Mindful practice

Mindful practitioners attend in a nonjudgmental way to their own physical a nd mental processes during ordinary, everyday tasks. This critical selfrefl ection enables physicians to listen attentively to patients' distress, reco gnize their own errors, refine their technical skills, make evidence-based decisions, and clarify their values so that they can act with compassion, t echnical competence, presence, and insight. Mindfulness informs all types o f professionally relevant knowledge, including propositional facts, persona l experiences, processes, and know-how, each of which may be tacit or expli cit. Explicit knowledge is readily taught, accessible to awareness, quantif iable and easily translated into evidence-based guidelines. Tacit knowledge is usually learned during observation and practice, includes prior experie nces, theories-in-action, and deeply held values, and is usually applied mo re inductively. Mindful practitioners use a variety of means to enhance the ir ability to engage in moment-to-moment self-monitoring, bring to consciou sness their tacit personal knowledge and deeply held values, use peripheral vision and subsidiary awareness to become aware of new information and per spectives, and adopt curiosity in both ordinary and novel situations. In co ntrast, mindlessness may account for some deviations from professionalism a nd errors in judgment and technique. Although mindfulness cannot be taught explicitly, it can be modeled by mentors and cultivated in learners. As a l ink between relationship-centered care and evidence-based medicine, mindful ness should be considered a characteristic of good clinical practice.