained at follow-up. In conclusion, this study contributes to the growing body of literature on the benefits of compassion training in healthcare and provides insights into the mechanisms through which compassion could support physicians and medical students.