This 4-day retreat-like workshop is designed to improve the quality of care that clinicians provide while improving their own resilience and well-being. It offers an experiential learning environment, with a focus on developing the capacity for self-awareness in stressful and demanding situations.
Mindful Practice® programs include interactive presentations, workshops, and seminars for physicians, trainees, other health professionals and medical educators. They are built on a strong bio-psychosocial foundation and contain three major components – mindfulness meditation, narrative medicine, and appreciative inquiry – each integrated with the others into a seamless approach. Mindful practice depends on developing a capacity for mindfulness. Mindfulness is a naturally occurring human capacity, not just restricted to meditation or other "mindfulness-based" interventions such as mindfulness-based stress reduction or mindfulness-based cognitive therapy. Mindfulness can be cultivated through various means including meditative exercises, physical activity, narrative, dialogue, poetry, and music. Mindful practice workshops use a set of contemplative practices that orient and inform other approaches. such as narrative and appreciative inquiry, to bring mindfulness to the clinical enterprise. Mindful Practice® curricula are specifically focused on three linked goals: Improving quality of care, quality of caring, and improving physician well-being and resilience.
Mindful Practice® programs focus on promoting qualities exhibited by exemplary physicians and clinicians that include, but are not limited to:
- Attentive observation: Being able to observe without making judgments that would otherwise distort or diminish one’s capacity to understand. This quality helps clinicians to monitor their own biases, thoughts and emotions on a moment-to-moment basis, developing the capacity to “observe the observer,” and cultivating “the observing self.”
- Critical curiosity: Seeing novelty in all situations, including familiar ones, and tolerating ambiguity and uncertainty. Cultivating curiosity helps clinicians to avoid common cognitive biases that lead to medical errors, such premature closure or ignoring dis-confirming data. Curiosity also helps clinicians to see patients and families as unique individuals.
- Beginner’s mind: Opening the mind to fresh perspectives and considering more than one perspective simultaneously. This quality compensates for the mind’s tendency to consider a problem from a fixed perspective, and instead allows for the consideration of multiple diagnostic and therapeutic options.
- Presence: Being physically, mentally and emotionally present for patients, communicating an accurate understanding of the patient’s concerns and feelings back to the patient and acting with compassion. A critical part of presence includes the simultaneous self-awareness of the clinician's own somatic, affective and cognitive experiences while engaging in the unfolding clinical dynamic. Though physicians have written powerful narratives of such experiences, they also often report that “being there” is challenging in demanding, fast-paced, and stressful clinical environments.
Mindful practice® programs offer strategies to enhance these qualities. In addition, participants find opportunities to share with each other their own strategies help them to be attentive, curious, flexible, and present.
Program Background and History
Ron Epstein's 1999 JAMA article, "Mindful Practice" established an intellectual basis for mindfulness and self-awareness in medicine. Mick Krasner brings years of experience teaching Mindfulness Based Stress reduction to patients and health professionals. Together, they created a series of programs in Mindful Practice at the University of Rochester School of Medicine and Dentistry to address the educational needs of medical students, residents, medical center faculty, and community-based physicians. They then began to offer similar programs nationally and internationally. Since 2010 they have offered intensive residential workshops for medical educators and practitioners at the Rochester Zen Center's Chapin Mill Retreat Center in Batavia, NY. They focus on cultivating healing intention, focused and panoramic attention, attentiveness to the needs of self and others, and caring and humanistic attitudes that foster better understanding of people, their contexts and their needs.
Three components that make up the core experience of Mindful Practice are:
- Formal and Informal Mindfulness Meditation: Cultivation of an open, receptive, and non-judgmental orientation to one’s present experience, which helps promote physical, emotional and cognitive stability
- Narrative Medicine: Creation and sharing of reflective stories that explore the profound and meaningful experiences one has as a physician/clinician, which helps connect the clinician with sources of professionalism and satisfaction
- Appreciative Interviews: Based on Appreciative Inquiry, a strength-based approach to individual and organizational change that alters habitual patterns of thinking and behavior, designed to help participants discover capacities and resources within themselves for positive potential
The acquisition of medical knowledge, assimilation of clinical information, and continued honing of manual skills are vital to professional competence. Likewise, the continual honing of interpersonal skills, steady development of increased intrapersonal and interpersonal awareness, and capacity to attend to patients with presence are also central tasks toward the goal of practicing high quality, relationship-centered medical care. A desirable outcome of Mindful Practice is the integration of these skills into the practitioner’s clinical understanding and individual expression in much the same way that the understanding of organ systems and their physiology and pathology become integrated into an approach to solving problems in a clinical encounter.
Goals of Mindful Practice® programs
- To foster skills of attentive observation, critical curiosity, "beginner's mind, and presence
- To improve recognition of error-prone situations, reduce medical errors, and improve responsiveness to errors
- To foster caring and compassion toward patients
- To promote professionalism
- To promote clinician flourishing--resilience, health, and well-being
- To help create mindful organizations that support teamwork, mindfulness, and clinician health and well-being
This workshop offers an experiential learning environment, with a focus on developing the capacity for self-awareness in stressful and demanding situations. At the conclusion of this activity, participants should be able to:
- Increase clinician self-awareness and self-monitoring during clinical work and teaching
- Increase clinicians’ ability to attend to patient’s needs, reduce and respond to errors, practice with greater effectiveness and compassion, and attend to their own well-being
- Incorporate mindful practice into clinical and educational activities at their home institutions?
Session themes and (provisional) schedule
Session themes include flourishing and finding meaning in medicine, noticing and attention, self-awareness and mindful communication, promoting deep listening and compassion, when things go wrong, uncertainty in medicine, gratitude, attending to self-care, resilience and well-being, and promoting mindfulness in participants’ own work settings.
Sunday 17 November 2019
- 18:00 Check-in / Registration (registration open from 16:00)
- 18:00 – 19:00 Dinner
- 19:15 – 21:15 Introduction
Monday 18 November 2019
- 06:30 – 07:30 Morning Meditation Practice
- 07:30 – 08:45 Breakfast
- 08:45 – 09:10 Affinity Groups
- 09:15 – 12:30 Morning session
- 12:30 – 14:30 Lunch
- 14:30 – 15:00 Affinity Groups
- 15:00 – 18:00 Afternoon Session
- 18:30 – 19:45 Dinner
- 19:45 – 20:00 Affinity Groups
- 20:00 – 21:20 Contemplative Skills Practice
Tuesday 19 November 2019
- 06:30 – 07:30 Morning Meditation Practice
- 07:30 – 08:45 Silent Breakfast
- 08:45 – 12:15 Morning Session
- 12:15 – 14:45 Lunch
- 14:45 – 15:15 Affinity Groups
- 15:20 – 18:00 Afternoon Session
- 18:30 – 19:30 Dinner
- 19:30 – 21:00 Evening open
Wednesday 20 November 2019
- 06:30 – 07:30 Morning Meditation Practice
- 07:30 – 08:30 Breakfast
- 08.30 – 08:45 Affinity Groups Final Meeting
- 08:45 – 11:45 Final Session
- 12:00 End (lunch is not included on this day)
The program is designed for physicians, medical specialists, and all other health care professionals, involved in medical care and education. No prior experience is required, however, experience with meditation or other contemplative practices is desirable.
Accreditation and certification
Accreditations with the Dutch organization for physicians have been applied for.
Upon request a certificate of attendance will be issued by the Centrum voor Mindfulness. The program counts for 21:45 hours of teaching (subject to review).