How medical specialists experience the effects of a mindful leadership course on their leadership capabilities: a qualitative interview study in the Netherlands

OBJECTIVES: Medical leaders are facing leadership challenges that ask for a leadership style that takes care of both themselves and their coworkers. Mindfulness may support this leadership style. We explored how a 'Mindful leadership for medical specialists' course affected medical specialists' leadership. DESIGN: We conducted a qualitative study based on in-depth interviews. The grounded theory method was used to analyse the data. SETTING: A university medical centre in the Netherlands. PARTICIPANTS: Seventeen medical specialists (six male) with an average age of 51 years (ranging from 40 to 66 years). INTERVENTIONS: The mindful leadership course consisted of 10-weekly 5-hour sessions that focused on cultivating mindfulness and compassion. In addition, sessions included didactic and interactional teaching about leadership theories. RESULTS: Four categories emerged from the data: (A) Self - Attitude: psychological attitude towards self, (B) Self - Behaviour: behaviour towards self, (C) Other - Attitude: psychological attitude towards others, and (D) Other - Behaviour: behaviour towards others. Themes were defined within these categories: awareness of self, open mind, insight and appreciation of self (A), emotional and cognitive self-regulation, letting go of unhelpful behaviour and developing helpful behaviour (B), differences in attitude to others such as awareness of (impact on) others, keeping an open mind about others, allowing difficult emotions associated with others, appreciating of others (C), and communicating more effectively, providing direction, empowering and caring for others (D). CONCLUSIONS: The results help us understand the core elements of mindful leadership, both with respect to one's psychological attitude and behaviour towards oneself and others. More research on mindful leadership and the effects on self and others is needed. Mindful leadership courses could be a valuable part of clinical training and might contribute to more sustainable healthcare organisations

Posaconazole Tablet Pharmacokinetics: Lack of Effect of Concomitant Medications Altering Gastric pH and Gastric Motility in Healthy Subjects.

Posaconazole oral suspension is an extended-spectrum triazole that should be taken with food to maximize absorption. A new posaconazole tablet formulation has demonstrated improved bioavailability over the oral suspension in healthy adults in a fasting state. This study evaluated the effects of concomitant medications altering gastric pH (antacid, ranitidine, and esomeprazole) and gastric motility (metoclopramide) on the pharmacokinetics of posaconazole tablets. This was a prospective open-label 5-way crossover study in 20 healthy volunteers. In each treatment period, a single 400-mg dose (4 100-mg tablets) of posaconazole was administered alone or with 20 ml antacid (2 g of aluminum hydroxide and 2 g of magnesium hydroxide), ranitidine (150 mg), esomeprazole (40 mg), or metoclopramide (15 mg). There was a ≥10-day washout between treatment periods. Posaconazole exposure, time to maximum concentration of drug in serum (Tmax), and apparent terminal half-life (t1/2) were similar when posaconazole was administered alone or with medications affecting gastric pH and gastric motility. Geometric mean ratios (90% confidence intervals [CIs]) of the area under the concentration-time curve from time zero to infinity (AUC0-inf) (posaconazole with medications affecting gastric pH and gastric motility versus posaconazole alone) were 1.03 (0.88-1.20) with antacid, 0.97 (0.84-1.12) with ranitidine, 1.01 (0.87-1.17) with esomeprazole, and 0.93 (0.79-1.09) with metoclopramide. Geometric mean ratios (90% CIs) of the maximum concentration of drug in serum (Cmax) were 1.06 (0.90-1.26) with antacid, 1.04 (0.88-1.23) with ranitidine, 1.05 (0.89-1.24) with esomeprazole, and 0.86 (0.73-1.02) with metoclopramide. In summary, in healthy volunteers, the pharmacokinetics of a single 400-mg dose of posaconazole tablets was not altered to a clinically meaningful extent when posaconazole was administered alone or with medications affecting gastric pH or gastric motility

Mindful Leader Development: How Leaders Experience the Effects of Mindfulness Training on Leader Capabilities

Mindfulness training is a novel method of leader development but contrary to its rising popularity, there is a scarcity of research investigating how mindfulness training may affect leader capabilities. To gain a better understanding of the potential of a new research field, qualitative research is advantageous. We sought to understand how senior leaders experience the impact of mindfulness training in their work lives and leadership ability. The sample comprised 13 leaders (n = 11 male) working in six organizations that completed a 10-week workplace mindfulness training (WMT). We conducted semi-structured interviews 6 to 12 months following course completion. We analyzed the data following thematic analysis steps and based on these findings, we devised a framework of the perceived impact of mindfulness training on self-leadership and leadership capabilities. We show that WMT exhibited impact on three self-leadership capacities: mindful task management, self-care and self-reflection and two leadership capacities: relating to others and adapting to change. Participants’ recounts additionally suggested effects may expand to the level of the team and the organization. We show that WMT may be a promising tool for self-directed leadership development and outline avenues for future research

