Do You Mind? A Mindfulness Practice Curriculum for ...

Do You Mind? A Mindfulness Practice Curriculum for Pharmacy Students

BY

BRIANNA M. MCQUADE

B.S., University of North Carolina at Chapel Hill, 2012

Pharm.D., University of North Carolina at Chapel Hill Eshelman School of Pharmacy, 2013

THESIS

Submitted as partial fulfillment of the requirements

for the degree of Master of Health Professions Education

in the Graduate College of the

University of Illinois at Chicago, 2020

Chicago, IL

Defense Committee:

Janet Riddle, Chair and Advisor

Yoon Soo Park

Jennie B. Jarrett, College of Pharmacy

ii

ACKNOWLEDGEMENTS

I would like to sincerely thank my thesis committee – Janet Riddle, Jennie Jarrett, and

Yoon Soo Park – for all their guidance with this thesis project. Their support and mentorship

helped me grow as a clinician and a researcher, and create data that will support the future of

pharmacists and other health professionals.

iii

TABLE OF CONTENTS

CHAPTER PAGE

1. Introduction……………………………………………………………………… 1

1.1.The Study Problem…………………………………………………….... 1

1.2.Research Question and Goals…………………………………………… 2

2. Related Literature and Theoretical Framework…………………………………. 4

2.1.Review of the Literature………………………………………………… 4

2.2.Theoretical Framework………………………………………………….. 5

3. Research Methodology………………………………………………………….. 8

3.1.Methods…………………………………………………………………. 8

3.1a Study Context: Mindfulness Curriculum…………………………... 8

3.1b Data Collection and Measurements………………………………... 9

3.1c Outcomes…………………………………………………………... 10

3.1d Scoring and Data Analysis………………………………………… 11

3.1e IRB…………………………………………………………………. 12

4. Results…………………………………………………………………………… 13

4.1.Participant Results………………………………………………………. 15

4.2.Participants vs. Controls………………………………………………… 19

5. Changes From Protocol…………………………………………………………. 21

6. Discussion………………………………………………………………………. 22

7. Conclusion………………………………………………………………………. 28

8. CV……………………………………………………………………………….. 29

9. Citations…………………………………………………………………………. 39

10. Appendices………………………………………………………………………. 42

10.1. A. Student Mindfulness Baseline Survey_Participants……………... 42

10.2. B. Student Mindfulness Week 8 and Week 12 Survey_Participants... 78

10.3. C. Student Mindfulness Daily Log………………………………….. 104

10.4. D. Student Curriculum Evaluation…………………………………... 109

10.5. E. Student Mindfulness Survey_Control Group…………………….. 113

10.6. F. Semi-Structured Interview Protocol for Mindfulness Curriculum

Student Participants……………………………………………………...

133

10.7. G. Free-Text Evaluation Responses from Student Participants…….. 134

iv

LIST OF TABLES

TABLE PAGE

I. Theoretical Frameworks Used to Evaluate Learning of Mindfulness…... 5

II. Pharmacy Student Mindfulness Curriculum Learning Objectives and

Activities…………………………………………………………………

8

III. Secondary Outcomes……………………………………………………. 11

IV. Baseline Demographics for Participant and Control Groups…………… 13

V. Student Reported Practice of Mindfulness……………………………… 15

VI. 5 Facet Mindfulness Questionnaire Results from Participants at

Baseline, Week 8, and Week 12…………………………………………

15

VII. Perceived Stress Survey Results from Participants at Baseline, Week 8,

and Week 12……………………………………………………………..

16

VIII. SF12 v2 Mental Health Summary (MCS) and Physical Health

Summary (PCS) Score Results from Participants at Baseline, Week 8,

and Week 12……………………………………………………………..

16

IX. Student Evaluation Responses on Learning Experience………………... 18

X. Comparison of PSS, MCS, and PCS Scores Between Participant and

Control Groups at Week 12……………………………………………...

20

v

LIST OF FIGURES

FIGURE PAGE

1. Social Cognitive Theory………………………………………………………… 5

2. Student Evaluation Ratings……………………………………………………... 17

a) Student Participant Rating of Achievement in Learning Objectives…… 17

b) Student Participant Rating of Instructor………………………………… 17

c) Student Participant Level of Agreement for Teaching and Learning

Strategies…………………………………………………………………

18

vi

LIST OF ABBREVIATIONS

ACCP – American College of Clinical Pharmacy

MCS – Mental Health Component Summary

PCS – Physical Health Component Summary

PSS – Perceived Stress Scale

SF-12 v2 – SF-12 v2 Health Related Quality of Life Scale

vii

SUMMARY

The nature of learning mindfulness practice and the impact of a mindfulness curriculum

on pharmacy student stress levels and quality of life was evaluated using a mixed-methods

research methodology. Twenty-five participant students in the mindfulness curriculum were

surveyed on their level of mindfulness, their perceived stress, and overall quality of life using the

5 Facet Mindfulness Questionnaire, the Perceived Stress Scale (PSS), and the SF-12 v2 Health

Related Quality of Life scale, respectively. Eighteen consented to full inclusion in the study. A

control group of 24 non-participants students were also surveyed on their stress levels and

quality of life using the same questionnaires. Twenty of the controls completed the full study.

Surveys were collected at baseline (prior to class intervention) and at 12 weeks (4 weeks post

course conclusion) in both groups for comparison. Student participants were also asked to

complete an online course evaluation at the conclusion of the course.

Compared to the control group, students who participated in the mindfulness practice

curriculum had significantly lower perceived stress and higher mental health-related quality of

life. Participants highly rated the course overall, though one to two students did report lower

achievement of course objectives. Based on participant evaluation free-text responses, concepts

related to the environment of learning mindfulness practice were discussed, resulting in

opportunities for future research focus with rigorous qualitative methodologies and data

analyses.

1

1. Introduction

1.1 The Study Problem

Methods to reduce stress and promote resiliency are needed in pharmacy students. Pharmacy

students report higher stress levels than the general population, which correlates to lower quality of

life.1–3 Additionally, there is the concern that unmitigated stress will cause higher levels of burnout

throughout their academic and professional career.4,5 It is important that students develop habits to

promote engagement and resiliency for current and future practice. One individual-based method to

reduce stress is mindfulness practice. The practice of mindfulness is the skill of focusing on the present

moment, without judgment or bias.6 Mindfulness practice can be informal or formal. Informally,

mindfulness is bringing awareness to anything that one does, from daily activities such as walking or

brushing one’s teeth. When practiced formally, one intentionally sets time aside to focus on mindfulness

practice, such as through meditation or yoga.7,8 Overall, it is a method of daily living that provides

participants a way of coping with stressors or unpleasant attitudes and emotions in a compassionate,

judgement-free way.1,6–8

Baer and colleagues theorized that mindfulness exerts its beneficial effects through observing,

describing, acting with awareness, and nonjudging of and nonreactivity to inner experience, also known

as the Five Facets of Mindfulness.6,9 Mindfulness practice has been shown to improve immune function,

reduce blood pressure, cortisol levels, anxiety, and depression, improve psychological well-being, and

enhance cognitive functioning in the general population.6,10 In college students, it reduces stress and

improves mood and academic performance.11 Specifically in health professions students, a systematic

review found that mindfulness significantly reduces stress and enhances mood.12 While the literature

indicates pharmacy students are interested in the concept and there is feasibility data to show it can

reduce stress, mindfulness interventions have not been studied explicitly in the US pharmacy student

2 population.13,14 Therefore, while mindfulness practice appears to be a solution to pharmacy student

stress, it is poorly studied in pharmacy students. Similarly, the best methods to effectively teach

mindfulness practice to this population are unknown.

There is a positive correlation between the practice of mindfulness and improvement in the five

components of observing, describing, acting with awareness, and nonjudging of and nonreactivity to

inner experience.15 The findings are consistent with neuroimaging studies that highlight the

neuroplasticity of the brain, the concept that the brain rewires itself through new practices.6,16,17

Consistent practice with mindfulness is vital to its beneficial impact. The ultimate goal, therefore, is to

teach pharmacy students mindfulness practice, and that they will utilize the practice methods in their

daily life to reduce stress and improve quality of life. The behaviors of interest in learning mindfulness

practice are the five behaviors that are proposed to confer the benefits of mindfulness (observing,

describing, acting with awareness, and nonjudging of and nonreactivity to inner experience,).9 However,

how does one change behavior to ensure consistent mindfulness practice? When teaching mindfulness to

pharmacy students, what are the ideal classroom characteristics and activities to induce this behavior

change?

1.2 Research Question and Goals

The goal of this research is to evaluate the nature of learning mindfulness in pharmacy students.

The overall aim is to evaluate the variables that allow for mindfulness learning to occur and in what

context. The research question is: what are the classroom characteristics and activities that support

learning and practicing of mindfulness and ensure consistent mindfulness practice outside of class? This

research will evaluate a pilot mindfulness curriculum in pharmacy students using a design-based

research approach to assess how the learning of mindfulness occurs and improve the educational

3 implementation of future courses.18 This research has been grant funded through the American College

of Clinical Pharmacy (ACCP).

4 2. Related Literature and Theoretical Framework

2.1 Review of the Literature

Many experts in mindfulness have described the theories of how mindfulness works.6,9,11,16,17,19–21

However, fewer have investigated the educational processes involved for mindfulness learning to

happen.

Bronson proposed that the ideal mindfulness interventions for nurses should be based on Nola

Pender’s Health Promotion Model. The Health Promotion Model is a theoretical framework with a focus

on health-related behavior change. The model postulates that individual characteristics and experiences,

behavior-specific perceptions, and behavioral outcomes drive human health-related behavior. This

model supports the use of mindfulness to improve burnout, self-care, and perceived stress among

nurses.22 While similar to the current proposed research project, the outcomes in Bronson’s study were

nursing-specific and did not evaluate the components and variables that made mindfulness education

successful in changing behaviors.

Beattie and colleagues investigated the predictors and determinants of success in sustained

mindfulness practice in adolescents. Using the reasoned action approach, a subset of the Theory of

Planned behavior, the authors proposed that perceived behavioral control and perceived norms would

influence the independent practice of mindfulness. This study focused on outcomes that would help

encourage practice of mindfulness, but was quantitative in nature and not designed to evaluate the

variables that contributed to the learning processes of mindfulness practice.23 Additionally, the focus on

perceived norms likely fits the age group represented in this study, but may have less impact in a

graduate, doctorate level course.

5

Table I. Theoretical Frameworks Used to Evaluate Learning of Mindfulness

Theoretical Framework Descriptors/Areas of Focus

Health Promotion Model22,24 Individual characteristic/experiences

o Prior related behavior

o Biological, psychological, sociocultural personal factors

Behavior-specific perceptions

o Perceived benefits, barriers to action

o Perceived self-efficacy

o Interpersonal, situational influence

o Commitment to plan/intention

o Competing demands/interests

Behavioral outcomes

o Health promoting behavior

Reasoned Action Approach23,25 Attitudes related to behavior

o Beliefs about consequences

o Evaluation of importance of those consequences

Perceived norms

o Injunctive - what others think a person should do

o Descriptive – what others are actually doing

Perceived behavioral control

o Beliefs of effectiveness in performing behavior

2.2 Theoretical Framework

The emphasis on the environment as a component of driving human behavior is minimal in the

Human Promotion Model and Reasoned Action Approach frameworks. Social cognitive theory (SCT)

can elucidate aspects of the learning environment that promote mindfulness practice.26 Social cognitive

theory (SCT) postulates that human behavior, particularly human health behavior, is influenced by three

domains: behavior, personal factors, and environmental influence. In this theory, one’s behavior,

personal factors, and the environment with which they interact within all intermingle and influence each

other bidirectionally26 (Figure 1).

Figure 1. Social cognitive theory26

Personal factors

Behavior Environmental influences

6

SCT is an ideal model to use for evaluating how mindfulness learning occurs because it

encompasses cognitive, behavioral, and emotional models of behavior change.26 It is well suited for

research regarding the learning environment of mindfulness. It allows that these three sources of

influence can be of different strengths for an individual.27 The hypothesis for this research is that the

learning environment, which includes an instructor, student peers, and the explicit mindfulness

curriculum (among others), will have a large impact on driving behavior for practicing mindfulness.

Role modeling by the instructor and fellow motivated students can positively influence the learning of

mindfulness practice; alternatively, an uncomfortable classroom setup that doesn’t invite collaboration

or teleconferencing to a remote campus could potentially hinder learning. Additionally, student behavior

can impact the learning environment through student engagement within the course, including

attendance and participation in group debriefing and practice sessions within the classroom setting,

which in turn influences other students’ behavior. Environmental factors outside the classroom will also

have a strong impact on behavior. Competing priorities, lack of peer support, or stressful relationships

can hinder behavior on practicing mindfulness outside the classroom setting. While the learning

environment will have an impact on behavior and vice versa, personal factors are also at play. Personal

factors important to this research include students’ previous experience with mindfulness and

meditation, preconceived beliefs about mindfulness practice’s benefits, and goals for the mindfulness

practice course. These personal factors can shape the learning environment while also influencing

student behavior in practicing mindfulness (for instance, if those participating are highly motivated to

engage in the course and practice outside of class, the learning environment would be different than if

those participating were skeptical about mindfulness practice and its effectiveness).

In order for the outcomes of interest to occur, one participating in mindfulness must practice

regularly. The reinforcement to practice regularly can come from the influence of the learning

environment on self-efficacy (or confidence in one’s ability to take action and continue to take action)

7 and the interaction and influence of others (such as the instructor or peers), which are hallmarks of

SCT.26 Similarly, in aligning with the theory of neuroplasticity, behavior can influence personal factors

such as brain structures.17,27 The behavior of practicing mindfulness can improve the five facets of

mindfulness (observing, describing, acting with awareness, and nonjudging of and nonreactivity to inner

experience) which in turn will allow the brain to rewire itself for the desired benefits of mindfulness

(such as decreased stress and anxiety).

Design-based research (DBR) is a methodological framework that can help answer the “how”

and “why” learning occurs in mindfulness teaching.18,28 It is designed to test and refine theories through

real-world, classroom settings and a mixed-method approach. The benefits of using the DBR

methodology include testing the applicability of social cognitive theory, learning how different variables

of the course affect one another, and allowing unforeseen variables to come to light.18 Ultimately, DBR

will bridge the gap between the research findings and educational practice, improving upon each

semester’s mindfulness curriculum.18

8

3. Research Methodology

3.1 Methods

The primary objective of this work was to evaluate a preclinical pharmacy student mindfulness

curriculum on student stress and overall quality of life. The secondary objective was to evaluate the

classroom activities and learning environment as it relates to changing behavior for practicing

mindfulness. The design-based research study was a mixed-method cohort study using survey methods

and semi-structured interviews. The intervention was an 8-week mindfulness curriculum, modified from

the Koru Mindfulness Program11, offered as an elective to first, second, and third year pharmacy

students.

