Mindful practice in action (I): Technical competence, evidence-based medicine, and relationship-centered care.

In this first of a 2-part series of articles, mindfulness is defined as a purposeful, non-anxious, reflective presence that can be applied to any aspect of practice. More than an occasional flash of insight, mindfulness is a state of mind that permits insight, presence, and reflection. Mindfulness applies equally to cognitive, technical, and interpersonal aspects of medicine, and invites a deeper examination of the process of care. Mindful practice includes core features: attentive observation, critical curiosity, “beginner’s mind,” and presence. Mindfulness can be recognized, and requires practice to become habitual. Although mindfulness is not taught explicitly in medical training, it is often invoked through clinical stories and by observing exemplary practitioners. Levels of mindfulness extend from mindless imitation to embodied presence, and are described in the text.