A Workplace Mindfulness Intervention May Be Associated With Improved Psychological Well-Being and Productivity. A Preliminary Field Study in a Company Setting

Background: Mindfulness trainings are increasingly offered in workplace environments in order to improve health and productivity. Whilst promising, there is limited research on the effectiveness of mindfulness interventions in workplace settings. Objective: To examine the feasibility and effectiveness of a Workplace Mindfulness Training (WMT) in terms of burnout, psychological well-being, organizational and team climate, and performance. Methods: This is a preliminary field study in four companies. Self-report questionnaires were administered up to a month before, at start of, and right at the end of the WMT, resulting in a pre-intervention and an intervention period. There was no separate control group. A total of 425 participants completed the surveys on the different time points. Linear mixed model analyses were used to analyze the data. Results: When comparing the intervention period with the pre-intervention period, significantly greater improvements were found in measures of burnout (mean difference = 0.3, p 0.8), moderate for well-being, burnout and perceived stress (d = 0.5-0.8), and ranged from low to moderate for organizational and team climate and personal performance (d = 0.2-0.8). Conclusion: These preliminary data suggest that compared to the pre-intervention period, the intervention period was associated with greater reductions in burnout and perceived stress, improvements in mindfulness, well-being, and increases in team and organizational climate and personal performance. Due to design limitations, no conclusions can be drawn on the extent to which the WMT or non-specific factors such as time have contributed to the findings. Further studies, preferably using randomized controlled designs with longer follow up periods are needed to evaluate whether the associations found can be attributed to the WMT and whether these sustain after the training

Intervention Fidelity in Mindfulness-Based Research and Practice: Developing Criteria to Acknowledge New Training Programs

The field of mindfulness-based research and practice is expanding fast. This development calls for a careful evaluation of the merits and scientific underpinnings of newly developed mindfulness-based programs (MBP’s). In this viewpoint, we describe a process initiated by two professional mindfulness teacher training organisations (the Dutch Vereniging Mindfulness-based Trainers Nederland , VMBN, and the British Association of Mindfulness-based Approaches , BAMBA) to develop a framework for evaluating the integrity of newly developed MBP’s. The framework aims to articulate criteria describing the elements and processes required to ensure that a new MBP meets good practice, adheres to evidenced-based practice, and is attending to the challenge of implementation and scalability. The development and implementation of the criteria are still a ‘work in progress’. We hope that this initiative offers a foundation for supporting the MBP field to balance innovation and grassroot community development with aligning to the principles of evidence-based practice

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<p>Background: Mindfulness trainings are increasingly offered in workplace environments in order to improve health and productivity. Whilst promising, there is limited research on the effectiveness of mindfulness interventions in workplace settings.</p><p>Objective: To examine the feasibility and effectiveness of a Workplace Mindfulness Training (WMT) in terms of burnout, psychological well-being, organizational and team climate, and performance.</p><p>Methods: This is a preliminary field study in four companies. Self-report questionnaires were administered up to a month before, at start of, and right at the end of the WMT, resulting in a pre-intervention and an intervention period. There was no separate control group. A total of 425 participants completed the surveys on the different time points. Linear mixed model analyses were used to analyze the data.</p><p>Results: When comparing the intervention period with the pre-intervention period, significantly greater improvements were found in measures of burnout (mean difference = 0.3, p < 0.001), perceived stress (mean difference = -0.2, p < 0.001), mindfulness [mean difference = 1.0 for the Freiburg Mindfulness Inventory (FMI) and 0.8 for the Mindfulness Attention Awareness Scale (MAAS), both p < 0.001], and well-being (mean difference = 0.4, p < 0.001). Additionally, greater increases in team climate, organizational climate and personal performance were reported during the intervention compared to the pre-intervention period with largest improvements in team cooperation (mean difference = 0.3, p < 0.001), productivity (mean difference = 0.5, p < 0.001), and stress (mean difference = -0.4, p < 0.001). Effect sizes were large for mindfulness (d > 0.8), moderate for well-being, burnout and perceived stress (d = 0.5–0.8), and ranged from low to moderate for organizational and team climate and personal performance (d = 0.2–0.8).</p><p>Conclusion: These preliminary data suggest that compared to the pre-intervention period, the intervention period was associated with greater reductions in burnout and perceived stress, improvements in mindfulness, well-being, and increases in team and organizational climate and personal performance. Due to design limitations, no conclusions can be drawn on the extent to which the WMT or non-specific factors such as time have contributed to the findings. Further studies, preferably using randomized controlled designs with longer follow up periods are needed to evaluate whether the associations found can be attributed to the WMT and whether these sustain after the training.</p