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MBSR enhances worker authenticity but not hiding of medical errors

29 Jun 2022 9:10 AM | Anonymous member (Administrator)

To err is human, but for organizations like hospitals even small errors can cost lives. Organizations try to anticipate and avoid errors, and high-stake demands to not err can motivate employees to hide mistakes when they occur. People who are more “authentic” may be less likely to hide their errors because their self-worth is less dependent on what others think of them.

Mindfulness may aid authenticity by facilitating greater self-awareness and self-acceptance, thereby enabling people to act in accord with their values. 

Choi et al. [Journal of Occupational Health Psychology] explored how changes in mindfulness affect authenticity and error hiding. They also studied the effects of mindfulness training compared to exercise or a wait-list control on mindfulness, authenticity, error hiding, and qualitative interview content.

The researchers randomly assigned 230 employees (94% female; age range=25-54 years; 35% held front-line clinical roles) from four Canadian hospitals to Mindfulness-Based Stress Reduction (MBSR), Pilates training, or a wait-list control.

The 8-week MBSR program was modified so that weekly group-based classes were one hour long. Pilates exercise training was also taught in a series of 8 one-hour weekly group sessions and was designed to improve core strength, balance, flexibility, and relaxation. 

Participants were assessed at baseline, post-intervention, and one-month follow-up on measures of mindfulness (5 items from the Mindful Attention and Awareness Scale), authentic functioning (12 items from the Authentic Functioning Scale) and error hiding (3 items from the Error Orientation and Motivation Scale).

The authentic functioning measure included items like “I frequently pretend to enjoy something when in actuality I really don’t.” The error hiding measure included items like “I do what I can to make sure that no one knows I make mistakes.”

The results show that all three groups showed increases in mindfulness scores over time but there were no significant between-group differences. The MBSR group showed significantly greater increases in authentic functioning than both comparison  groups at post-intervention and follow-up. There were no significant differences in error hiding over time or between conditions.

The researchers then examined the interrelationship between changes in variables over time regardless of group assignment. They found that the rate of increase in mindfulness correlated with the rate of increase in authentic functioning (r = .76), which in turn correlated with the rate of decrease in error hiding (r = -.45). 

A qualitative analysis of post-intervention interviews with MBSR and Pilates participants showed increases in self-acceptance, self-awareness, self-compassion, self-esteem, and self-determination. There were dramatic between-group differences in how often these themes were reported. For example, 71% of the MBSR group reported improvements in attention and awareness, while only 21% of the Pilates exercise group did.

Similarly 50% of the MBSR group reported greater life fulfillment, while 0% of the Pilates group did. The same magnitude of differences occurred with greater reports of improved work-related outcomes, interpersonal effects, emotional regulation, and relationship with oneself in the MBSR group.

The study shows MBSR is more effective in increasing authentic functioning than Pilates exercise or a wait-list control. There was no evidence MBSR reduces error hiding, but the error hiding measure used was probably too brief to show much variability in scores. It also only measured what people were willing to say about how they viewed making errors, and did not measure actual errors, either hidden or unhidden.

The study is limited by its reliance on self-report measures, and the fact that qualitative analysis raters were not blinded to condition.


Reference:

Choi, E., Leroy, H., Johnson, A., & Nguyen, H. (2022). Flaws and all: How mindfulness reduces error hiding by enhancing authentic functioning. Journal of Occupational Health Psychology.

Link to study

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