3.1a Study Context: Mindfulness Curriculum

The variables that allow for learning

mindfulness were assessed in the setting of

a 1 credit hour elective. The mindfulness

curriculum was developed using the Six-

Step Approach for Medical Education.29

Problem identification and general and

targeted needs assessments have been

described as above. Goals and objectives

with corresponding educational strategies

are show in Table II. End of course

evaluations were used to judge the success

of the program and participants’ attitudes regarding the value of the program. The elective course was

Table II. Pharmacy Student Mindfulness Curriculum Learning

Objectives and Activities

Learning Objectives Educational Strategies/Learning

Activities

Discuss the benefits

of mindfulness in the

general public and

the healthcare

professions

population

(cognitive)

Outside of class:

Chapter readings from Holly B.

Rogers’ “The Mindful Twenty

Something.” (optional)

Articles from literature (optional)

In class:

Facilitated small group discussion

Understand the key

messages of the

practice of Koru

mindfulness11 (mind-

body skills,

meditation practice,

peer and facilitator

interactions) as it

relates to being a

student pharmacist

(affective)

Integrate mindfulness

practice into daily

life (psychomotor)

Outside of class

Practice mindfulness (app

encouraged, but not required) for at

least 10 minutes daily

In class:

Small group discussion on

mindfulness experiences

(challenges, successes), focusing on

student pharmacist life

In class guided meditation

(breathing techniques, Gatha

meditation, self-compassion

meditation, body scan, chair yoga,

labeling thoughts)

9 approved by the University of Illinois at Chicago College of Pharmacy (UIC COP) Department of

Academic Affairs.

Student participants were recruited through direct and indirect advertisement of the mindfulness

elective course at the University of Illinois at Chicago College of Pharmacy (UIC COP).

Announcements were made in a first-year core class lecture and an email was sent out from the Office of

Academic Affairs to the remaining students alerting them of the available elective. Students eligible to

participate in the elective and the study were preclinical pharmacy students at the UIC COP Chicago and

Rockford campuses (Pharmacy Year [PY] 1, 2, and 3) who choose to enroll in the elective. Rockford is

a satellite campus and video teleconference was utilized for participation. As this was a pilot curriculum

that is designed to support up to thirty students, the target population are all pharmacy students who

registered for the course (30 students). All enrolled students were offered the opportunity to participate

in this study. The control group consisted of all preclinical students not participating in the mindfulness

curriculum, with a target sample size to match the intervention group size of 30 students. The control

group was comparable to the intervention group in that they will were pre-clinical pharmacy students at

both the Chicago and Rockford campuses and had similar stressors and responsibilities as the

intervention cohort.

Halfway through the semester, Coronavirus Disease 2019 (COVID-19) required distance

learning for all students. Spring break was extended to two weeks, reducing the proposed 8-week course

to 7 weeks. Blackboard Collaborate was utilized for the remaining two classes of the semester.

3.1b Data Collection and Measurements: Survey instruments were pilot tested by fourth year pharmacy

students and first year pharmacy residents to ensure usability and readability prior to administration to

the pre-clinical pharmacy student body. Prior to the course, both intervention and control students filled

out a baseline demographic survey (Appendices A and E). Beyond demographics, the baseline survey

also assessed factors that could contribute to one’s stress, including time commitments outside of school

10 , social network support (adapted from Antoni and colleagues30), stress coping mechanisms, and current

or past use of mindfulness-based exercises.

To assess mindfulness and as a surrogate to measure behavior change, the validated 5 Facet

Mindfulness Questionnaire was used.9 This questionnaire was developed to measure how mindfulness

exerts its beneficial effects through observing, describing, acting with awareness, and nonjudging of and

nonreactivity to inner experience.9 To measure stress, the Perceived Stress Scale (PSS) was used, an

instrument validated to assess stress level in the general population that has been used previously in

pharmacy student populations.2, 11,12 As a reflection of overall well-being, the SF-12 v2 Health Related

Quality of Life Scale was used, a validated tool measuring both mental and physical states of health

often used as a measure of QoL.34 Students participating in the curriculum answered these instruments at

baseline (prior to course), at the end of the course (8 weeks), and four weeks post-course (12 weeks).

Control participants filled out the demographic survey, PSS, and SF-12 v2 at baseline and week 12.

These data were collected through Qualtrics® (Appendices B and E). Control participants were

encouraged to participate at both time points in order to accurately compare their results to the

intervention group. Student participants in the intervention course were also required to submit daily

mindfulness practice logs, indicating the mindfulness activity practiced and the time spent.

At the end of the course, mindfulness curriculum students were invited to participate in semi-

structured interviews (by non-instructor research personnel) regarding their mindfulness experience. The

target participation in interviews was ten students. Interviews were to be audio recorded and transcribed

by non-instructor personnel to ensure anonymity of students. Appendix F shows the questions that were

asked in the semi-structured interviews.

3.1c Outcomes: The primary outcome is the change in 5 Facet Mindfulness Questionnaire in

intervention group from baseline to week 12. Secondary outcomes are listed in Table III.

11

3.1d Scoring and Data Analysis:

The 5 Facet Mindfulness Questionnaire

is scored based on the five facets – observing,

describing, awareness, nonjudging, and

nonreactivity – on a scale of 1 (never or very

rarely true) to 5 (very often or always true),

with higher scores indicating higher levels of

mindfulness. The results correlating to each

facet are averaged to provide the final score for

observing, describing, awareness, nonjudging,

and nonreactivity. The PSS is a 10-item

questionnaire scored from 0 (never) to 4 (very

often), with results summed and ranging from

0-40 and higher scores indicating higher

stress.35 Both the 5 Facet Mindfulness Questionnaire and PSS have several questions that require reverse

scoring, which was done by the principal investigator prior to averaging and summing results. The SF-

12 v2 Health Related Quality of Life Scale consists of a mental health component summary (MCS) and

a physical health component summary (PCS), with higher scores in each component indicating higher

physical and mental health-related quality of life, respectively.34,36 The MCS and PCS are scored using

norm-based methods, with both PCS and MCS having a mean score of 50 in the general US

population.36

Descriptive statistics were used to report on attendance, participation, frequency and time spent

on mindfulness activities outside of class, and the quantitative outcomes of the ratings on the course

Table III. Secondary Outcomes

Quantitative

Outcomes Difference in difference in PSS scores

between the intervention group and the

matched control group at week 12

Difference in SF-12 v2 scores between

intervention group and matched control

group at week 12

Changes in PSS and SF-12 v2 scores in

intervention group from baseline to

weeks 8 and 12

Frequency of attendance

Frequency of types of mindfulness

practice activities done outside of class

over the course

Time spent on each mindfulness activity

outside of class over the entire course

Difference in post-course PSS and SF-12

v2 between Chicago and Rockford

campuses

Evaluation scores of course objectives,

content, instructor, instructional methods,

and applicability for future use

Qualitative

Outcomes Mindfulness activities perceived to have

the highest value

Barriers to practicing mindfulness on

one’s own

Themes regarding student attitude and

beliefs towards mindfulness practice and

its impact on their future pharmacy

practice

Experiences of mindfulness

Identification of unanticipated outcomes

of the mindfulness curriculum

12 evaluations. The 5 Facet Mindfulness Questionnaire, PSS and SF-12 v2 (MCS and PCS) score

comparisons over time within the intervention group were analyzed using paired T-tests. Comparisons

between intervention and control groups were done using the analysis of covariance (ANCOVA).

Quantitative analysis was done using SPSS. Prior to the course, the planned analysis of the interview

data results was by the constant comparative method associated with grounded theory to develop codes

and themes,37,38 with corresponding quotes as applicable. However, the low response rate for the

interview portion limited a more robust qualitative analysis. As a post hoc analysis, investigators

analyzed the free-text results from the course evaluations and stratified themes by New World

Kirkpatrick Model Levels (1 – reaction, 2 – learning, 3 – behavior, and 4 – results) to highlight

effectiveness of mindfulness practice teaching and support quantitative findings.39

3.1e IRB

This study was approved by the University of Illinois at Chicago Institutional Review Board.

Consent was obtained for participation in all aspects of the study, including each survey submission.

13

4. Results

Twenty-five students enrolled and participated in the 7-week mindfulness course. Of those,

eighteen (72%) completed all study surveys and consented to full study inclusion. One student

consented to an interview after the course completion. For the control group, twenty-four participated in

the baseline survey, with twenty (83%) completing the full study. Baseline demographics and survey

responses for both cohorts are shown in Table IV.

Table IV. Baseline Demographics for Participant and Control Groups

Participants, n (%)

(N=25)

Control, n (%)

(N=24)

Demographic

Gender

Female 16 (64%) 17 (71%)

Male 9 (36%) 7 (29%)

Degree

Bachelor’s 20 (80%) 17 (71%)

Associate’s 4 (16%) 2 (8%)

High School 0 3 (13%)

Other 1 (4%) 2 (8%)

Current Pharmacy School Year

First year 10 (40%) 4 (16%)

Second year 14 (56%) 10 (42%)

Third year 1 (4%) 10 (42%)

Time Commitments

Average time spent on pharmacy school coursework outside of class (per day)

Less than 1 hour 1 (4%) 1 (4%)

1 - < 2 hours 4 (16%) 2 (8%)

2 - < 3 hours 10 (40%) 7 (29%)

3 - < 4 hours 5 (20%) 5 (21%)

More than 4 hours 5 (20%) 9 (38%)

Hours worked per week

Do not work 4 (16%) 3 (13%)

Less than 5 hours 2 (8%) 1 (4%)

5 to <10 hours 9 (36%) 11 (46%)

10 to < 15 hours 6 (24%) 7 (29%)

15 to < 20 hours 3 (12%) 2 (8%)

More than 20 hours 1 (4%) 0

Relationship Support30

Do you have someone in your life you feel comfortable sharing your thoughts and feelings (both positive and negative)?

Yes 20 (80%) 18 (75%)

No 3 (12%) 2 (8%)

Unsure 2 (8%) 4 (17%)

Do you have someone in your life you can count on to lend you a hand when you need it (e.g., getting a ride somewhere,

moving furniture, etc.)?

14 Yes 22 (88%) 24 (100%)

No 1 (4%) 0

Unsure 2 (8%) 0

Do you have someone in your life who you enjoy spending your time with (these will probably be the people who make

you feel most positive about yourself)?

Yes 22 (88%) 22 (92%)

No 2 (8%) 1 (4%)

Unsure 1 (4%) 1 (4%)

Do you have someone in your life who you feel truly cares about you and would be supportive of you under almost any

circumstance?

Yes 22 (88%) 22 (92%)

No 2 (8%) 1 (4%)

Unsure 1 (4%) 1 (4%)

Stress Coping Mechanisms

Sleep 21 (84%) 20 (83%)

Spending time with family/friends 19 (76%) 18 (75%)

Exercise 18 (72%) 10 (42%)

Talking about it/debriefing 18 (72%) 16 (67%)

Recreational/relaxation activities 13 (52%) 13 (54%)

Alcohol 7 (28%) 5 (21%)

Spiritual methods 4 (16%) 5 (21%)

Formal counseling or therapy 2 (8%) 3 (13%)

Prescription drugs (anxiolytics,

antidepressants)

1 (4%) 3 (13%)

Meditation/mindfulness techniques 3 (12%) 1 (4%)

Yoga 2 (8%) 1 (4%)

Other 5 (20%) 6 (25%)

Meditation/Mindfulness Experiences

How often do you practice meditation?

Never meditated 16 (64%) 18 (75%)

Do not currently meditate 8 (32%) 5 (21%)

Less than one time per week 0 1 (4%)

1 – 2 times per week 0 0

2 – 3 times per week 1 (4%) 0



More than 7 times per week 0 0

How often do you practice yoga?

Never practiced yoga 8 (32%) 13 (54%)

Do not currently practice yoga 15 (60%) 10 (42%)

Less than one time per week 1 (4%) 0



4 – 5 times per week 1 (4%) 1 (4%)


More than 7 times per week 0 0

How often do you practice mindfulness?

Never practiced mindfulness 19 (76%) 16 (67%)

Do not currently practice mindfulness 3 (12%) 3 (13%)

Less than one time per week 0 2 (8%)

1 – 2 times per week 1 (4%) 2 (8%)


4 – 5 times per week 1 (4%) 1 (4%)


More than 7 times per week 1 (4%) 0

15

4.1 Participant Results

Of the 25 students who completed the course, two students missed one class each, resulting in a

>98% attendance rate. A total of 1067 mindfulness practice events were collected from the 25 students

reporting on their daily mindfulness practice log over the duration of the course. On average, students

spent 11.5 minutes on mindfulness practice per activity outside of class. The most common mindfulness

practice was belly breathing, which students reported practicing 46% of the time. Table V has the

mindfulness practice breakdown.

Table V. Student Reported Practice of Mindfulness (N = 1067 activities)

Mindfulness Practice Activity Number of times activity was reported, n (%)

Belly breathing 493 (46.2%)

Dynamic breathing 223 (20.9%)

Gatha meditation 145 (13.6%)

Walking meditation 86 (8.1%)

Body scan 83 (7.8%)

Guided imagery 80 (7.5%)

Eating meditation 72 (6.7%)

Labeling of thoughts 62 (5.8%)

Loving-kindness meditation 31 (2.9%)

Labeling of feelings 30 (2.8%)

Chair yoga* 8 (0.7%)

Ocean breathing* 5 (0.5%)

Average time spent practicing per mindfulness activity,

min (SD)

11.5 (6)

*Not practiced in class due to COVID-19 cancellations

For the primary outcome, shown in Table VI, students significantly increased scores for the

observing, awareness, nonjudging, and nonreactivity facets of the 5 Facet Mindfulness Questionnaire

from baseline to Week 12. These results were maintained from the end of the course (Week 8).

