Mindful medical practice: An innovative core course to prepare medical students for clerkship
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Perspect Med Educ https://doi.org/10.1007/s40037-020-00591-3
Mindful medical practice: An innovative core course to prepare medical students for clerkship Tom A. Hutchinson
· Stephen Liben
© The Author(s) 2020
Abstract Background Medical students show a decline in empathy and ethical reasoning during medical school that is most marked during clerkship. We believe that part of the problem is that students do not have the skills and ways of being and relating necessary to deal effectively with the overwhelming clinical experience of clerkship. Approach At McGill University in Montreal, starting in January 2015, we have taught a course on mindful medical practice that combines a clinical focus on the combination of mindfulness and congruent relating that is aimed at giving students the skills and ways of being to function effectively in clerkship. The course is taught to all medical students in groups of 20, weekly for 7 weeks, in the 6 months immediately prior to clerkship, a time when students are very open to learning the skills they need to take effective care of patients. Evaluation The course has been well accepted by students as evidenced by their engagement, their evaluations, and their comments in the essays that they write at the end of the course. In a follow-up session at the simulation centre one year later students remember clearly and enact what they were taught in the course. Reflection The next steps will be to conduct a formal evaluation of the effect of our teaching that will involve a combination of qualitative methods to clarify T. A. Hutchinson () Department of Medicine, Faculty of Medicine, Programs in Whole Person Care, McGill University, Montreal, Quebec, Canada [email protected]
the nature of the impact on our students and a quantitative assessment of the difference the course makes to students’ experience and performance in clerkship. Keywords Mindful medical practice · Whole person care · Congruence · Experiential learning
Background Description of problem and generalizability There is evidence that rather than experiencing an increase in empathy and ethical reasoning as they progress in their training, medical students actually experience a decrease in these key ways of being [1, 2]. The decline appears to be most severe during their intense clinical exposure during clerkship [3]. One theory is that this decline is a result of being overwhelmed by intimate interactions with patients and other stressful aspects of the clinical milieu [4, 5]. We propose that, although this may be part of the problem, the issue may be fundamentally that students are not given sufficient skills and ways of relating before clerkship that would prepare them to manage effectively their clinical and professional relationships. We believe this is a problem that is general to medical schools across the world but perhaps most immediately relevant to North American medical schools where clerkship can be such a challenging experience for students [4] during the latter part of their medical school trajecto
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