Mindful Practice

Student and Resident Programs

Starting in 2007, we implemented a required Mindful Practice curriculum for medical students and residents at URMC. The goal was to teach and reinforce patient-centered care using secular contemplative practices, narrative medicine, reflective questioning and appreciative inquiry. Each of the 12 training modules we developed is built around a particular theme, such as witnessing suffering, medical errors, physician well-being and burnout, breakdowns in communication, time pressure, handling conflict compassionately and times when trainees have been particularly effective with patients. After an initial didactic component in which information and research data relevant to the theme are presented, participants engage in a brief period of contemplative practice. These include guided mindfulness meditation, a secular practice that involves applying conscious attention to bodily sensations, thoughts and feelings to promote self-awareness and awareness of one’s environment, as well as other exercises that bring attention to the present moment. Participants then participate in a narrative exercise in which they recall a clinical experience related to the theme and spend a period of time writing about their experience. After writing, trainees pair up or divide into small groups, taking turns telling and listening to each other’s stories using techniques of reflective questioning. In some sessions, participants interview each other, focusing on how difficult situations were managed effectively. The sessions close with simple mindfulness exercises to practice on their own at home and during clinical practice. The detailed syllabus, which includes a facilitator guide, session descriptions, PowerPoints and multimedia materials, is available to order in print and CD-ROM format. Similar programs exist at other institutions.

As of July 2013, over 600 University of Rochester medical students and 1,000 residents in 8 specialties have participated. Sessions have been facilitated by 24 faculty members whom we have trained, 2-3 from each clinical department. We have documented that there is a need for the program – levels of burnout are high among practitioners, residents, and students. Student focus groups and surveys suggest that most find the sessions useful and many find them transformative.

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