Table VI: 5 Facet Mindfulness Questionnaire Results from Participants at Baseline, Week 8, and Week 12

5 Facet Mindfulness

Questionnaire

Baseline, mean

(SD)

(n=20)

Week 8, mean

(SD)

(n=20)

P-value (95% CI) Week 12, mean

(SD)

(n=18)

P-value* (95%

CI)

Observing Facet 3.3 (0.67) 3.7 (0.54) P = 0.02 (3.4 – 4.1) 3.5 (0.49) P = 0.02 (3.4 –

4.0)

Describing Facet 3.2 (0.68) 3.5 (1.37) P = 0.25 3.3 (0.78) P = 0.17

16 Awareness Facet 2.6 (0.72) 3.0 (0.67) P = 0.07 3.0 (0.73) P = 0.01 (2.7 –

3.1)

Nonjudging Facet 3.0 (0.67) 3.5 (0.74) P > 0.05 3.4 (0.67) P = 0.03 (3.0 –

3.7)

Nonreactivity Facet 2.9 (0.55) 3.4 (0.63) P = 0.02 (3.0 – 3.7) 3.5 (0.55) P < 0.0001 (3.2 –

3.7)

*P-value compared to baseline

The Perceived Stress Survey results are shown in Table VII. At week 12, PSS scores among

participants were statistically lower than at baseline (p = 0.007).

Table VII: Perceived Stress Survey Results from Participants at Baseline, Week 8, and Week 12

Baseline, mean (SD)

(n=25)

Week 8, mean (SD)

(n=24)

P-value Week 12, mean (SD)

(n=22)

P-value*

20.2 (4.0) 19.0 (5.2) P = 0.19 18.0 (6.4) P = 0.007


The SF-12 v2 Quality of Life scores are shown in Table VIII. At week 8, the MCS was

statistically higher than baseline among participants, and this was maintained through week 12. There

was no difference in the PCS at either week 8 or 12.

Table VIII: SF-12 v2 Mental Health Summary (MCS) and Physical Health Summary (PCS) Score Results from

Participants at Baseline, Week 8, and Week 12

Baseline, mean

(SD)

(n=25)

Week 8, mean

(SD)

(n=23)

P-value (95%

CI)

Week 12, mean

(SD)

(n=22)

P-value* (95%

CI)

MCS 36.7 (9.9) 42.9 (11.1) p = 0.026 (37.5 –

48.2)

45.8 (9.6) P = 0.001 (40.7 –

50.0)

PCS 46.7 (7.0) 47.4 (5.6) P = 0.92 44.7 (7.0) P = 0.330


Course Evaluation results are shown in Figures 2a-c. The majority of students (over 90%) rated

the achievement of learning objectives as excellent or good. Similarly, all students rated instructor

effectiveness as excellent or good. All students agreed that teaching and learning strategies were

effective. Table IX shows the free-text box responses sorted or categorized as a post hoc analysis using

New World Kirkpatrick Model Level.39 Full responses are shown in Appendix G.

17

9%

4%

4%

9%

4%

9%

83%

91%

87%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Objective 3: Integrate mindfulness practice into daily life

Objective 2: Understand the key messages of the practiceof mindfulness (mind-body skills, meditation practice, peerand facilitator interactions) as it relates to being a student

pharmacist

Objective 1: Discuss the benefits of mindfulness in thegeneral public and the healthcare professions population

Figure 2a. Student participant rating of achievement in learning objectives

N=23

Excellent Good Fair Poor

12%

4%

8%

8%

88%

96%

92%

92%

0% 20% 40% 60% 80% 100% 120%

The speaker's knowledge about the topic was:

The organization of the curriculum was:

The speaker's ability to communicate clearly was:

The speaker's ability to answer questions was:

Figure 2b. Student participant rating of instructorN=25

Excellent Good Fair Poor

18

Table IX. Student Evaluation Responses on Learning Experience

Level 1 – Reaction

Degree to which

students find the

course satisfying,

engaging, and

relevant to them

Satisfaction “I loved this class! It was a welcome respite from the busy

“success driven” classes of pharmacy school.”

“[Instructor] is an excellent teacher and this class was great

because of the way she taught it. She has a very calm soothing

voice so it’s easier to do meditations while listening to her”

“Thank you for the wonderful experience, I truly wish there were

a part 2!”

Participant requested “a silent classroom”

“Include more students”

Engagement “The background music really helped me during the session.

Maybe incorporating more sensual things such as therapeutic

scents would be beneficial.”

“Making some reading required rather than optional. Then

having student write a paragraph about what it meant to them, or

answer questions about it to drive the points home.”

“It would help to be able to read the readings that were read

aloud in class. I am a very visual person, so I often got lost while

listening to the dense readings and did not feel like I could

participate in class afterwards.”

“Maybe when the group is sharing at the beginning of class, so

around the room and have everyone either share their experiences

for that particular week of practice or decline to share. I think

this would improve participation while still giving people the

opportunity to decline sharing if they do not want to participate.”

8%

12%

12%

16%

92%

88%

88%

84%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

The educational material presented was well organized

The educational methods illustrated concepts well

The supplementary materials (readings, videos) helpedme apply the content

The teaching strategies were appropriate to attain theobjectives

Figure 2c. Student participant level of agreement for teaching and learning strategies

N=25

Strongly Agree Agree Disagree Strongly Disagree

19 Relevance “I wish more didactic lessons about research on mindfulness

were incorporated”

“I think that some of the studies behind meditation should be

shown earlier in class to help the class get on board with the

message.”

“ I loved that this class focused on personal growth, rather than a

way to further our pharmacy careers, or our professional image.”

“I think the emphasis on consistency was important.”

Level 2 – Learning

Extent to which

students acquire the

intended knowledge,

skills, and have the

confidence and

commitment to

practice these skills

Skill and

attitudes “I never knew WHAT mindfulness is. I now know that it is a

tool I can use to help stay in the present.”

“The different meditation techniques and how not to succumb to

the flowing river of thought.”

“Learning the different meditation techniques and which one

worked best for me helped me dealing with anxiety and

nervousness, especially in the last month.”

“Learning a lifelong skill that I can take with me wherever I go

and whenever I leave the house is truly changing my entire

mental perception of the world around me.”

“The most important thing I learned from this course was being

able to accept myself and others without judgment, and to live in

the present.”

“Definitely have become more aware in situations and know how

to acknowledge the negative feelings that I have but not let them

control me.”

“Learning to control my emotion over frustrat[ing] situation”

Confidence “I learned how to realistically and successfully make changes in

my life, despite how overwhelming or unattainable the changes

might seem.”

“I know that the lessons learned here will help me succeed in

pharmacy school and in my career”

“I have found that this course gave me new skills in order to cope

with stress in life. The techniques were new and very well

explained. They were also simple to add to my daily routine and

have found it very inspiring to keep going for my own benefit.”

Commitment “I have started incorporating a 10-minute mindfulness session

into my morning routine … I also (over the last few days) have

started using the Headspace app, particularly as a way to take

short breaks (10-20 minutes each) during study sessions to give

my mind a break from being active.”

“It is still difficult for me to practice mindfulness daily, so my

goal is to try to incorporate it into my life at least 2-3 times a

week for now. Maybe go for walks or just do deep breathing

when I feel overwhelmed.”

4.2 Participants vs Controls

The comparison between participant and controls for the PSS, MCS, and PCS results at week 12

are shown in Table X. Compared to controls, participants had significantly lower PSS scores at week 12.

20 Participants additionally had higher MCS scores at week 12 compared to controls. There was no

difference between the two groups with regards to PCS scores.

Table X. Comparison of PSS, MCS, and PCS Scores Between Participant and Control Groups at Week 12

Participants (n=22) Control (n=20) P-value

PSS score at Week 12,

mean (SD)

18.0 (6.4) 19.9 (6.6) P=0.037

MCS score at Week 12,

mean (SD)

45.7 (9.6) 36.8 (12.6) P=0.003

PCS score at Week 12,

mean (SD)

44.7 (7.0) 48.7 (8.2) P=0.165

21 5. Changes from Protocol

Several adjustments from the original research protocol must be noted. Firstly, the book students

were encouraged to read was changed to “The Mindful Twenty-Something” by Holly Rogers in the two

weeks’ prior to course initiation. Students were given the course syllabus after this change was made.

The instructor (PI) attended a Koru Mindfulness Training seminar where the book was mandatory

reading and she deemed it more appropriate for class use.

The second deviation from protocol was due to COVID-19 social distancing and shelter-in-place

orders that occurred midway through the course. Student spring break was extended from one to two

weeks, cutting the class meetings from 8 to 7 weeks in duration and in-person teaching were cancelled

for the remainder of the semester. Teaching shifted to online for the last 2 sessions. Students were

encouraged to practice on their own during this time. While the course had previously relied on

teleconferencing to reach the Rockford campus, this adjustment was still profound. Students had

previously met in groups on their respective campuses. After the shelter in place order, students were no

longer meeting face-to-face with their peers.

Due to low participation rate, several outcomes were adjusted. Multivariate analyses were not

performed to control for baseline factors, such as previous mindfulness practice, social network support,

or outside time commitments. Comparisons of survey results were not done between Rockford and

Chicago. As previously mentioned, the response rate for the planned interview sessions was low. Only

one student consented to be interviewed after course completion. The interview data was not included

for analysis as we could not explore the range of students’ experiences. This limited the qualitative data

available for analysis to the free text boxes from the course evaluations.

22 6. Discussion

This research sought to investigate the nature of learning mindfulness among pharmacy students.

Using the theoretical frameworks of the Five Facets of Mindfulness and Social Cognitive Theory, we

sought to understand the learning context that induced behavior change of consistent mindfulness

practice both within and outside the classroom. Using a mixed-methods, case control study design, we

evaluated evidence of learning among pharmacy students who participated in a mindfulness practice

curriculum.

Baseline characteristics collected on student participants provided an understanding of the personal

factors that may have influenced behavior change and learning of mindfulness. The majority of students

who participated in the mindfulness elective were females with bachelor’s degrees in their second year

of pharmacy school. The majority (>80%) reported relationship support in their lives. Eighty percent

spent two or more hours per day on schoolwork outside of class time; furthermore, 76% work greater

than five hours per week. Despite these extraneous time commitments, students still reported practicing

an average of 11.5 minutes per mindfulness activity, which aligned with the course requirements. A

small percentage (<15%) of students reported coping with stress using meditation/mindfulness

techniques, with even less (<8%) currently practicing either technique. The majority of students (76%)

entered the course having never practiced mindfulness previously. Students in the control group had

similar background demographics, though were more likely to be in their third year of pharmacy school.

Most students in the control group had no experience with meditation or mindfulness (75% and 64%,

respectively). For intervention and control groups, the most common method of coping with stress was

reported as sleep (84% and 83%, respectively) and spending time with family/friends (76% and 75%,

respectively).

The primary outcome of this research was to evaluate changes in the 5 Facet Mindfulness

Questionnaire from baseline to 4-weeks post course completion (week 12) as a surrogate for both

23 learning and behavior change due to a mindfulness practice curriculum. Student scores statistically

increased in the observing facet, awareness facet, nonjudging facet, and nonreactivity facet; there was no

statistical increase in the describing facet (Table VI). These results were similar to immediate post

course scores (week 8), indicating a sustained learning and behavior change in mindfulness practice

even after the course was completed. Students reported practicing 11.5 minutes per activity, on average,

which is consistent with previous literature supporting mindfulness benefits.11

The increase in four of the five mindfulness facets corresponded with a statistically significant

decrease in perceived stress as measured by the PSS (Table VII). Interestingly, there was no significant

decrease in stress scores at Week 8, but the difference was seen at Week 12. This could be due to the

COVID-19 outbreak and shelter-in-place orders which had just started around Week 8 but may have

become more normalized by Week 12. With regards to participants’ quality of life, the mental health

component summary (MCS) statistically increased (or improved) by weeks 8 and weeks 12 (Table VIII),

though there was no change in physical health component summary (PCS). Likely the lack of change in

PCS is due to selection bias; participants were young adults in school who were unlikely to have

significant physical health ailments.

When compared to a control group, participants had significantly lower stress levels and higher

mental health-related quality of life at Week 12 (Table X). This further supports the prediction that the

behavior change of practicing mindfulness correlates to the desired benefits of decreased stress and

improved mental quality of life.27 It is important to note that the MCS and PCS for both participants and

controls is lower than the general population (population mean = 50), and this corresponds with other

reports of pharmacy students in the literature.31,32,36 However, this research supports that a mindfulness

curriculum is beneficial, as the intervention group’s MCS increased from 36.7 to 45.8 in 12 weeks with

mindfulness practice.

24 Students rated the achievement of learning objectives in their post-course evaluation (Figure 2a).

While the majority rated achieving the learning objectives highly, there were one or two students who

rated them low, indicating that some aspect of the learning environment – the teacher, their peers, or the

curriculum - was not sufficient to accomplish the desired learning outcomes. It is unclear the factors that

may have contributed to this lack of achievement based on the data collected. However, it is worth

noting that one student who rated the “incorporate mindfulness into daily life” objective as fair indicated

the curriculum could be more effective if the quotes read aloud were also provided in print format.

Based on feedback provided from the class as a whole, adjustments can be done to the learning

curriculum and environment to enhance achievement of learning objectives in the future.

The evidence of learning is highlighted by the 5 Facet Mindfulness Questionnaire, PSS, SF-12

v2 outcomes, and course evaluation results. This research also sought to answer the question how

mindfulness learning occurs and the context that allows this to happen (“how” and “why”). Using a

Design Based Research approach, we had hoped to combine the previously-mentioned quantitative

outcomes with qualitative data through semi-structured interviews of several student participants to test

the SCT and elucidate the learning environment under which mindfulness practice can be

maximized.18,28 Low participation in the interviews caused us to shift our qualitative focus to free text

responses from the post-course evaluations. While these responses are not of the highest rigor for

qualitative analyses purposes, there were several interesting findings that can be expanded upon in the

future.40

The main themes to emerge from the evaluations regarding Level 1 (Reaction) from the New

World Kirkpatrick Model include course content and environmental recommendations, such as more

evidence-based lectures and a silent classroom. These responses also hint at the aids and hindrances in

the learning environment that may have impacted behavior change, such as the instructor’s soothing

voice or too few students to interact with. Indeed, not being required to speak about one’s experiences

25 during group debriefs or a noisy distracting classroom may have contributed to the lack of significant

change in the “describing facet”. Making adjustments to the curriculum based on this feedback may

enhance the learning environment to support even greater commitments to practice and subsequent

changes in behavior.

