MD Aware: A Mindful Medical Practice Course Guide



 

Written by Stephen Liben and Tom A Hutchinson

Patricia Lynn Dobkin, PhD1

Perm J 2020;24:19.221 [Full Citation]

https://doi.org/10.7812/TPP/19.221
E-pub: 02/14/2020

19.221Medical education has been evolving in the way physicians are “raised.” Where didactic expert lecturers once dominated pedagogy, problem-focused learning, small group experiences, and mentoring are becoming accepted methods. Within this context, recognition of relatively high rates of medical students’ psychological distress and the need to promote resilience have been included when considering curriculum.

Mindful Medical Practice (MMP) has been steadily finding its way into medical education as outlined in Mindful Medical Practitioners: A Guide for Clinicians and Educators.1 MD Aware: A Mindful Medical Practice Guide2 builds upon this trend. It describes a course rolled out in 2015 that aims to reinforce positive qualities inherent in medical students that will help them maintain their enthusiasm for medicine and provide them with the means to hold onto their humanity.

Two voices are harmonized across the 12 concise chapters. Although they were written separately (except the Introduction), the authors’ intentions are clearly in sync. The MMP course is divided into seven 3-hour classes, each described in depth. Interestingly, the authors share the underlying processes that led to the teaching methods described. Although core content and a template for each class are provided, what is most appealing is the way the authors show the reader what it feels like to be with 20 second-year medical students on the threshold of clerkship—an anxiety-provoking transition for many.

Classes 1 through 7 are theme-based covering the following topics: 1) Attention and Awareness, 2) Congruent Communication, 3) Awareness and Decision Making, 4) Clinical Congruence, 5) Building Resilience, 6) Responding to Suffering, and 7) Mindful Congruent Practice in Clerkship and Beyond. These subjects build upon one another and are integrated so that at the end of the MMP course students ideally have the means to become good physicians who know how to approach complex medical issues. Clinical examples are used throughout the course to allow students to see the relevance of what is being taught. Contemplative practices are seamlessly integrated into each class highlighting experiential learning as a method that “sticks” because it evokes emotions. Narrative medicine exercises, deep listening exchanges, and safe space sharing enrich the course.

Liben, in Chapter 2, reaches out to aspiring MMP teachers—just what does it take to lead a class? A whole person who is self-aware and comfortable leading guided awareness practices in an authentic manner. Showing, not telling, is emphasized. “Great faith, great doubt, and great effort”2 are prerequisites for teaching MMP. Then, logistics are described.

Chapters 3 through 9 take the reader into the classroom experience. Each exercise is explained, guided contemplation transcripts are provided, and a one-page class template is offered so that a teacher can take it to class as a guide. Computers and other devices, including smartphones, are left out on purpose. Distractions are avoided. Elements of Mindfulness-Based Stress Reduction courses are maintained (eg, Triangle of Attention, S T O P exercise) as are Satir’s communication stances3 that promote whole person care and healing. How MMP methods differ from standard medical training is underscored.

Hutchinson, in Chapter 10, invites the reader directly into his sixth class (Responding to Suffering) via an audio transcript. This level of vulnerability is unprecedented. We glimpse not only the inner workings of a gifted teacher, but also students’ responses to his way of being. We are privileged to be privy to a “master class”—one whereby a lifetime of clinical work and pedagogy meld together effortlessly.

Liben, in Chapter 11, tackles the nuts and bolts of what can and cannot be done when creating an MMP course elsewhere. For example, which parts of the course can be or should not be altered is mentioned. He justifies the format of the course, class size, consecutive weekly classes, and explains how to create a safe space for teaching and learning in this unique way. How to select and train MMP teachers is outlined. Critical in medical training, how to evaluate student learning is also addressed.

Finally, medical students’ views are shared via their essays pertaining to the MMP course. It seems the experiment was a success as they relate how they feel ready to face the challenges awaiting them during clerkship and beyond.

Author Affiliations

1 McGill University, Montreal, Quebec, Canada

Corresponding Author

Patricia Lynn Dobkin, PhD ()

How to Cite this Article

Dobkin PL. MD aware: A mindful medical practice course guide, by Stephen Liben and Tom A Hutchinson. Perm J 2020:19.221. DOI: https://doi.org/10.7812/TPP/19.221

References
1.    Dobkin PL, Hassed CS. Mindful medical practitioners: A guide for clinicians and educators. Cham, Switzerland: Springer International Press; 2016
    2.    Liben S, Hutchinson TA. MD aware: A mindful medical practice course. Cham, Switzerland: Springer Nature; 2019
    3.    Satir V. Peoplemaking. Palo Alto, CA: Souvenir Press; 1990

Keywords: book review, medical education, mindful medical practice, narrative medicine, whole person care

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