The Mindful Practice in Medicine programs are based on three core components of theory and practice.
Formal and Informal Mindfulness Practice
Mindfulness, a naturally occurring human capacity, is the awareness that arises by paying attention, on purpose, to experience as it unfolds, with the goals of greater understanding, compassion and wisdom. We believe that mindfulness is an essential quality of excellent health care. We are all endowed with the capacity for mindfulness, which can be further cultivated through various means, among them meditative practices, physical activity, conversation, poetry, music, and others.
We have designed the secular formal contemplative practices in the Mindful Practice in Medicine program to enhance your awareness of the stream of thoughts, flow of feelings, and current of sensations that usually go unnoticed yet inform action and behavior from moment to moment. Through regular practice it becomes possible to step out of “automatic pilot”, and experience and act with greater awareness.
Informal mindfulness practice refers to fostering the same quality of awareness during everyday life at work. We offer to “practice” informally during the entire Mindful Practice in Medicine program including during meals, casual conversations, group discussions, and narrative exercises described below.
Narrative Medicine provides a way to understand both the personal connections between clinicians and patients, and the meaning of medical practice and experiences for individual physicians. Sharing of clinician narratives reflect clinicians’ values and beliefs, how these become manifest in the clinician-patient relationship, and the influence of the social and cultural environment that surrounded their creation.
Narrative medicine in the Mindful Practice in Medicine program involves sharing of stories that arise from the participants’ professional experiences. These include reflection, dialogue, and discussion in large and small groups, specific writing exercises, and journaling.
Program participants share narratives from their own personal experiences that have affected them on cognitive and emotional levels. Sometimes participants discover the impact of these experience through the processes of reflection and recollection with a partner or partners engaged in the process of deep listening. We emphasize confidentiality and support; participants are encouraged to care for themselves, sharing narratives they feel comfortable with given the environment of the group.
Appreciative Interviews and Appreciative Inquiry
Appreciative Inquiry strives to foster growth and change by focusing participants’ attention on successes rather than problems and challenges. Much of medical training focuses on what is wrong rather than what is right. Patients are described in terms of problem lists, but there are no defined places to describe their strengths and resources. Morbidity and mortality rounds focus on analyzing bad outcomes, but there are few opportunities to explore effective teamwork and joint decision-making. Originally designed to build more resilient and vision-focused organizations, Appreciative Inquiry fosters imagination, innovation and teamwork.
Appreciative Interviews use reinforcement and analysis of positive experiences. In that way they build on individual strengths and positive behaviors, in comparison to a problem-oriented approach that focuses on negative experiences or failures. Appreciative interviews involve the art of asking questions that acknowledge, anticipate, and heighten positive potential.
Mindful Practice in Medicine guides participants in the application of Appreciative Interview techniques when engaged in dialogues, discussion, and reflection. With practice and support, this approach can become second nature.