At Level 2 (Learning), the majority of responses reflect the themes and facets of the mindfulness

practice course. For example, students reported not getting swept up in their feelings/thoughts,

understanding different meditations for different times in their day and lives, and using mindfulness

practice as a tool to stay present and aware. These comments support the findings of statistical change in

the 5 Facet Mindfulness Questionnaire, the PSS, and the MCS of the SF-12 v2. The students report a

commitment to continued use of mindfulness practice, which could also support the significant findings

even weeks after conclusion of the course.

Both the Reaction Level and Learning Level responses support the hypothesis that the learning

environment and explicit mindfulness curriculum would have a large impact on driving behavior change

for practicing mindfulness (out of the three components of SCT). The theme of self-efficacy, or the

confidence in one’s ability to take action and continue to take action,26 is apparent in the responses

regarding one’s learning. The multiple recommendations regarding group discussions highlight the

importance of this classroom structure in aiding mindfulness practice, reflection, and growth.

Finally, there were a few unexpected outcomes found from the mixed-methods approach. It was

interesting to find that the describing facet was the only facet not statistically improved by the end of the

survey period. This could be due to reasons stated above regarding the learning environment.

Additionally, the majority of practices that students reported doing outside of class were belly breathing,

dynamic breathing, and Gatha meditations – none of these techniques require the practice of describing

or identifying one’s thoughts or feelings. In the future, these topics should be emphasized. Also

unexpected was that several students expressed an interest in required or additional assignments that

26 would further support their learning, including required written reflections and required readings.

Leaving readings optional was meant to limit the task burden of these already over-worked students, but

the responses indicate there is utility in the readings provided and a balance should be found in the next

course.

There are several limitations to this study. A few have already been mentioned, including the

course structure change due to COVID-19. Given the course relied heavily on group discussions, this

may have had an impact on the learning environment. Furthermore, the change in lifestyle, uncertainty

about the future, and concern for one’s health were a drastic change that were unforeseen when this

research was conceived and certainly were potential influences on the outcomes of interest (stress and

quality of life). This could have impacted not only learning mindfulness practice, but also independently

influenced one’s stress levels and mental health. However, the purpose of implementing a DBR

approach allows for analysis of the real-world scenarios of teaching and learning, and the outcomes

collected could reflect such a change.18 As many courses go online in this post-COVID era, this

research’s data can be used to support an the logistical success of an online platform for mindfulness

practice. Another limitation was the small sample sizes of the intervention group and control group,

which limited both qualitative and quantitative analyses. For example, an issue with relying on course

evaluation feedback is that it would be skewed towards the learning environment and not illuminate

personal or behavioral factors that may have (and likely did) contribute to one’s behavior change in

practicing mindfulness. Furthermore, course evaluations rarely inspire deep insight and elaboration on

the topics of interest; in this case, the topic of interest being the complex interplay of behavioral,

personal, and environmental factors that influence practicing mindfulness. Our method of analyzing free

text responses is not considered a rigorous qualitative methodology.40 Sample sizes were small and

participants were all volunteers. Such a selection bias may have resulted in intervention participants

having baseline positive attitudes towards practicing mindfulness. Certainly, there were missed themes

27 and facets on “how” and “why” learning truly occurred. However, to my knowledge, this is the first

research attempting to answer how and why learning occurs in mindfulness practice, and thus an area

where any research contributes to the literature. Furthermore, the free text data analysis, while not

scientifically rigorous to stand on its own, supports the quantitative findings as an adjunct analysis.40

28

7. Conclusion

Consistent mindfulness practice among pharmacy students increased mindfulness facets

(observing, awareness, nonjudging, and nonreactivity) from baseline to four weeks post course

completion. Compared to controls, students who practiced mindfulness had statistically lower levels of

stress and higher mental health-related quality of life. Student feedback indicated the class environment

played a significant role in their learning, consistent with the Social Cognitive Theory.

29 8. Curriculum Vitae

Brianna M. McQuade, PharmD, BCACP, MHPE

CURRICULUM VITAE

PERSONAL DATA

1035 W. Van Buren St, Apt 1904

Chicago, IL 60607

Phone: (919) 395-1187

Email: [email protected]

LICENSURE

2013 – Present North Carolina, License # 23420

2015 – Present Massachusetts, License # PH236351

2018 – Present

Illinois, License # 051301170

PROFESSIONAL EXPERIENCE

2020 – Present Clinical Pharmacist, Family Medicine

Substance Use Disorder/Mental Health

University of Illinois Health

Miles Square Health Center (Federally Qualified Health

Clinic)

2018 – Present Clinical Staff Pharmacist, University of Illinois Health

University of Illinois at Chicago

2016 – 2018 Field Medical Director

Dermatology, Inflammation and Immunology Division

Pfizer, Inc.

2015 – 2016 Clinical Pharmacy Specialist in Ambulatory Care

Tufts Medical Center Department of Dermatology

Tufts Medical Center

2013 – 2015 Staff Pharmacist

New Hanover Regional Medical Center

ACADEMIC APPOINTMENTS

2018 – Present Clinical Instructor

University of Illinois at Chicago College of Pharmacy

Department of Pharmacy Practice

EDUCATION

mailto:[email protected]

30

2018 – 2020 Master of Health Professions Education (MHPE)

University of Illinois at Chicago College of Medicine

Department of Medical Education

2009 – 2013 Doctor of Pharmacy

University of North Carolina at Chapel Hill Eshelman

School of Pharmacy

2006 - 2009 Bachelor of Science in Pharmaceutical Sciences

University of North Carolina at Chapel Hill

POST-GRADUATE TRAINING

2018 – 2020 Academic and Family Medicine Research Fellow


Program Director: Jennie B. Jarrett, PharmD, BCPS,

MMedEd

2014 – 2015 Ambulatory Care (PGY2) Pharmacy Residency

New Hanover Regional Medical Center, Wilmington NC

Program Director: Lisa Edgerton, PharmD, BCPS, CPP

2013 – 2014 Pharmacy Practice (PGY1) Residency

New Hanover Regional Medical Center, Wilmington NC

Program Directors: Melissa Blair, BS, PharmD, FCCP,

FASHP, BCPS; Holly Snider, PharmD, BCPS

CERTIFICATION

2016 – Present Board Certified Ambulatory Care Pharmacist (BCACP)

Board of Pharmaceutical Specialties

2013 – Present Advanced Cardiovascular Life Support

American Heart Association

2011 – Present Pharmacist Based Immunization

American Pharmacist Association

HONORS AND

AWARDS

2019 Resident/Fellow Travel Award, American College of Clinical Pharmacy

Ambulatory Care Practice and Research Network

2019 Best MHPE 502 Course Paper Award, UIC MHPE Program

2018 W.E. Upjohn Award, Pfizer, Inc.

31

2015 Residency Teaching Award, New Hanover Regional Medical Center

2012 Clinical Scholars Program, UNC Eshelman School of Pharmacy

2012 Reginald Conway Ferrell Award, Kappa Psi, Inc. Beta Xi Chapter

LEADERSHIP ACTIVITIES

National

American Pharmacist Association Well-being and Resilience Among the Pharmacist

Workforce: A National Consensus Conference

2019 Consensus Member

Local

Pfizer, Inc.

2017 – 2018 Business Technology Leader


2015 – 2016 Member, Resident Advisory Committee

2015 – 2016 Member, Pharmacy Practice Advancement Council

PUBLICATIONS

Primary Literature

1. McQuade BM, Reed BN, DiDomenico RJ, Baker WL, Shipper AG, Jarrett JB. Feeling the

burn? A systematic review of burnout in pharmacists. J Am Coll Clin Pharm. 2020;3:663-675.

https://doi.org/10.1002/jac5.1218

2. McQuade, BM, Jarrett JB, Albright E, Morris L. Should we use zoledronate to reduce

fractures in women with osteopenia? Family Physicians Inquiries Network. Evidence-Based

Practice. 2020.

3. McQuade, BM, Jarrett JB. Dupilumab (Dupixent) for moderate to severe atopic dermatitis.

Family Physicians Inquiries Network. Evidence-Based Practice. 2019.

4. Jarrett, JB, McQuade, BM. Pharmacist burnout: the real dilemma and missing pieces. Am J

Health-Syst Pharm. 2019;76:16:1181-2

5. Noell, C, McQuade, B, Gottlieb A, Rosmarin D. Anti IL-17 flared psoriasis in a patient on

secukinumab. Dermatologic Therapy. 2016;30:e12505

32 6. Rothstein, BE, McQuade, B, Greb, JE, Goldminz, AM, Gottlieb, AB. Apremilast with

secukinumab combined therapy in a patient with recalcitrant plaque psoriasis. J Drugs

Dermatol. 2016;15(5):648-49

7. McQuade, B, Blair, M. Influenza treatment with oseltamivir outside of labeled

recommendations. Am J Health-Syst Pharm. 2015;72:112-6

Book Chapters

1. Manasse, HR, McQuade BM, Jarrett JB. (2019). Needs-Based Education in Pharmacy. In

Zaheer-Ud-Din-Barbar (Ed.), Encyclopedia of Pharmacy Practice and Clinical Pharmacy.

Academic Press.

Miscellaneous Projects/Publications (Non-Peer Reviewed)

1. McQuade BM, Jarrett JB. Mindfulness for Pharmacy Students: A New Curriculum.

Education and Training Practice and Research Network (PRN) Newsletter. American College

of Clinical Pharmacy. Fall 2019.

2. McQuade B. FDA lifts restrictions on rosiglitazone prescribing. New Hanover Regional

Medical Center Pharmagram. Feb 2014

3. McQuade B. FDA updates on APAP labeling. New Hanover Regional Medical Center

Pharmagram. Nov 2013.

4. McQuade B. Clopidogrel with aspirin in acute minor stroke/TIA: CHANCE trial. New

Hanover Regional Medical Center Pharmagram. August 2013.

GRANT FUNDING

Current Funding

Substance Abuse and Mental Health Services Administration

Title: Substance Use Disorder Screening, Evaluation, and Treatment Education: the SUB-SET

Program

Grant amount: $478,998 Role: Key Personnel 2010 – 2023

American College of Clinical Pharmacy Adult Medicine PRN Seed Grant

Title: Do You Mind? A Mindfulness Curriculum for the Pharmacy Workforce

Grant amount: $2,500.00 Role: Co-Investigator 2019 – 2020

Health Resources and Services Administration – Geriatric Workforce Enhancement Program (HRSA-

GWEP)

Title: SAFE - Home Opioid Management Education in Older Adults: Naloxone Awareness Program

Grant Amount: $125,000.00 Role: Key Personnel 2019 – 2024

American College of Clinical Pharmacy (ACCP) Ambulatory Care PRN Innovation Grant

Title: Stratification on Burnout in Health Systems Pharmacists: A Focus on the Ambulatory Care

Pharmacist

Grant Amount: $2,000.00 Role: Co-Investigator 2019 – 2020

33

Past Funding

University of Illinois at Chicago College of Pharmacy Vahlteich Research Award

Title: Entrustable Professional Activities Assessment within Experiential Curricula: A Primer for

Evaluation


Health Resources and Services Administration – Geriatric Workforce Enhancement Program (HRSA-

GWEP)

Title: An Opioid Prescription Tool to address Optimal Utilization of Treatment: OPT-OUT Initiative


Patient-Centered Outcomes Research Institute (PCORI)

Title: Patient Empowered Strategy to Reduce Asthma Morbidity in Highly Impacted Populations

(PREPARE)


American College of Clinical Pharmacy Adult PRN Seed Grant

Title: Combating Implicit Bias in the Healthcare Team: A Pharmacist’s Role

Grant amount: $5,000.00 Role: Co-Investigator 2018 – 2019

LECTURES/PRESENTATIONS

International

1. Stranges PM, McQuade BM, Akinwunmi BO, Chang KL, Chupp GL, Coleman E, Dolor RJ,

Estrom J, Hernandez ML, Hurley LP, Kuczak J, Jarrett JB, Nunez A, Mottus K, Riley IL, Pace

WD, Shade LE, Thomas J, on behalf of all PREPARE Investigators. “Guideline concordant

care among highly impacted adults with asthma at the time of screening for a randomized

controlled trial.” North American Primary Care Research Group (NAPCRG) Annual Meeting.

Poster Presentation. Toronto, Canada. November 2019.

2. Jarrett, JB, McQuade BM, Ballard S, Lounsbery J. “Integration and Optimization of Clinical

Pharmacists as Clinician-Educators and Faculty Members Within Family Medicine Residency

Programs”. Society of Teachers of Family Medicine Annual Meeting. Platform Presentation.

Toronto, Canada. April 2019.

3. McQuade BM, Koronkowski M, Jarrett JB. “Home Opioid Management Education in Older

Adults (SAFE-HOME): Naloxone Awareness Program”. Society of Teachers of Family

Medicine Annual Meeting. Platform Presentation. Toronto, Canada. April 2019.

4. McQuade BM, Koronkowski M, Gruss V, Hasnain M, Jarrett JB. “The Opioid Prescription

Tool to address Optimal Utilization of Treatment (OPT-OUT) Initiative: Interprofessional

Collaborations for Engaging Community Pharmacies in Patient Education on Safe Opioid

Practices”. Society of Teachers of Family Medicine Annual Meeting. Roundtable

Presentation. Toronto, Canada. April 2019.

34

5. McQuade BM, Jarrett JB. “Tadpole Tank for Family Medicine: Real-time Feedback for

Primary Care Research Ideas”. Society of Teachers of Family Medicine (STFM) Annual

Spring Conference, Toronto, Canada. April 2019.

National

1. McQuade BM, Lounsbery J, Ballard S, Jarrett JB. “Creating an online resource for

optimization of pharmacists as clinician-educators within Family Medicine Residency

Programs.” Society of Teachers of Family Medicine Annual Meeting. Online Virtual

Presentation. July 2020.

2. Jarrett JB, McQuade BM. “A Mindfulness-Based Approach to Mitigating Burnout in Clinical

Pharmacists.” American Society of Health-System Pharmacists Midyear Clinical Meeting. Las

Vegas, NV. Platform Presentation. December 2019.

3. Jarrett JB, McQuade BM. “Burnout and Stress Reduction: An Approach for Pharmacy

Students.” American Society of Health-System Pharmacists Midyear Clinical Meeting. Las

Vegas, NV. Platform Presentation. December 2019.

