Mindful Practice

Abstract

Mindful practitioners attend in a nonjudgmental way to their own physical and mental processes during ordinary, everyday tasks. This critical self-reflection enables physicians to listen attentively to patients' distress, recognize their own errors, refine their technical skills, make evidence-based decisions, and clarify their values so that they can act with compassion, technical competence, presence, and insight. Mindfulness informs all types of professionally relevant knowledge, including propositional facts, personal experiences, processes, and know-how, each of which may be tacit or explicit. Explicit knowledge is readily taught, accessible to awareness, quantifiable and easily translated into evidence-based guidelines. Tacit knowledge is usually learned during observation and practice, includes prior experiences, theories-in-action, and deeply held values, and is usually applied more inductively. Mindful practitioners use a variety of means to enhance their ability to engage in moment-to-moment self-monitoring, bring to consciousness their tacit personal knowledge and deeply held values, use peripheral vision and subsidiary awareness to become aware of new information and perspectives, and adopt curiosity in both ordinary and novel situations. In contrast, mindlessness may account for some deviations from professionalism and errors in judgment and technique. Although mindfulness cannot be taught explicitly, it can be modeled by mentors and cultivated in learners. As a link between relationship-centered care and evidence-based medicine, mindfulness should be considered a characteristic of good clinical practice.

Exploring and Validating Patient Concerns: Relation to Prescribing for Depression

“…These cognitive processes are affected by 28,29 may be more attuned and responsive to patients' concerns and signs and symptoms of depression; they may also tend to engage in mindful examinations of their own scripts and tendencies toward premature closure. 27 The fi nal common pathway may be achievement of an attentive, nonanxious state with a fuller understanding of the patient's experience, 14,15,30 leading to more informed prescribing. We incidentally noted the lack of consistency in each physician's reactions to 2 quite similar standardized patient roles.…”

Impact of Instruction and Feedback on Reflective Responses during an Ambulatory Care Advanced Pharmacy Practice Experience

“…By initiating this process of reflection, a practitioner is more mindful of previous knowledge, the impact of tacit understandings, and has the awareness of novel approaches to patient care. 5 A reflective practitioner will gain confidence in expertise and develop into a more competent member of the health care team. 1 Incorporating reflection into pharmacy education can foster the development of life-long learners and graduates who demonstrate patient-centered care.…”

Capsule Commentary on Dzeng et al., Moral Distress Amongst American Physician Trainees Regarding Futile Treatments at the End of Life: a Qualitative Inquiry

“…As programs adopt essential palliative care competencies, 4 the heart of these skills remain the mindful practice and self-care that allow clinicians to negotiate and navigate these tough decisions. 5 …”