Optimizing Compassion Training in Medical Trainees: Feasibility, Acceptability, and Preliminary Effects of an Adjunct mHealth Application (Preprint)

BACKGROUND While structured compassion training programs have shown promise for increasing compassion among medical trainees and professionals, a major challenge is applying the concepts and practices taught during the program into the complex, dynamic, time-pressured, and often hectic hospital workplace. OBJECTIVE The purpose of this pilot study was to examine the feasibility, acceptability and preliminary effects of Compassion Coach, an mHealth smartphone application designed to bolster a 6-week mindfulness and self-compassion training program in medical trainees. METHODS Participants (N = 29) primarily self-identified as female (57%) between the ages of 30 – 35 (59%). Approximately half were medical students (n = 14; 48%) and half were residents (n = 15; 52%). Notifications to remind, encourage, and measure the perceived impact of informal mindfulness and compassion practices taught during the program were delivered at 7am, 12pm and 7pm, respectively, three times per week for a total of 21 notifications. The application also contained a library of guided audio formal mindfulness and compassion practices to allow quick and easy access. RESULTS Average response rate to notifications was 58% (SD = 29.19; range = 12% - 98%) with the rate of adherence significantly declining over time (OR = 0.98, P = .009). The majority of participants agreed the informal practices prompted by Compassion Coach helped them feel grounded and centered (73%), improved compassion (71%), reduced burnout (56%), and improved mood (70%). A total of 16 participants (55%) accessed guided audio recordings on average three times (SD = 3.4) throughout the program. At post-treatment, most participants (72%) indicated Compassion Coach helped them engage in compassion practices in daily life, and half (50%) indicated Compassion Coach helped improve interactions with patients. CONCLUSIONS Preliminary results of Compassion Coach are encouraging, however additional modifications are indicated to improve adherence and applicability. Future work should focus on tailoring Compassion Coach according to participant characteristics and preferences.