4. McQuade BM, Kuczak JM, Jarrett JB, Stranges PM. “Guideline Concordant Care Among

Highly Impacted Adults With Asthma the Year Leading Up To Enrollment in a Large

Pragmatic Asthma Randomized Controlled Trial, Person Empowered Asthma Relief

(PREPARE).” American Society of Health-System Pharmacists Midyear Clinical Meeting.

Las Vegas, NV. Poster Presentation. December 2019.

5. McQuade BM, Bauer J. “Mindfulness for Stress Reduction in Pharmacy Faculty.” American

Association of Colleges of Pharmacy Annual Meeting. Chicago, IL. Platform Presentation.

July 2019.

6. McQuade BM, Allen S, Choye M, Jarrett JB. “Utilization of Entrustable Professional

Activities to Develop Professional Identity and Reflective Learning Skills”. American

Association of Colleges of Pharmacy Annual Meeting, Chicago, IL. Poster Presentation. July

2019.

7. McQuade BM, Jarrett JB. “Bright Spot Topic: Pharmacist Integration into Family Medicine

Practice: Practical Pearls”. Society of Teachers of Family Medicine (STFM) Conference on

Practice Improvement. Invited Platform Presentation. Tampa, FL. December 2018.

8. McQuade BM, Jarrett JB. “An opioid toolkit for safe and appropriate prescribing and

deprescribing”. Society of Teachers of Family Medicine (STFM) Conference on Practice

Improvement. Platform Presentation. Tampa, FL. December 2018.

9. McQuade B, Edgerton L. “Impact of a pharmacist on Medicare Annual Wellness Visits in a

family medicine clinic.” American Society of Health-System Pharmacists Midyear Meeting.

Poster Presentation. Anaheim, CA. December 2014.

10. McQuade B, Cosby S. “Implementation of a decentralized pharmacy technician into direct

patient care activities in a community teaching hospital.” American Society of Health-System

Pharmacists Midyear Meeting. Poster Presentation. Orlando, FL. December 2013.

35

Local/Regional

1. McQuade BM. “Mindfulness Practice for Stress Reduction.” American Association of

University Women/Oklahoma Biennial 2020 Virtual Convention. Invited Presentation. July

2020.

2. McQuade BM. “Naloxone for reversal of opioid overdose.” University of Illinois at Chicago

College of Pharmacy. Continuing Education Presentation. March 2020.

3. McQuade BM. “Burnout and Stress Reduction: An Approach for Pharmacy Students.”

University of Illinois at Chicago College of Pharmacy. Introduction to Pharmacy Practice

Course. November 2019.

4. McQuade BM. “Pharmacist Burnout: How Do We Stop the Burn?” Chicago State University

Preceptor Appreciation Meeting. Invited Continuing Education Lecture. October 2019.

5. McQuade BM. “Pharmacist Burnout: How Do We Stop the Burn?” University of Illinois at

Chicago College of Pharmacy Continuing Education Department. Live Continuing Education

Lecture June 2019. Online CE Lecture July 2019 – Present.

6. McQuade BM. “What’s the Difference Between PGY1 Residency, PGY2 Residency, and

Fellowship?” Topics and Issues in Post-Graduate Training. University of Illinois at Chicago

College of Pharmacy. September 2019.

7. McQuade BM. “Medication reconciliation.” University of Illinois at Chicago College of

Pharmacy Introduction to Patient Care Course. Online Lecture. February 2019.

8. McQuade BM. “Interviewing 101.” Topics and Issues in Post-Graduate Training. University

of Illinois at Chicago College of Pharmacy. April 2019.

9. McQuade BM, Eades A. “Topical medications.” University of Illinois at Chicago College of

Pharmacy Introduction to Pharmacy Practice Course. Lecture. September 2018.

10. McQuade BM, Merchant A, Narajeenron K, Ross S. “Integrating Team Based Learning in a

Health Professional Wellness Curriculum.” University of Illinois at Chicago College of

Medicine Department of Medical Education MHPE 502 Course. Lecture and Small Group

Facilitation. August 2018.

11. McQuade BM. “Overview of clinical prescribing information of crisaborole ointment 2% and

atopic dermatitis disease state review.” Pfizer, Inc. Lecture. January 2017 – June 2018.

12. McQuade BM. “Presentation of investigator-initiated research.” Pfizer, Inc. Research

Presentations. February 2017 – April 2018.

13. McQuade BM. “Ambulatory Care Pharmacy Practice at Tufts.” Tufts Medical Center

Department of Pharmacy Practice. Continuing Education Lecture. September 2016.

36 14. McQuade B, Edgerton L. “Impact of a pharmacist on Medicare annual Wellness Visits in a

family medicine clinic.” University of North Carolina Research in Education and Practice

Symposium, Chapel Hill NC. Research Presentation. May 2015.

15. McQuade BM. “Medication use in the elderly.” New Hanover Regional Medical Center

Family Medicine Residency Program. Lecture. April 2015.

16. McQuade BM. “Long acting anticholinergics: a breath of fresh air in asthma.” New Hanover

Regional Medical Center Department of Pharmacy. Continuing Education Lecture. November

2014.

17. McQuade BM. “Dermatology medications.” New Hanover Regional Medical Center Family

Medicine Residency Program. Lecture. August 2014.

18. McQuade BM. “Hyperglycemic crises.” New Hanover Regional Medical Center Internal

Medicine Residency Program. Clinical Pearl Discussion. June 2014.

19. McQuade B, Cosby S. “Implementation of a decentralized pharmacy technician into direct

patient care activities in a community teaching hospital.” Southeastern Residency Conference

(SERC), Athens GA. Research Presentation. May 2014.

TEACHING EXPERIENCE


Experiential

Introductory & Advanced Pharmacy Practice Experiences (IPPE & APPE)

2018 – Present Introduction to Patient Care (PHAR 414) Coordinating Assistant

Didactic

2020 – Present Mindfulness Practice for Pharmacy Students: Course Coordinator

2018 – Present Topics and Issues in Post-Graduate Training: Invited Lecturer

2018 – Present Introduction to Patient Care: Invited Lecturer

Residency Programs

2018 – Present Pharmacy Residency Program (PGY1) Noon Report Facilitator

Pfizer, Inc.

Didactic/Experiential

2016 – 2018 Commercial Team Educator


Experiential

2016 Asthma and COPD: Case Base Review Coordinator

2016 Discharge Counseling Cases Co-Coordinator

37 Residency Programs

2016 Resident Patient-Case Discussion Series Facilitator

OTHER PROFESSIONAL ACTIVITIES

Conference Content/Grant Reviewer

2020 American Society of Health-System Pharmacists Midyear Clinical Meeting

Submission Reviewer

2019 American Association of Colleges of Pharmacy (AACP) New Investigator

Award

Manuscript Reviewer

2019 – Current Dermatologic Therapy

2019 – Current Currents in Pharmacy Teaching and Learning

2018 – Current Journal of the American College of Clinical Pharmacy

2018 – Current Pharmacotherapy

2018 – Current Journal of the American Pharmacist Association

ORGANIZATIONAL MEMBERSHIP

2018 – Present American Association of Colleges of Pharmacy (AACP)

2018 – Present Society of Teachers of Family Medicine (STFM)

2016 – Present American College of Clinical Pharmacy (ACCP)

2019 – 2020: Member, Ambulatory Care PRN Research Process

Committee

2012 – Present American Society of Health-System Pharmacists (ASHP)

COMMITTEE MEMBERSHIP


2015 – 2016 Resident Advisory Committee

New Hanover Regional Medical Center

2013 – 2015 Pharmacy Practice Advancement Council

PROFESSIONAL AND COMMUNITY SERVICE

Professional Service

2018 – Present University of Illinois at Chicago Flu Shot Clinic Preceptor

38

2018 UIC Community Health Fair Preceptor

Community Service

2015 – 2017 AIDS Walk Boston

39

11. Citations

1. Marshall LL, Allison A, Nykamp D, Lanke S. Perceived Stress and Quality of Life Among Doctor

of Pharmacy Students. Am J Pharm Educ. 2008;72(6):137. doi:10.5688/aj7206137

2. Beall J, DeHart R, Riggs R, Hensley J. Perceived Stress, Stressors, and Coping Mechanisms among

Doctor of Pharmacy Students. Pharmacy. 2015;3(4):344-354. doi:10.3390/pharmacy3040344

3. Hirsch JD, Do AH, Hollenbach KA, Manoguerra AS, Adler DS. Students’ Health-Related Quality

of Life Across the Preclinical Pharmacy Curriculum. Am J Pharm Educ. 2009;73(8):147.

doi:10.5688/aj7308147

4. Ried LD, Motycka C, Mobley C, Meldrum M. Comparing Self-reported Burnout of Pharmacy

Students on the Founding Campus With Those at Distance Campuses. Am J Pharm Educ.

2006;70(5):114. doi:10.5688/aj7005114

5. Kaur M, Long JW, Luk FS, et al. Burnout and Engagement in Doctor of Pharmacy Students: Its

Relation to Perception of Academic Ability. Am J Pharm Ed. 2020;84(4).

6. Hölzel BK, Lazar SW, Gard T, Schuman-Olivier Z, Vago DR, Ott U. How Does Mindfulness

Meditation Work? Proposing Mechanisms of Action From a Conceptual and Neural Perspective.

Perspect Psychol Sci. 2011;6(6):537-559. doi:10.1177/1745691611419671

7. Eisler M. What’s the difference between meditation and mindfulness? Chopra Cent. Published

online 2018. https://chopra.com/articles/whats-the-difference-between-meditation-and-mindfulness

8. Daly A. What’s actually the difference between mindfulness and meditation? Womens Health Mag.

Published online 2017. Accessed December 19, 2019.

https://www.womenshealthmag.com/life/a19941792/mindfulness-vs-meditation/

9. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using Self-Report Assessment Methods

to Explore Facets of Mindfulness. Assessment. 2006;13(1):27-45. doi:10.1177/1073191105283504

10. Khoury B, Lecomte T, Fortin G, et al. Mindfulness-based therapy: A comprehensive meta-analysis.

Clin Psychol Rev. 2013;33(6):763-771. doi:10.1016/j.cpr.2013.05.005

11. Greeson JM, Juberg MK, Maytan M, James K, Rogers H. A Randomized Controlled Trial of Koru:

A Mindfulness Program for College Students and Other Emerging Adults. J Am Coll Health.

2014;62(4):222-233. doi:10.1080/07448481.2014.887571

12. O’Driscoll M, Byrne S, Mc Gillicuddy A, Lambert S, Sahm LJ. The effects of mindfulness-based

interventions for health and social care undergraduate students – a systematic review of the

literature. Psychol Health Med. 2017;22(7):851-865. doi:10.1080/13548506.2017.1280178

13. O’Driscoll M, Byrne S, Kelly M, Lambert S, Sahm LJ. A Thematic Analysis of Pharmacy

Students’ Experiences of the Undergraduate Pharmacy Degree in Ireland and the Role of

Mindfulness. Am J Pharm Educ.:10.

40 14. O’Driscoll M. Mindfulness Training of Pharmacy Undergraduate Students in University College

Cork (UCC) – Quantitative Results of a Mixed Methods Study. :15.

15. Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness,

medical and psychological symptoms and well-being in a mindfulness-based stress reduction

program. J Behav Med. 2008;31(1):23-33. doi:10.1007/s10865-007-9130-7

16. Hamilton DR. How Meditation Affects the Gray Matter of the Brain. Huffington Post. Published

online October 2010:2.

17. Begley S. The Brain: How The Brain Rewires Itself. Time. Published online January 19, 2007:4.

18. Dolmans DHJM, Tigelaar D. Building bridges between theory and practice in medical education

using a design-based research approach: AMEE Guide No. 60. Med Teach. 2012;34(1):1-10.

doi:10.3109/0142159X.2011.595437

19. Baer RA. Mindfulness Training as a Clinical Intervention: A Conceptual and Empirical Review.

Clin Psychol Sci Pract. 2003;10(2):125-143. doi:10.1093/clipsy.bpg015

20. Hayes SC, Plumb JC. Mindfulness from the Bottom Up: Providing an Inductive Framework for

Understanding Mindfulness Processes and their Application to Human Suffering. Psychol Inq.

2007;18(4):242-248. doi:10.1080/10478400701598314

21. Brown KW, Ryan RM, Creswell JD. Mindfulness: Theoretical Foundations and Evidence for its

Salutary Effects. Psychol Inq. 2007;18(4):211-237. doi:10.1080/10478400701598298

22. Bronson K. Using mindfulness to decrease burnout and stress among nurses working in high

intensity areas. Published online 2017. https://cdr.lib.unc.edu/downloads/w9505128s?locale=en

23. Beattie M, Hankonen N, Salo G, Knittle K, Volanen S-M. Applying Behavioral Theory to Increase

Mindfulness Practice Among Adolescents: an Exploratory Intervention Study Using a Within-Trial

RCT Design. Mindfulness. 2019;10(2):312-324. doi:10.1007/s12671-018-0976-2

24. Petiprin A. Pender’s Health Promotion Model. Nurs Theory. Published online 2016. Accessed

January 24, 2020. https://nursing-theory.org/theories-and-models/pender-health-promotion-

model.php

25. Arevalo M, Brown LD. Using a reasoned action approach to identify determinants of organized

exercise among Hispanics: a mixed-methods study. BMC Public Health. 2019;19(1):1181.

doi:10.1186/s12889-019-7527-1

26. Office of Behavioral and Social Sciences Research. Social and behavioral theories. Natl Inst

Health. Accessed December 10, 2019. https://obssr.od.nih.gov/wp-content/uploads/2016/05/Social-

and-Behavioral-Theories.pdf

27. Bandura A. Social cognitive theory. In: Annals of Child Development. Vol 6. JAI Press; 1989:1-60.

28. Barab S, Squire K. Design-Based Research: Putting a Stake in the Ground. J Learn Sci.

2004;13(1):1-14. doi:10.1207/s15327809jls1301_1

41 29. Kern DE, Thomas PA, Hughes MT. Curriculum Development for Medical Education: A Six-Step

Approach. Vol 2nd edition. The Johns Hopkins University Press; 2009.

30. Antoni MH, Ironson G, Schneiderman N. Social support network questionnaire. In: Cognitive-

Behavioral Stress Management: Workbook. Oxford University Press; 2007.

https://www.oxfordclinicalpsych.com/view/10.1093/med:psych/9780195327908.001.0001/med-

9780195327908

31. Marshall LL, Allison A, Nykamp D, Lanke S. Perceived Stress and Quality of Life Among Doctor

of Pharmacy Students. Am J Pharm Educ. 2008;72(6):137. doi:10.5688/aj7206137

32. Beall JW, DeHart RM, Riggs RM, Hensley J. Perceived Stress, Stressors, and Coping Mechanisms

among Doctor of Pharmacy Students. Pharmacy. 2015;3(4):344-354.

