Does personal resilience create more efficient clinicians?

Jane Muir, 3rd year nursing student and "Young Innovator" grantee

With a $7,350 grant from the Boston-based Lown Institute, U.Va. School of Nursing 3rd year student Jane Muir will implement a resilience program for nursing and medical students with the goal of enhancing compassion, clinical abilities and efficiency.

(12-1-14) Can learning how to be more attentive and resilient be a route to increasing efficiency, reducing medical redundancy and boosting clinicians’ compassion at the bedside? Third-year University of Virginia nursing student Jane Muir thinks so.

Muir’s hunch – that learning specific ways to be attentive and tune into others will engage specific neural pathways and augment the quality and efficiency of developing clinicians’ care – will soon be put to into action. The Chantilly, Va. native, named one of RightCare Alliance’s 11 “Young Innovator” grantees by the Lown Institute earlier this month, is, along with her mentor, Kluge Professor Susan Bauer-Wu, and U.Va. School of Medicine student partner J. Andy Starr, developing a series of workshops on mindfulness, communication, wisdom, and self-care for 30 nursing and medical students with the hope that insights gained from the training will enable them to be role models for their peers and have a lasting impact on their future clinical practice. 

“Overuse in the clinical setting often stems from a lack of being fully attentive due to competing demands, our fast-paced, high-tech culture, personal and professional stress, limited time with patients and heavy workloads,” explains Muir. “By introducing clinicians early on to self-reflection and mind-body practices, we think they’ll be more tuned in, less easy to distract, less emotionally reactive and stressed, and more present – and ultimately less inclined to overuse things like medication and tests and able perhaps to get to the root of problems determined by more subtle cues.”

The four, three-hour sessions will be held at the School every other weekend over eight weeks, ending with a final summative all-day retreat to be held at U.Va.’s 7,000-acre Morven Farm. The program will be led by U.Va. faculty from the School of Nursing’s Compassionate Care Initiative, and co-taught with faculty from the School of Medicine’s Center for Appreciative Practice, and the U.Va. Mindfulness Center. Participants will also carry out a mini project related to resiliency and overuse to implement in their daily interactions with patients and colleagues.

The thought, explains Muir, is that teaching the next generation of clinicians about the primacy of attentiveness will enable them to truly tune into patients – and deliver leaner, more efficient, compassionate care.

“Using and understanding contemplative practices will, we think, allow clinicians to be more present for their patient so they can pick up on more subtle cues and avoid overuse of tests and an overreliance on medication,” says Muir. “We believe that teaching students early on how to pay close attention, to be present and compassionate will promote a culture of wise and compassionate care and less a culture of overuse.”

In early 2014, the Lown Institute – a Boston-based think-tank – put out a call for proposals with special focus on ways to improve quality of care, boost efficiency, and reduce medical redundancy and waste. Lown received 80 applications from 200 individuals across 25 states, the vast majority of them from medical faculty, residents and students. Muir was the only nursing student and the only undergraduate to receive funding.

As a Young Innovator grantee, Muir will contribute to a Lown blog, create a video and present her findings at two forthcoming conferences. The grant also offers her a chance to demystify what she calls “the M-word,” which often flummoxes clinicians who may feel put off by the seemingly esoteric and unreachable ideas of meditation and mindfulness.

“I think people get overwhelmed when they hear about resilience and contemplation,” says Muir, “but our hope is to bring caregivers back to the basics, and away from this go-go-go society, where auto-pilot is the rule and not the exception. “We want to change the culture of health care, form new habits in the brain, and make people more compassionate to themselves and their patients.”

“The Compassionate Care Initiative shapes the way we learn about nursing and medicine here at U.Va.,” she adds, “and the Lown Institute has given us another avenue to spread the word.”