Development of a Positive Psychology Program (LAVENDER) for Preserving Medical Student Well-being: A Single-Arm Pilot Study

Elaine O Cheung; Ian Kwok; Allison B Ludwig; William Burton; Xinzi Wang; Neha Basti; Elizabeth L Addington; Carly Maletich; Judith T Moskowitz

doi:10.1177/2164956120988481

Development of a Positive Psychology Program (LAVENDER) for Preserving Medical Student Well-being: A Single-Arm Pilot Study

Glob Adv Health Med. 2021 Jan 28:10:2164956120988481. doi: 10.1177/2164956120988481. eCollection 2021.

Authors

Elaine O Cheung^{1

2}, Ian Kwok¹, Allison B Ludwig³, William Burton³, Xinzi Wang¹, Neha Basti¹, Elizabeth L Addington^{1

2}, Carly Maletich¹, Judith T Moskowitz^{1

2}

Affiliations

¹ Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
² Osher Center for Integrative Medicine, Northwestern Medicine, Chicago, Illinois.
³ Department of Family and Social Medicine, Albert Einstein College of Medicine, New York City, New York.

Abstract

Background: Mental health tends to worsen over the course of medical school, with steep declines in well-being in students' clerkship year (M3). Positive emotion promotes adaptive coping to stress and may help preserve medical student well-being.

Objective: This study describes the development of LAVENDER (Leveraging Affect and Valuing Empathy for Nurturing Doctors' Emotional Resilience), a program aimed at increasing positive emotion to preserve well-being in medical students.

Methods: We conducted a single-arm pilot of LAVENDER, a positive psychology intervention developed for medical students delivered in an interactive classroom format to a cohort of 157 third-year medical students at the Albert Einstein College of Medicine. Our primary outcome was the acceptability of LAVENDER. We also examined preliminary efficacy using measures of emotion, stress and burnout collected at each intervention session.

Results: LAVENDER showed good acceptability: 76% of participants agreed that the LAVENDER skills were useful and 72% agreed that they would recommend the LAVENDER program to others. Qualitative feedback suggested that medical students enjoyed the program and found the skills to be useful for coping with stress, but also reported the following barriers to engagement: lack of time to practice the skills, resistance to the mandatory nature of the wellness sessions, and difficulty integrating the skills in daily life. We did not find support for the preliminary efficacy of LAVENDER for improving medical student well-being in students' clerkship year. Participants showed decreases in positive emotion and increases in symptoms of burnout over the intervention period (ps < .01).

Conclusion: The current paper describes the development and a single-arm pilot test of LAVENDER, a positive psychology program tailored for medical students. Although we found preliminary evidence for the acceptability of LAVENDER, we did not find support for the preliminary efficacy. Lessons learned and next steps for the program are discussed.

Keywords: Positive psychology; burnout; coping; emotion; intervention; stress.