Mindful Practice in Press

The past few years have seen a proliferation of literature on programs for health professionals, and here I’ll be highlighting three by colleagues in the USA, Canada, the Netherlands and the UK and published in the past few months. It is so difficult to keep track of all of the activity, and we welcome news about what you’re doing in your home institutions. You can access the articles here.

First, a review article. I met Renee Scheepers at a physician well-being conference in Greece in 2018, and was impressed with her understanding and deep questions about the application of mindfulness-based approaches for health professionals. She and her colleagues, Kiki Lombarts and Helge Emke had already drafted a literature review, and invited me to be a co-author. While originally developed as a systematic review, the editors at Medical Education suggested that it be recast as a narrative review, given the heterogeneity of programs that claim to promote “mindfulness.” For example, one program was a single session, less than an hour, which successfully promoted mindful handwashing by raising self-awareness. The longest programs lasted up to a year. While the emphasis on mindfulness is welcome for those entering and practicing an increasingly beleaguered profession, the term has also become popularized and associated with claims that range from the sensible to the sensational. Renee’s paper helped to bring order to the confusion about structure, goals and methods used in different programs that aspire to cultivate mindfulness for health professionals.(1)

In a recent article in Perspectives in Medical Education, Tom Hutchinson and Stephen Liben at McGill describe early findings from their Mindful Medical Practice course for medical students, based in part on our mindful practice workshops. Their program addresses important issues such as the relationship between self-awareness, well-being and clinical effectiveness (including empathy, communication and clinical decision-making); they build on successes and failures of prior attempts to humanize medical training; they have thought carefully about timing and format so that it would have maximal impact. They also raise important questions that many of us have faced when implementing mindful practice programs in educational settings that are (paradoxically) both highly structured and chaotic – such as: Can you actually teach someone to be mindful? How can you train enough teachers to meet the demand? What should be your standards for success? And, while there are guidelines for mindfulness teachers in general, how do programs for health professionals differ from those that are designed for patients or the general public?(2, 3)

In the British Journal of General Practice, Manuel Villareal and Majid Khan have recently published a needs assessment in planning for large scale training of British GPs using a modified version of our mindful practice workshops.(4) The logistics, need for trained facilitators and overall scope of their project is daunting, to say the least. Needs assessments are also scary – because people may feel they need things you cannot offer and may resist those that you think will help – and require adopting a beginner’s mind to begin to navigate towards a program that is not only ideal in your own mind, but will engage and transform learners. And rolling out a program that is part of the requirements for GP training is quite different than a program which people attend voluntarily because of a personal need or calling. A paper documenting the outcomes of the program is on its way.

So much creative activity is happening to bring mindful practice programs to health professionals in North and South America, Europe, Asia and Australia/New Zealand. For those of you who are moved to publish your findings and perspectives, you share your wisdom and experience with the rest of us and help us all grow.

Thanks to you all.

1. Scheepers RA, Emke H, Epstein RM, Lombarts K. The impact of mindfulness-based interventions on doctors' well-being and performance: a systematic review. Med Educ. 2020;54(2):138-149.
2. Epstein RM. Mindfulness in medical education: coming of age. Perspect Med Educ. 2020.
3. Hutchinson TA, Liben S. Mindful medical practice: An innovative core course to prepare medical students for clerkship. Perspect Med Educ. 2020.
4. Hanson P, Clarke A, Villarreal M, Khan M, Dale J. Burnout, resilience, and perception of mindfulness programmes among GP trainees: a mixed-methods study. BJGP Open. 2020:bjgpopen20X101058.