Table 3.

Qualitative analysis of continued student skill use (N = 34), application (N = 29), and transfer of skills (N = 26)

Coded Themes	Representative Student Quotes	Significance
Build a routine to practice breathing, expanding compassion, meditation, and/or mindfulness	“Daily morning meditation and in times of severe stress, really helps me get centered” “To focus on my breathing in times of stress. I do it a lot now during my everyday life.” “I used the skills I learned…towards the patients I meet and the people that I regularly meet with. I found myself to be more patient and more affable towards others. This course has been one of the best things happened in medical school so far.”	Students report using CCT stress-management and cicompassion-expansion skills clinically, academically, and in their personal lives. They find practical skills for stress mitigation, mindfulness, and compassion building useful along with the ability to recognize and think through the emotions they feel. Students also benefited from the realization that other students have similar issues and the safe space to discuss these common challenges.
Compassion for patients, others, and self	“[I learned] how to be compassionate and caring without taking on the patient’s pain myself. I’ve used it in every patient encounter since, I consciously think about wanting them to be healthy and happy and being compassionate but remind myself not to feel the pain myself.” “I have been able to apply compassion far more readily in clinical situations and find myself applying nearly no judgment for problems that might even be deemed reckless by patients.” “[I use] mindfulness when I am speaking with a patient or even with friends. When I start to zone out or get impatient with what they are saying I refocus and think to myself how important this is to them. And it makes me a kinder and more compassion doctor and friend.” “I enjoyed hearing from [the instructor] and the other students on a more personal level--why they were who they were, how past experiences had shaped them, etc. It allowed us all to connect on a deeper level and it revealed to me in plain view the benefit of understanding the experiences that have brought a patient to you.” “My interpersonal relationships have improved since beginning mindfulness training. I have better control of my emotions, and have been a happier medical student as a result.” “The idea that you don’t beat yourself up after your mind wanders during mediation. I am one to beat myself up for messing it up.” “[I learned] how to forgive yourself.”
Decrease stress in studying and clinical encounters	“I believe I have become less drained at the end of a long day in the hospital by practicing compassion.” “I do meditations in between studying. That way it helps me to reset my brain and start studying for another few hours.” “Mediation helps to calm down my breathing and to help me relax.”
More present, centered, or aware before and during clinical settings	“I feel calm and focused after I meditate which makes me more present for my patients. I am able to take a deep breath before entering a patient’s room and truly focus on that patient.” “In clinical settings, I feel that have become more aware of others’ thoughts and feelings and am able to slow down and make sure that I do not ignore them”
Stress inventory and self-awareness	“I can recognize my emotions better and know how to handle them.” “The ability to recognize my stress. I am more in tune with what is going on in my body before my mind starts to take over. I feel that I have had decreased levels of anxiety and fewer seasons of depression as a result of mindfulness, and CCT was the first step towards my current practice.”