33. Cohen S, Janicki-Deverts D. Who’s Stressed? Distributions of Psychological Stress in the United

States in Probability Samples from 1983, 2006, and 20091: PSYCHOLOGICAL STRESS IN THE

U.S. J Appl Soc Psychol. 2012;42(6):1320-1334. doi:10.1111/j.1559-1816.2012.00900.x

34. Ware JE, Krosinksi M, Keller SD. A 12-Item Short-Form Health Survey: Construction of Scales

and Preliminary Tests of Reliability and Validity. Med Care. 1996;34(3):15.

35. Cohen S. Perceived Stress Scale. Mind Gard. Published online 1994. Accessed August 15, 2019.

http://www.mindgarden.com/documents/PerceivedStressScale.pdf

36. Ware JE, Kosinski M, Keller S. SF-12: How to Score the SF012 Physical and Mental Health

Summary Scales. 2nd ed. The Health Institute, New England Medical Center; 1995.

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paperback printing. Aldine; 2009.

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Developing Grounded Theory. SAGE Publications, Inc.; 2008. doi:10.4135/9781452230153

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he%20Kirkpatrick%20New%20World%20Model.pdf

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Rigorous Qualitative Insights: Acad Med. 2018;93(3):347-349.

doi:10.1097/ACM.0000000000002088

42 12. Appendices

A. Student Mindfulness Baseline Survey_Participants

Start of Block: Default Question Block

Q1 Mindfulness Survey Electronic Consent Form We are asking you to participate in a study about the impact of the practice on mindfulness on stress during pharmacy school. This study will help us learn how using mindfulness as a part of the pharmacy curriculum may help improve the wellness of students. What is the reason for this study? This study will assess whether providing instruction in the practice of mindfulness as a part of the pharmacy curriculum will reduce the stress levels of students and improve their overall well-being. What are you asking me to do? We will ask you to participate in a series of surveys that are designed to collect background information about you as well as assess your perceptions about stress levels. You will take the first survey at the beginning of this course, the second at the end of the course, and a third and final survey four weeks after the end of the course. These surveys will be independently administered as a course requirement; however you may either consent to allow your responses to be additionally used for research purposes or decline to exclude your responses from this study. How will you use my information? We will keep your responses confidential. Only the researchers will see your responses. We ask for your university ID number (UIN) to link your surveys. Once we link your two surveys, we will remove your UIN. We will only share information with the public about the whole study, not specific people. We keep all personal information and survey data in a password-protected computer in a locked office. Am I required to do this study? It is your choice to take part in this study. You can stop at any time. Your choice will in no way impact any grade that you will earn for this course. How do I benefit from this study? We do not anticipate any personal benefits to participants for allowing their responses to be used for research purposes. Are there any risks? We do not expect any risks or discomfort related to the survey. You can skip any questions that you don’t want to answer. Your decision on whether or not to participate in the study will in no way affect any grade that you receive for this course. What if I have questions? If you have questions, please contact: Dr. Jennie Jarrett Phone: 312-996-1098 Email: [email protected] The University of Illinois at Chicago Institutional Review Board (UIC IRB) has approved this survey. For any questions about your rights, call UIC IRB at 312-996-1711. By checking the appropriate box below, you agree that: ● You have read this information ● You understand this information ● You understand that your responses are confidential and whether you choose to participate or not will not impact the grade you receive in this course in any way ● By

43 checking the “I agree” statement, you understand that you are providing your consent for your responses to be used for the purposes of research in addition to being used for course work.

o I consent to release my survey responses for the purposes of research (1)

o I do not consent to release my responses to this survey for the purposes of research (2)

Page Break

44 Q94 What is your UIN?

________________________________________________________________

Q2 What is your gender?

o Male (1)

o Female (2)

o Other (3) ________________________________________________

o Prefer not to answer (4)

Q3 What is your highest degree?

o High School Degree (1)

o Bachelor's Degree (2)

o Master's Degree (3)

o Doctorate Degree (4)

o Other (please specify): (5) ________________________________________________

Q4 What is your year in pharmacy school?

o P1 (1)

o P2 (2)

o P3 (3)

45 Q95 By the end of this mindful course, I am hoping to:

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

Page Break

46 Q9 The following questions are regarding your relationship and support networks. Adapted from Personal Stress Management Program: Oxford Clinical Psychology 2006

Q5 Do you have someone in your life you feel comfortable sharing your thoughts and feelings (both positive and negative)?

o Yes (1)

o No (2)

o Unsure (3)


Q6 Do you have someone in your life you can count on to lend you a hand when you need it (e.g., getting a ride somewhere, moving furniture, etc.)?

o Yes (1)

o No (2)

o Unsure (3)


47 Q7 Do you have someone in your life who you enjoy spending your time with (these will probably be the people who make you feel most positive about yourself)?

o Yes (1)

o No (2)

o Unsure (3)


Q8 Do you have someone in your life who you feel truly cares about you and would be supportive of you under almost any circumstance?

o Yes (1)

o No (2)

o Unsure (3)


Page Break

48 Q10 The following questions are regarding your time commitments.

Q11 How much time do you spend outside of pharmacy school on coursework on an average day? Do not include time spent on rotation.

o Less than 1 hour (1)

o 1 - (2)

o 2 - (3)

o 3 - (4)

o More than 4 hours (5)

Q12 Do you have a job outside of pharmacy school requirements?

o Yes (1)

o No (2)

Skip To: Q14 If Do you have a job outside of pharmacy school requirements? = No

Q13 How many hours per week do you work?

o Less than 5 hours (1)

o 5 - (2)

o 10 - (3)

o 15 - (4)


49 Page Break

50 Q15 The following question addresses how you deal with stress

Q14 Select the coping strategies you use to deal with stress. Select all that apply.

▢ Exercise (1)

▢ Spending time with family/friends (2)

▢ Talking about it/debriefing (3)

▢ Sleep (4)

▢ Alcohol (5)

▢ Prescription drugs (e.g., anxiolytics, antidepressants) (6)

▢ Formal counseling or therapy (7)

▢ Spiritual methods (e.g., prayer, house of worship) (8)

▢ Recreational/relaxation activities (9)

▢ Meditation or mindfulness techniques (10)

▢ Yoga (11)

▢ Other (specify): (12) ________________________________________________

Page Break

51 Q16 The following questions ask about your experience with meditation, yoga, and mindfulness practice (the practice of focusing on the present moment, with compassion and without judgment).

Q17 Have you ever practiced meditation?

o Yes (1)

o No (2)

Skip To: Q20 If Have you ever practiced meditation? = No

Q18 Do you currently meditate?

o Yes (1)

o No (2)

Skip To: Q20 If Do you currently meditate? = No

Q19 How often per week do you meditate?

o Less than once a week (1)

o 1 - 2 times per week (2)




o More than 7 times per week (6)

52 Q20 Have you ever practiced yoga?

o Yes (1)

o No (2)

Skip To: Q23 If Have you ever practiced yoga? = No

Q21 Do you currently practice yoga?

o Yes (1)

o No (2)

Skip To: Q23 If Do you currently practice yoga? = No

Q22 How often per week do you practice yoga?







Q23 Have you ever practiced mindfulness? Mindfulness practice is the practice of focusing on the present moment, bringing awareness to thoughts and feelings, with compassion and without judgment.

o Yes (1)

o No (2)

Skip To: Q26 If Have you ever practiced mindfulness? Mindfulness practice is the practice of focusing on the pres... = No

53

Q24 Do you currently practice mindfulness?

o Yes (1)

o No (2)

Skip To: Q37 If Do you currently practice mindfulness? = No

Q25 How often per week do you practice mindfulness?







Page Break

54 Q37 The following questions ask you to rate your level of mindfulness. Choose the number that best describes your own opinion of what is generally true for you. 5 Facet Mindfulness Questionnaire. Baer et al. 2006.

Q38 1. When I'm walking, I deliberately notice the sensations of my body moving.

o 1 - Never true to or very rarely true (1)

o 2 - Rarely true (2)

o 3 - Sometimes true (3)

o 4 - Often true (4)

o 5 - Very often or always true (5)

Q39 2. I'm good at finding words to describe my feelings.






55 Q40 3. I criticize myself for having irrational or inappropriate emotions.






Q41 4. I perceive my feelings and emotions without having to react to them.






Q42 5. When I do things, my mind wanders off and I'm easily distracted.






56 Q43 6. When I take a shower or bath, I stay alert to the sensations of water on my body.






Q44 7. I can easily put my beliefs, opinions and expectations into words.






Q45 8. I don't pay attention to what I'm doing because I'm daydreaming, worrying, or otherwise distracted.






57 Q46 9. I watch my feelings without getting lost in them.






Q47 10. I tell myself I shouldn't be feeling the way I'm feeling.






Q48 11. I notice how foods and drinks affect my thoughts, bodily sensations, and emotions.






58 Q49 12. It's hard for me to find the words to describe what I'm thinking.






Q50 13. I am easily distracted.






Q51 14. I believe some of my thoughts are abnormal or bad and I shouldn't think that way.






59 Q52 15. I pay attention to sensations, such as the wind in my hair or sun on my face.






Q53 16. I have trouble thinking of the right words to express how I feel about things.






Q54 17. I make judgments about whether my thoughts are good or bad.






60 Q55 18. I find it difficult to stay focused on what's happening in the present.






Q56 19. When I have distressing thoughts or images, I "step back" and am aware of the thought or image without getting taken over by it.






Q57 20. I pay attention to sounds, such as clocks ticking, birds chirping, or cars passing.






61 Q58 21. In difficult situations, I can pause without immediately reacting.






Q59 22. When I have a sensation in my body, it's difficult for me to describe it because I can't find the right words.






Q60 23. It seems I am "running on automatic" without much awareness of what I am doing.






62 Q61 24. When I have distressing thoughts or images, I feel calm soon after.






Q62 25. I tell myself that I shouldn't be thinking the way I'm thinking.






Q63 26. I notice the smells and aromas of things.






63 Q64 27. Even when I'm feeling terribly upset, I can find a way to put it into words.






Q65 28. I rush through activities without being really attentive to them.






Q66 29. When I have distressing thoughts or images I am able to just notice them without reacting.






64 Q67 30. I think some of my emotions are bad or inappropriate and I shouldn't feel them.






Q68 31. I notice visual elements in art or nature, such as colors, shapes, textures, or patterns of light and shadow.






Q69 32. My natural tendency is to put my experiences into words.






65 Q70 33. When I have distressing thoughts or images, I just notice them and let them go.






Q71 34. I do jobs or tasks automatically without being aware of what I'm doing.






Q72 35. When I have distressing thoughts or images, I judge myself as good or bad, depending what the thought/image is about.






66 Q73 36. I pay attention to how my emotions affect my thoughts and behavior.






Q74 37. I can usually describe how I feel at the moment in considerable detail.






Q75 38. I find myself doing things without paying attention.






67 Q76 39. I disapprove of myself when I have irrational ideas.






Page Break

68 Q26 The following questions ask you to rate your level of stress for the past month. For each question, choose from the following: 0 - never 1 - almost never 2 - sometimes 3 - fairly often 4 - very often Perceived Stress Scale. Cohen

Q27 1. In the last month, how often have you been upset because of something that happened unexpectedly?

o 0 - Never (1)

o 1 - Almost Never (2)

o 2 - Sometimes (3)

o 3 - Fairly Often (4)

o 4 - Very often (5)

69 Q28 2. In the last month, how often have you felt that you were unable to control the important things in your life?

o 0 - Never (1)


o 2 - Sometimes (3)



Q29 3. In the last month, how often have you felt nervous and stressed?

o 0 - Never (1)


o 2 - Sometimes (3)



Q30 4. In the last month, how often have you felt confident about your ability to handle your personal problems?

o 0 - Never (1)


o 2 - Sometimes (3)



70 Q31 5. In the last month, how often have you felt that things were going your way?

o 0 - Never (1)


o 2 - Sometimes (3)



Q32 6. In the last month, how often have you found that you could not cope with all the things you had to do?

o 0 - Never (1)


o 2 - Sometimes (3)



Q33 7. In the last month, how often have you been able to control irritations in your life?

o 0 - Never (1)


o 2 - Sometimes (3)



71 Q34 8. In the last month, how often have you felt that you were on top of things?

o 0 - Never (1)


o 2 - Sometimes (3)



Q35 9. In the last month, how often have you been angered because of things that happened that were outside of your control?

o 0 - Never (1)


o 2 - Sometimes (3)



Q36 10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?

o 0 - Never (1)


o 2 - Sometimes (3)



72

Page Break

73 Q77 The following questions asks for your views about your health. Answer each question by choosing just one answer. If you are unsure how to answer a question, please give the best answer you can. Short Form 12-Item (short) Questionnaire.

Q78 1. In general, would you say your health is:

o Excellent (1)

o Very Good (2)

o Good (3)

o Fair (4)

o Poor (5)

Q79 The following questions are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?

Q80 2. Moderate activities such as moving a table, pushing a vacuum cleaner, bowling, or playing golf

o YES, limited a lot (1)

o YES, limited a little (2)

o NO, not limited at all (3)

74 Q82 3. Climbing several flights of stairs




Q81 During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of your physical health?

Q83 4. Accomplished less than you would like.

o Yes (1)

o No (2)

Q84 5. Were limited in the kind of work or other activities.

o Yes (1)

o No (2)

Q85 During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as a result of any emotional problems (such as feeling depressed or anxious)?


o Yes (1)

o No (2)

75 Q87 7. Did work or activities less carefully than usual.

o Yes (1)

o No (2)

Q88 8. During the past 4 weeks, how much did pain interfere with your normal work (including work outside the home and housework)?

o Not at all (4)

o A little bit (5)

o Moderately (6)

o Quite a bit (7)

o Extremely (8)

Q89 These questions are about how you have been feeling during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling.

Q90 9. How much of the time during the past 4 weeks have you felt calm and peaceful?

o All of the time (1)

o Most of the time (2)

o A good bit of the time (3)

o Some of the time (4)

o A little of the time (5)

o None of the time (6)

76

Q91 10. How much of the time during the past 4 weeks did you have a lot of energy?







