Effect of an Intensive Mindful Practice Workshop on Patient-Centered Compassionate Care, Clinician Well-Being, Work Engagement, and Teamwork

Abstract

Introduction: Mindfulness-based interventions for health professionals have been linked to improvements in burnout, well-being, empathy, communication, patient-centered care, and patient safety, but the optimal formats and intensity of training have been difficult to determine because of the paucity of studies and the heterogeneity of programs. A 4-days residential "Mindful Practice" workshop for physicians and medical educators featuring contemplative practices, personal narratives, and appreciative dialogs about challenging experiences may hold promise in improving participants' well-being while also improving compassionate care, job satisfaction, work engagement, and teamwork. Methods: We collected baseline and 2-month follow-up data during four workshops conducted in 2018 to 2019 at conference centers in the United States and Europe. Primary outcomes were burnout, work-related distress, job satisfaction, work engagement, patient-centered compassionate care, and teamwork. Results: Eighty-five of 120 participants (71%) completed both surveys (mean age was 49.3 and 68.2% female). There were improvements (P < .01) in two of three burnout components (emotional exhaustion and depersonalization), work-related distress, job satisfaction, patient-centered compassionate care, work engagement and meaning, teamwork, well-being, positive emotion, mindfulness, somatic symptoms, and spirituality. Effect sizes (standardized mean difference of change) ranged from 0.25 to 0.61. With Bonferroni adjustments (P < .0031), teamwork, general well-being, and mindfulness became nonsignificant. Discussion: An intensive, multiday, mindfulness-based workshop for physicians had clinically significant positive effects on clinician well-being, quality of interpersonal care and work satisfaction, and meaning and engagement, all important indicators of improved health and sustainability of the health care workforce. Future iterations of the program should increase the focus on teamwork.

Mechanics and gardeners: The role of mindfulness in medical education

“…[17][18][19][20][21] Attentive observation, critical curiosity, beginner's mind and presence are skills and qualities of mind fundamental to evidence-based decision-making, forming trusting relationships, activating patients to engage in their own care, ethical practice and the sustainability of the health care workforce. [22][23][24][25][26][27][28] Our work and that of others show that it is possible to cultivate these skills. 27,[29][30][31] In the frenzied, distracted and crisis-oriented environments in which we practise now, 32 more than ever, clinicians need to draw on self-awareness during everyday work to bring our attention to that which matters most.…”

“…[22][23][24][25][26][27][28] Our work and that of others show that it is possible to cultivate these skills. 27,[29][30][31] In the frenzied, distracted and crisis-oriented environments in which we practise now, 32 more than ever, clinicians need to draw on self-awareness during everyday work to bring our attention to that which matters most. Pausing momentarily during the day-perhaps between one patient and the next-can be opportunities to observe ourselves, take a breath and make micro-calibrations to be more attentive and set aside that which is less immediately relevant.…”

“…Research by our group indicates that these mindfulness-enhancing activities can be embedded in everyday clinical practice, involve a minimum of time, create greater efficiency, sense of purpose and meaning in work and help clinicians provide more compassionate patient-centred care. 27 Over the past 30 years, there has been considerable progress in medical education focusing on reflection, self-awareness, identity-formation, professionalism and mindfulness, providing greater hope for sustainability of the health care workforce and the provision of the care that our patients really want. However, health care and medical institutions must support the efforts of individual clinicians to be mindful.…”

“…Presence helps us to reconceptualise patients' distress in their terms; it energises us to go the extra mile 17–21 . Attentive observation, critical curiosity, beginner's mind and presence are skills and qualities of mind fundamental to evidence‐based decision‐making, forming trusting relationships, activating patients to engage in their own care, ethical practice and the sustainability of the health care workforce 22–28 …”

Growing Pains During COVID-19

“…8 Rowland et al 9 signal in their short report that their intention to explore the intersections between knowledge mobilization and CPD within educational practices deployed in response to COVID-19. Epstein and colleagues 10 investigate the use of mindfulness-based interventions to positively affect individual physician well-being, but also their capacity to enact patient-centered compassionate care. They also emphasize the need for coordinated system and individual-level CPD intervention designs.…”