The art of healing requires knowledge-facts, technical skills, methods, processes-but it also requires deep awareness of oneself and of others. Helping residents gain that awareness, and helping them find the tools to cultivate it, are the goals of the Department of Family Medicine's (DFM) Aware Medicine course.

And now, with comprehensive information about the course publicly available on the DFM Web site, other departments and institutions at UW and beyond can begin learning how to integrate Aware Medicine in the training of their future healers.

The Aware Medicine Course

The Aware Medicine course was launched in 2006 with a three-year, $30,000 grant from the George Washington Institute for Spirituality and Health (GWish).

With those grant funds, J. Adam Rindfleisch, MD, and Luke Fortney, MD, developed a three-year curriculum for family medicine residents in Madison, which includes:

• Seminars on topics such as ethics, belief systems of different cultures and religions, epistemology, communication skills, and end-of-life issues;
• Experiential mindfulness and meditation sessions, many of which can be tailored to the resident's individual preferences;
• Tools and exercises for developing self-awareness and improving self-care; and
• A mentoring program for residents to share experiences and obtain guidance and support.

The Aware Medicine course represents one of the first times a residency program has formally included mindfulness training as part of its curriculum. And although the course is a requirement of the family medicine residency, residents have some choice in the extent of their participation.

"We ask all residents to give us a minimum of 10 hours of their time," said Dr. Rindfleisch. "Beyond that, there is room for flexibility. If they choose, residents may take additional time to enrich their experience."

The Value of Awareness

According to Dr. Rindfleisch, the course gives family medicine residents a venue to explore the meaning of all the experiences they have during residency. "We're helping residents as they go through the healer's journey," he said. "They're learning to be present to the suffering of others."

That journey can be tough, though, so it follows that self-care techniques are emphasized throughout the course. Residents learn ways to manage stress and prevent burnout, and also develop a personal plan for staying healthy-physically, mentally, emotionally, and spiritually.

Although on the surface, it may seem incongruous to integrate spirituality into a healthcare curriculum, the two are closely connected, according to Dr. Rindfleisch.

"We define spirituality as practices or experiences that awaken the heart and mind," he explained. "This can come from organized religion, or it can come from meditation, T'ai Chi, yoga, or other practices. It can also come from the natural world or creative pursuits. Every individual will take a different path."

According to Dr. Rindfleisch, spiritual exploration helps residents more deeply understand themselves and their purpose, which in turn helps them be more understanding of their patients.

"This is important to any healer in training, regardless of medical specialty or individual beliefs," he added. "In fact, it's something we all need as human beings."

Expanding Awareness Into the Future

Although the grant that helped launch the Aware Medicine curriculum ends soon, the structure is in place to continue offering it in the coming years. Dr. Rindfleisch and Dr. Fortney continue to lead the course, but are also focused on communicating its benefits to groups beyond the DFM.

"Now that the DFM Web site has introduced the Aware Medicine curriculum to the broader public, we look forward to seeing how it might influence other healthcare training programs," Dr. Rindfleisch said. "If we can make an experience like medical school or residency more positive for even one person, all our efforts will have been worthwhile."

Dr. Rindfleisch added that some UW programs are thinking about integrating a similar curriculum, and that he and Dr. Fortney have been working with other institutions, notably Duke University, as they develop comparable courses for their residency programs.