Q92 11. How much of the time during the past 4 weeks have you felt down-hearted and blue?







77 Q93 12. During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting friends, relatives, etc.)?






End of Block: Default Question Block

78

B. Student Mindfulness_Week 8 and Week 12 Survey_Participants


Q1 Mindfulness Survey Electronic Consent Form We are asking you to participate in a study about the impact of the practice on mindfulness on stress during pharmacy school. This study will help us learn how using mindfulness as a part of the pharmacy curriculum may help improve the wellness of students. What is the reason for this study? This study will assess whether providing instruction in the practice of mindfulness as a part of the pharmacy curriculum will reduce the stress levels of students and improve their overall well-being. What are you asking me to do? We will ask you to participate in a series of surveys that are designed to collect background information about you as well as assess your perceptions about stress levels. You will take the first survey at the beginning of this course, the second at the end of the course, and a third and final survey four weeks after the end of the course. These surveys will be independently administered as a course requirement; however you may either consent to allow your responses to be additionally used for research purposes or decline to exclude your responses from this study. How will you use my information? We will keep your responses confidential. Only the researchers will see your responses. We ask for your university ID number (UIN) to link your surveys. Once we link your two surveys, we will remove your UIN. We will only share information with the public about the whole study, not specific people. We keep all personal information and survey data in a password-protected computer in a locked office. Am I required to do this study? It is your choice to take part in this study. You can stop at any time. Your choice will in no way impact any grade that you will earn for this course. How do I benefit from this study? We do not anticipate any personal benefits to participants for allowing their responses to be used for research purposes. Are there any risks? We do not expect any risks or discomfort related to the survey. You can skip any questions that you don’t want to answer. Your decision on whether or not to participate in the study will in no way affect any grade that you receive for this course. What if I have questions? If you have questions, please contact: Dr. Jennie Jarrett Phone: 312-996-1098 Email: [email protected] The University of Illinois at Chicago Institutional Review Board (UIC IRB) has approved this survey. For any questions about your rights, call UIC IRB at 312-996-1711. By checking the appropriate box below, you agree that: ● You have read this information ● You understand this information ● You understand that your responses are confidential and whether you choose to participate or not will not impact the grade you receive in this course in any way ● By

79 checking the “I agree” statement, you understand that you are providing your consent for your responses to be used for the purposes of research in addition to being used for course work.

o I consent to release my survey responses for the purposes of research (1)

o I do not consent to release my responses to this survey for the purposes of research (2)

Page Break

80 Q2 What is your UIN?

________________________________________________________________

Page Break

81 Q37 The following questions ask you to rate your level of mindfulness. Choose the number that best describes your own opinion of what is generally true for you.

Q38 1. When I'm walking, I deliberately notice the sensations of my body moving.






Q39 2. I'm good at finding words to describe my feelings.






82 Q40 3. I criticize myself for having irrational or inappropriate emotions.






Q41 4. I perceive my feelings and emotions without having to react to them.






Q42 5. When I do things, my mind wanders off and I'm easily distracted.






83 Q43 6. When I take a shower or bath, I stay alert to the sensations of water on my body.






Q44 7. I can easily put my beliefs, opinions and expectations into words.






Q45 8. I don't pay attention to what I'm doing because I'm daydreaming, worrying, or otherwise distracted.






84 Q46 9. I watch my feelings without getting lost in them.






Q47 10. I tell myself I shouldn't be feeling the way I'm feeling.






Q48 11. I notice how foods and drinks affect my thoughts, bodily sensations, and emotions.






85 Q49 12. It's hard for me to find the words to describe what I'm thinking.






Q50 13. I am easily distracted.






Q51 14. I believe some of my thoughts are abnormal or bad and I shouldn't think that way.






86 Q52 15. I pay attention to sensations, such as the wind in my hair or sun on my face.






Q53 16. I have trouble thinking of the right words to express how I feel about things.






Q54 17. I make judgments about whether my thoughts are good or bad.






87 Q55 18. I find it difficult to stay focused on what's happening in the present.






Q56 19. When I have distressing thoughts or images, I "step back" and am aware of the thought or image without getting taken over by it.






Q57 20. I pay attention to sounds, such as clocks ticking, birds chirping, or cars passing.






88 Q58 21. In difficult situations, I can pause without immediately reacting.






Q59 22. When I have a sensation in my body, it's difficult for me to describe it because I can't find the right words.






Q60 23. It seems I am "running on automatic" without much awareness of what I am doing.






89 Q61 24. When I have distressing thoughts or images, I feel calm soon after.






Q62 25. I tell myself that I shouldn't be thinking the way I'm thinking.






Q63 26. I notice the smells and aromas of things.






90 Q64 27. Even when I'm feeling terribly upset, I can find a way to put it into words.






Q65 28. I rush through activities without being really attentive to them.






Q66 29. When I have distressing thoughts or images I am able to just notice them without reacting.






91 Q67 30. I think some of my emotions are bad or inappropriate and I shouldn't feel them.






Q68 31. I notice visual elements in art or nature, such as colors, shapes, textures, or patterns of light and shadow.






Q69 32. My natural tendency is to put my experiences into words.






92 Q70 33. When I have distressing thoughts or images, I just notice them and let them go.






Q71 34. I do jobs or tasks automatically without being aware of what I'm doing.






Q72 35. When I have distressing thoughts or images, I judge myself as good or bad, depending what the thought/image is about.






93 Q73 36. I pay attention to how my emotions affect my thoughts and behavior.






Q74 37. I can usually describe how I feel at the moment in considerable detail.






Q75 38. I find myself doing things without paying attention.






94 Q76 39. I disapprove of myself when I have irrational ideas.






Page Break

95 Q26 The following questions ask you to rate your level of stress for the past month. For each question, choose from the following: 0 - never 1 - almost never 2 - sometimes 3 - fairly often 4 - very often


o 0 - Never (1)


o 2 - Sometimes (3)



Q28 2. In the last month, how often have you felt that you were unable to control the important things in your life?

o 0 - Never (1)


o 2 - Sometimes (3)



96 Q29 3. In the last month, how often have you felt nervous and stressed?

o 0 - Never (1)


o 2 - Sometimes (3)




o 0 - Never (1)


o 2 - Sometimes (3)



Q31 5. In the last month, how often have you felt that things were going your way?

o 0 - Never (1)


o 2 - Sometimes (3)



97 Q32 6. In the last month, how often have you found that you could not cope with all the things you had to do?

o 0 - Never (1)


o 2 - Sometimes (3)




o 0 - Never (1)


o 2 - Sometimes (3)



Q34 8. In the last month, how often have you felt that you were on top of things?

o 0 - Never (1)


o 2 - Sometimes (3)



98 Q35 9. In the last month, how often have you been angered because of things that happened that were outside of your control?

o 0 - Never (1)


o 2 - Sometimes (3)




o 0 - Never (1)


o 2 - Sometimes (3)



Page Break

99 Q77 The following questions asks for your views about your health. Answer each question by choosing just one answer. If you are unsure how to answer a question, please give the best answer you can.


o Excellent (1)

o Very Good (2)

o Good (3)

o Fair (4)

o Poor (5)






Q82 3. Climbing several flights of stairs




100



o Yes (1)

o No (2)


o Yes (1)

o No (2)



o Yes (1)

o No (2)

Q87 7. Did work or activities less carefully than usual.

o Yes (1)

o No (2)

101 Q88 8. During the past 4 weeks, how much did pain interfere with your normal work (including work outside the home and housework)?

o Not at all (4)

o A little bit (5)

o Moderately (6)

o Quite a bit (7)

o Extremely (8)









102 Q91 10. How much of the time during the past 4 weeks did you have a lot of energy?














104

C. Student Mindfulness Daily Log


Q1 What is your UIN?

________________________________________________________________

Q2 What is this practice day's date?

________________________________________________________________

Q9 What are you grateful for on this day?

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

105 Q3 What mindfulness mind-body skill or meditation did you practice on this day? Select all that apply

▢ Belly breathing (1)

▢ Dynamic breathing (2)

▢ Body Scan (3)

▢ Walking meditation (4)

▢ Gatha meditation (5)

▢ Guided Imagery (6)

▢ Labeling of thoughts (7)

▢ Eating meditation (8)

▢ Labeling of feelings (9)

▢ Ocean breathing (10)

▢ Chair yoga (11)

▢ Loving-kindness (12)

▢ Other: (13) ________________________________________________

Q5 Approximately how long (minutes) did you practice mindfulness on this day?

________________________________________________________________

Q11 Mindfulness Practice Reflection

________________________________________________________________

________________________________________________________________

106 ________________________________________________________________

________________________________________________________________

________________________________________________________________

Q7 Did you do any additional readings on mindfulness on this day?

o Yes (1)

o No (2)

Display This Question:

If Did you do any additional readings on mindfulness on this day? = Yes

107 Q8 What did you read? Select all that apply.

▢ From the book: "Wherever You Go, There You Are." Jon Kabat-Zinn (1)

▢ From the book: "The Mindful Twenty-Something." Holly Rogers (2)

▢ "7 Myths of Meditation" Deepak Chopra (3)

▢ "The Body Scan Meditation" Jon Kabat-Zinn (4)

▢ "Why We Find it Hard to Meditate" Ed and Deb Shapiro (5)

▢ "The Brain: How The Brain Rewires Itself" Sharon Begley (6)

▢ "How Meditation Affects the Gray Matter of the Brain" David R. Hamilton (7)

▢ "Meditation: It's Not What You Think" Jon Kabat-Zinn (9)

▢ "Mindful Yoga" Jon Kabat-Zinn (10)

▢ "Harnessing the Upsides of Stress" Harvard Health Publications (12)

▢ "STOP: One-Minute Breathing Space" Palouse Mindfulness (13)

▢ "Does Mindfulness Make You More Compassionate?" Shauna Shapiro (14)

▢ "Self-Compassion: The Secret to Empowered Action is Learning Not to Beat Yourself Up" Emma Seppala (15)

▢ "The Five Myths of Self-Compassion" Kristin Neff (16)

▢ "Suggestions for Daily Practice" Jon Kabat-Zinn (17)

▢ "A Randomized Controlled Trial of Koru: A Mindfulness Program for College Students and Other Emerging Adults" Greeson et al (18)

▢ "A Mindfulness Course Decreases Burnout and Improves Well-Being Among HCPs" Goodman and Schorling (19)

▢ “Awareness is the first step”: An interprofessional course on mindfulness & mindful-movement for healthcare professionals and students. Kinser et al. (20)

108

▢ "Cultivating mindfulness in health care professionals: A review of empirical studies of mindfulness-based stress reduction (MBSR)" Irving et al (23)

▢ "How Effective are Mindfulness-Based Interventions for Reducing Stress Among Healthcare Professionals? A Systematic Review and Meta-Analysis" by Burton et al (24)

▢ "Mindfulness-based therapy: A comprehensive meta-analysis" Khoury et al (26)

▢ Other: (27) ________________________________________________

Q6 Please write any additional comments in the space below.

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

Q10 Do you grant permission to address your reflection and/or comments on the BlackBoard site as a learning point for others? Your response will be posted anonymously.

o Yes (1)

o No (2)


109

D. Student Curriculum Evaluation


Q1 Course Objectives/Content

Q2 Rate how well the course objectives were achieved:

Level Acheived:

Poor (1) Fair (2) Good (3) Excellent (4)

Discuss the benefits of

mindfulness in the general public and

the healthcare professions

population (1)

o o o o

Understand the key messages of the practice of

mindfulness (mind-body skills,

meditation practice, peer and

facilitator interactions) as it relates to being a

student pharmacist (2)

o o o o

Integrate mindfulness

practice into daily life (3)

o o o o

Q4 Teacher Evaluation

110 Q3 Please select the option that best matches your view about the presenter:

Level Acheived:

Poor (1) Fair (2) Good (3) Excellent (4)

The speaker’s knowledge about the topic was: (1) o o o o The organization of the curriculum

was: (2) o o o o The speaker’s

ability to communicate

clearly was: (3) o o o o

The speaker’s ability to answer

questions was: (4) o o o o

Q5 Instructional Methods

Q6 Select your level of agreement with the following statements:

Level Acheived:

Strongly Disagree

(1) Disagree (2) Agree (3) Strongly Agree (4)

111

The educational material

presented was well organized (1)

o o o o

The educational methods

illustrated concepts well (2)

o o o o

The supplementary

materials (readings, videos) helped me apply the content (3)

o o o o

The teaching strategies were appropriate to

attain the objectives (4)

o o o o

Q8 Clinical Application

Q9 What was the most important thing you learned from this course?

________________________________________________________________

Q11 After participating in this session, what change(s) will you make in your life? Please be specific.

________________________________________________________________

Q12 What can be done to improve the effectiveness of this curriculum? Please be specific.

________________________________________________________________

112 Q13 Any additional comments:

________________________________________________________________


113

E. Student Mindfulness Survey_Control Group


Q1 Mindfulness Survey Electronic Consent Form We are asking you to participate in a study about the impact of the practice on mindfulness on stress during pharmacy school. This study will help us learn how using mindfulness as a part of the pharmacy curriculum may help improve the wellness of students. What is the reason for this study?This study will assess whether providing instruction in the practice of mindfulness as a part of the pharmacy curriculum will reduce the stress levels of students and improve their overall well-being. What are you asking me to do?We will ask you to participate in two surveys that are designed to collect background information about you as well as assess your perceptions about stress levels. You will take the first survey now, and the second twelve weeks later to assess any changes over time. How will you use my information?We will keep your responses confidential. Only the researchers will see your responses. We ask for your university ID number (UIN) to link your surveys. Once we link your two surveys, we will remove your UIN. We will only share information with the public about the whole study, not specific people. We keep all personal information and survey data in a password-protected computer in a locked office. Am I required to do this study?It is your choice to take part in this study. You can stop at any time. Your choice will have no academic or professional impact on your capacity as a student at UIC. How do I benefit from this study?There is no personal benefit associated with participation in this study. Your participation will provide researchers with data that has the potential to improve the content of the pharmacy school curriculum. Are there any risks?We do not expect any risks or discomfort related to the survey. You can skip any questions that you don’t want to answer. Your decision on whether or not to participate in the study will have no negative impact on your capacity with UIC. What if I have questions?If you have questions, please contact:Dr. Jennie JarrettPhone: 312-996-1098Email: [email protected] The University of Illinois at Chicago Institutional Review Board (UIC IRB) has approved this survey. For any questions about your rights, call UIC IRB at 312-996-1711. By checking the box below, you agree that:● You have read this information● You understand this information● You understand that your responses are confidential and whether you choose to participate or not will not impact you negatively in any way● You want to participate in this research study

o I agree with the above statements and consent to participate in this study. (1)

Page Break

114 Q98 Are you a P1, P2, or P3 student?

o Yes (4)

o No (5)

Skip To: End of Survey If Are you a P1, P2, or P3 student? = No

Q99 Are you currently enrolled in the class PMPR 390: Mindfulness Practice with Dr. McQuade?

o Yes (4)

o No (5)

Skip To: End of Survey If Are you currently enrolled in the class PMPR 390: Mindfulness Practice with Dr. McQuade? = Yes

Q94 What is your UIN?

