Assessing Mindfulness-Based Teaching Competence: Good Practice Guidance.

Inclusion of assessment of teaching competence in Mindfulness-Based Program (MBP) teacher training enables international benchmarking of standards, which in turn underpins the integrity of this emerging field and the potential to deliver effective, transformative interventions. However, there is a risk that the inclusion of competence assessment could lead to reductionism and undermining of the pedagogical features that make mindfulness-based teaching distinct. It can also make the costs of training prohibitive. The science underpinning the integrity of competence assessment is not yet robust enough to justify wide scale implementation, but when feasible, including the option for assessment enables trainees to engage in rigorous and effective training processes. When assessment is included, it is critically important that the process is held with awareness and sensitivity, and is implemented by experienced assessors with thoughtful governance. Navigating these issues involves balancing rigour with accessibility and pragmatism. This paper lays out some guidelines for good practice for MBP teaching assessment, and raises unresolved dilemmas and questions.

Can We Agree What Skilled Mindfulness-Based Teaching Looks Like? Lessons From Studying the MBI:TAC.

BACKGROUND: The Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) is a widely used tool for assessing fidelity in mindfulness-based program (MBP) research and training. It also supports MBP teacher reflective and skill development. MBI:TAC assessors review MBP teaching and rate the teaching on 6 domains. The MBI:TAC yields individual domain and overall scores, using 6 levels of competence. Although the MBI:TAC is widely used in MBP research and training, research is at an early stage. OBJECTIVE: We developed and tested a method of training MBI:TAC assessors to use the tool reliably and examined interrater reliability of the tool. METHODS: A total of 31 international senior MBP teachers were recruited to join an online training to build their skills in using the MBI:TAC. The training systematically and iteratively built familiarity and skills in assessing the 6 MBI:TAC domains. Qualitative and quantitative data on trainee's experience of the training were gathered. Interrater reliability in using the tool was tested each week of the training. At the end of the training, interrater reliability was tested by asking trainees to individually assess videos that they had not previously seen. Their ratings were compared to benchmark assessments, which had been established via consensus agreement between 4 expert users of the MBI:TAC. RESULTS: The training was well received and appreciated, with some challenges experienced in applying the assessment methodology. Participants' ratings became progressively more in line with one another and the benchmark ratings during the training. At the end, interrater reliability was high (ranging from 0.67 to 1.0). CONCLUSION: It is possible for senior MBP trainers, coming from different regions in the world, to align toward common understandings of the elements of MBP teaching competence and program integrity. An assessor training methodology was tested, and the learning from this project has led to refinements for future delivery.

Tending the Field of Mindfulness-Based Programs: The Development of International Integrity Guidelines for Teachers and Teacher Training.

Since Jon Kabat-Zinn first introduced a contemporary, secularized application of mindfulness for the relief of pain and stress in physical health-care settings, there has been a significant and rapid expansion of the range of mindfulness-based programs (MBPs) designed for various health care, education, workplace, and other settings. As is common with developing programs, these often run ahead of carefully considered and researched effectiveness evaluations. This raises questions of how to best train mindfulness teachers to skillfully facilitate such interventions while minimizing the potential for harm. In this article, we describe the work of an international group of senior teacher trainers who met to develop guidelines on the ethics and standards for teacher trainers and their training pathways. In this article, we will define MBPs; describe the process by which these international guidelines were developed; and share details of the collaborative team who made up the international network that worked on them. We offer these guidelines as "living documents" that specifically set out: (1) ethical standards for mindfulness teachers and trainers; (2) criteria and standards for teacher trainers; and (3) criteria and standards for training pathways. As "living documents," these will continue to be commented on and refined over time. Given that MBPs offered within secular settings in most countries currently have limited oversight or accreditation processes, we hope these guidelines will provide support and clarity to the teachers of all established and emerging MBPs, and their trainers and supervisors.

The suitability of mindfulness-based stress reduction for chronic hepatitis C.

As incidence of chronic hepatitis C (CHC) in the United States increases, management of physical and psychological symptoms over the long term becomes crucial. Research has shown meditation to be a valuable tool in reducing such symptoms for various chronic illnesses. In particular, the Mindfulness-Based Stress Reduction (MBSR) program offers curriculum that has been shown to influence both physiology and perception of disease states. Although there has been no direct research to date on the effectiveness of the MBSR program for CHC, several studies have shown significant findings affecting other chronic conditions, including heart disease, fibromyalgia, and HIV. The purpose of this literature review is to examine recent research, summarize findings, and indicate appropriate inclusion of MBSR as a primary, secondary, and tertiary treatment option in conjunction with biomedical care for those diagnosed with CHC. Thusly, nurses can better inform their clients with this condition.