________________________________________________________________

Q95 What is your email address?

________________________________________________________________

Q2 What is your gender?

o Male (1)

o Female (2)

o Other (3) ________________________________________________


115 Q97 What is your highest degree?

o High School Degree (1)

o Bachelor's Degree (2)

o Master's Degree (3)

o Doctorate Degree (4)

o Other (please specify): (5) ________________________________________________

Q4 What is your year in pharmacy school?

o P1 (1)

o P2 (2)

o P3 (3)

Page Break

116 Q9 The following questions are regarding your relationship and support networks. Adapted from Personal Stress Management Program: Oxford Clinical Psychology 2006

Q5 Do you have someone in your life you feel comfortable sharing your thoughts and feelings (both positive and negative)?

o Yes (1)

o No (2)

o Unsure (3)


Q6 Do you have someone in your life you can count on to lend you a hand when you need it (e.g., getting a ride somewhere, moving furniture, etc.)?

o Yes (1)

o No (2)

o Unsure (3)


117 Q7 Do you have someone in your life who you enjoy spending your time with (these will probably be the people who make you feel most positive about yourself)?

o Yes (1)

o No (2)

o Unsure (3)


Q8 Do you have someone in your life who you feel truly cares about you and would be supportive of you under almost any circumstance?

o Yes (1)

o No (2)

o Unsure (3)


Page Break

118 Q10 The following questions are regarding your time commitments.

Q11 How much time do you spend outside of pharmacy school on coursework on an average day? Do not include time spent on rotation.

o Less than 1 hour (1)

o 1 - (2)

o 2 - (3)

o 3 - (4)


Q12 Do you have a job outside of pharmacy school requirements?

o Yes (1)

o No (2)

Skip To: Q14 If Do you have a job outside of pharmacy school requirements? = No

Q13 How many hours per week do you work?

o Less than 5 hours (1)

o 5 - (2)

o 10 - (3)

o 15 - (4)


119 Page Break

120 Q15 The following question addresses how you deal with stress

Q14 Select the coping strategies you use to deal with stress. Select all that apply.

▢ Exercise (1)

▢ Spending time with family/friends (2)

▢ Talking about it/debriefing (3)

▢ Sleep (4)

▢ Alcohol (5)

▢ Prescription drugs (e.g., anxiolytics, antidepressants) (6)

▢ Formal counseling or therapy (7)

▢ Spiritual methods (e.g., prayer, house of worship) (8)

▢ Recreational/relaxation activities (9)

▢ Meditation or mindfulness techniques (10)

▢ Yoga (11)

▢ Other (specify): (12) ________________________________________________

Page Break

121 Q16 The following questions ask about your experience with meditation, yoga, and mindfulness practice.

Q17 Have you ever practiced meditation?

o Yes (1)

o No (2)

Skip To: Q20 If Have you ever practiced meditation? = No

Q18 Do you currently meditate?

o Yes (1)

o No (2)

Skip To: Q20 If Do you currently meditate? = No

Q19 How often per week do you meditate?







122 Q20 Have you ever practiced yoga?

o Yes (1)

o No (2)

Skip To: Q23 If Have you ever practiced yoga? = No

Q21 Do you currently practice yoga?

o Yes (1)

o No (2)

Skip To: Q23 If Do you currently practice yoga? = No

Q22 How often per week do you practice yoga?







Q23 Have you ever practiced mindfulness? Mindfulness practice is the practice of focusing on the present moment, bringing awareness to thoughts and feelings, with compassion and without judgment.

o Yes (1)

o No (2)

Skip To: Q26 If Have you ever practiced mindfulness? Mindfulness practice is the practice of focusing on the pres... = No

123

Q24 Do you currently practice mindfulness? Mindfulness practice is the practice of focusing on the present moment, bringing awareness to thoughts and feelings, with compassion and without judgment.

o Yes (1)

o No (2)

Skip To: Q26 If Do you currently practice mindfulness? Mindfulness practice is the practice of focusing on the pr... = No

Q25 How often per week do you practice mindfulness?







Page Break

124 Q26 The following questions ask you to rate your level of stress for the past month. For each question, choose from the following: 0 - never 1 - almost never 2 - sometimes 3 - fairly often 4 - very often


o 0 - Never (1)


o 2 - Sometimes (3)



Q28 2. In the last month, how often have you felt that you were unable to control the important things in your life?

o 0 - Never (1)


o 2 - Sometimes (3)



125 Q29 3. In the last month, how often have you felt nervous and stressed?

o 0 - Never (1)


o 2 - Sometimes (3)




o 0 - Never (1)


o 2 - Sometimes (3)



Q31 5. In the last month, how often have you felt that things were going your way?

o 0 - Never (1)


o 2 - Sometimes (3)



126 Q32 6. In the last month, how often have you found that you could not cope with all the things you had to do?

o 0 - Never (1)


o 2 - Sometimes (3)




o 0 - Never (1)


o 2 - Sometimes (3)



Q34 8. In the last month, how often have you felt that you were on top of things?

o 0 - Never (1)


o 2 - Sometimes (3)



127 Q35 9. In the last month, how often have you been angered because of things that happened that were outside of your control?

o 0 - Never (1)


o 2 - Sometimes (3)




o 0 - Never (1)


o 2 - Sometimes (3)



Page Break

128 Q77 The following questions asks for your views about your health. Answer each question by choosing just one answer. If you are unsure how to answer a question, please give the best answer you can.


o Excellent (1)

o Very Good (2)

o Good (3)

o Fair (4)

o Poor (5)






Q82 3. Climbing several flights of stairs




129



o Yes (1)

o No (2)


o Yes (1)

o No (2)



o Yes (1)

o No (2)

Q87 7. Did work or activities less carefully than usual.

o Yes (1)

o No (2)

130 Q88 8. During the past 4 weeks, how much did pain interfere with your normal work (including work outside the home and housework)?

o Not at all (4)

o A little bit (5)

o Moderately (6)

o Quite a bit (7)

o Extremely (8)









131 Q91 10. How much of the time during the past 4 weeks did you have a lot of energy?














133 Appendix F. Semi-structured interview protocol for Mindfulness Curriculum Student Participants

1. Why did you choose to take this elective?

a. Probe: previous experiences in learning or practicing mindfulness (e.g., yoga,

meditation)

b. Probe: how this elective relates to previous learning or mindfulness practices

2. We are interested in your experiences of the elective curriculum. What were your experiences of

learning about mindfulness in this elective?

a. Probe: what aspects contributed to your learning, what aspects got in the way of you

learning about mindfulness

b. Probe: what aspects of the classroom environment contributed to your learning or got in

the way of your learning (e.g., classroom space, your teacher, your fellow students)

3. Tell me how you used the assigned activities before class or during class to help you learn about

mindfulness.

a. Topics to probe: reading assignments, use of apps, classroom practice activities and

discussion

4. You were asked to practice mindfulness outside of class. What was that like for you?

a. Probe: what helped you to do that practice outside of class, what barriers did you

experience?

5. How have your attitudes and beliefs about mindfulness changed as a result of this course, if at

all?

a. Probe: what most influenced/contributed to the changes in your attitudes/beliefs about

mindfulness?

6. How do you think what you’ve learned in this elective will be important in your next phase as a

student pharmacist?

134 Appendix G. Free-Text Evaluation Responses from Student Participants What was the most important thing you learned from this course?

a) Different meditation techniques, listening to other people's thoughts and engaging in discussions.

b) c) Mindfulness is not ignoring or running away from problems, and it is a very healthy

and useful method for understanding and being at peace with your emotions and what is going on around you.

d) I think the emphasis on consistency was important.

e) Gaining tools to help me in everyday situations f) Learning the different meditation techniques and which one worked the best for me

helped me with dealing with anxiety and nervousness, especially in the last month.

g)

h) How to incorporate mindfulness into my life.

i) The different meditations and how not to succumb to the flowing river of thought

j) Daily and consistent mindfulness practice is important k) Learning the different methods of practicing mindfulness because it allows me to do it

wherever I am!

l) That I can be mindful at school. m) Learning a lifelong skill that I can take with me wherever I go and whenever I leave the

house is truly changing my entire mental perception of the world around me. n) I never knew WHAT mindfulness is. I now know that it is a tool that I can use to help

stay in the present.

o) p) The most important thing I learned from this course was being able to accept myself

and others without judgment, and to live in the present. q) I learned how to get back into meditation. It has been something that I have wanted

to do for a while now. r) Relax during difficult situations. Learned to understand me and be in the present

moment.

s) Tolls to help me with every day life t) How to be more aware of my thoughts and feelings. I find myself being more present

than before. u) I have found that this course gave me new skills in order to cope with stress in life.

The techniques were new and very well explained. They were also simple to add to my daily routine and have found it very inspiring to keep going for my own benefit.

v) I learned how to realistically and successfully make changes in my life, despite how overwhelming or unattainable the changes might seem.

w) How to cope with anxiety

x)

y) learning to control my emotion over frustrated situation

135 After participating in this session, what change(s) will you make in your life? Please be specific.

A. Incorporate mindfulness into my daily life, remember to live in the moment and not to keep worrying about the past that can't be changed and future that's often unknown.

B. C. I have started incorporating a 10-minute mindfulness session into my morning routine

every day. I also (over the last few days) have started using the Headspace app, particularly as a way to take short breaks (10-20 minutes each) during study sessions to give my mind a break from being active. Although I haven't done this a lot, I have done a lot better at staying motivated and engaged with my work throughout the day than I have in the past.

D. I think I will be more aware of when I am stressed and how to address it.

E. Being more present and working through my thoughts F. It's still difficult for me to practice mindfulness daily, so my goal is to try to

incorporate it into my life at least 2-3 times a week for now. Maybe go for walks or just do deep breathing when I feel overwhelmed.

G.

H. Try to be mindful more often. A few times a week. I. Definitely have become more aware in situations and know how to acknowledge the

negative feelings that I have but not let them control me.

J. Continue to use mindfulness practices whenever possible K. It has allowed to me to be more cognizant of my current surroundings rather than

constantly planning and thinking about things outside of the situation. Therefore, the change would be focusing more on the present rather than the past or the future.

L. I will take time out of my day to be mindful. M. Applying mindfulness exercises everyday, first thing in the morning. Especially

breathing exercises and guided imagery. N. I will be labeling my thoughts a lot more. I will try to always remember to stay in the

present. I also will share the meditations with my friends to help them stay in the present when they are feeling stressed.

O. P. I would like to continue to practice mindfulness and incorporate it into my daily

activities and work. Q. I am going to start meditating more. I really like that this class got me back in the

habit of doing so. R. Mediate practice often if not daily. Finds ways to incorporate mindfulness into daily

activities such as walking, wake up stretches, and brushing my hair. Let negative thoughts pass by and be in the present moment. Learn to forget and forgive others and me. Let go of negative lingering thoughts.

S. Incorporating these tools T. Focusing more on controlling my breathing in efforts to control my feelings and

emotions.

136

U. V. My goal is to keep up the practice of mindfulness, as consistently as possible. I have a

broader goal of observing things around me without judging.

W. Using meditation to cope with stressors and being able to manage them better

X.

Y. I will keep practicing mindfulness because I recognize its benefits for my soul What can be done to improve the effectiveness of this curriculum? Please be specific.

A. N/A

B.

C. I wish more didactic lessons about the research on mindfulness were incorporated. D. I believe the surveys we completed could be completed in a better format. Maybe a

submission portal for a whole weeks worth of material rather than day by day surveys.

E. Making some reading required rather than optional. Then having student write a paragraph about what it meant to them, or answer questions about it to drive the points home.

F. None

G. H. It would help to be able to read the readings that were read aloud in class. I am a very

visual person, so I often got lost while listening to the dense readings and did not feel like I could participate in class afterwards.

I. Nothing . It’s great the way it is

J. K. Maybe when the group is sharing at the beginning of class, go around the room and

have everyone either share their experiences for that particular week of practice or decline to share. I think this would improve participation while still giving people the opportunity to decline sharing if they do not want to participate.

L. N/A

M. Lengthen the course, and include more students!

N. A silent classroom.

O.

P. N/A Q. I think that some of the studies behind meditation should be shown earlier in the class

to help the class get on board with the message. R. The background music really helped me during the session. Maybe incorporating

more sensual things such as therapeutic scents would be beneficial. S. Required reading assignments to drill points home, perhaps with a little writing

assignment T. I feel that the style of teaching through open discussion could use improvement. It is

great having discussion but I feel it is difficult at times if everybody doesn’t participate. An adjustment could possibly be having more time for instruction/presenting educational material rather than relying 100% on discussion for the class.

137

U.

V.

W. Nothing

X.

Y. Having writing reflection papers Any additional comments:

A. Thanks for a short but great semester!

B. C. This course was very well run, and I feel so thankful to have been a part of it! I know

that the lessons I learned here will help me succeed in pharmacy school and in my career.

D.

E. Thanks for making this course!

F.

G. Thank you, this course helped me a lot in calming down and dealing with challenges

H. Thank you for your help! I. Dr. McQuade is an excellent teacher and this class was great because of the way she

taught it. She has a very calm soothing voice so it’s easier to do meditations while listening to her. Thank you for teaching this class!

J.

K. Great class and great professor!

L. N/A

M. Thank you for the wonderful experience, I truly wish there was a part 2!

N. nope!

O.

P. N/A

Q.

R.

S.

T. Thank you for a great semester!

U. V. I loved this class! It was a welcome respite from the busy ‚”success driven” classes of

pharmacy school. I loved that this class focused on personal growth, rather than a way to further our pharmacy careers, or our professional image. Thanks Dr. McQuade!

W.

X.

Y.

Do You Mind? A Mindfulness Practice Curriculum for ...

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