The efficacy of mindful practice in improving diagnosis in healthcare: a systematic review and evidence synthesis


Author: Ralph Pinnock1, Darren Ritchie2, Steve Gallagher2, Marcus A Henning3, Craig S Webster3

Affiliation: <sup>1</sup> Medical Education Unit, Dunedin School of Medicine, Otago Medical School - Dunedin Campus, University of Otago, Dunedin, New Zealand. ralph.pinnock@otago.ac.nz.

<sup>2</sup> Medical Education Unit, Dunedin School of Medicine, Otago Medical School - Dunedin Campus, University of Otago, Dunedin, New Zealand.

<sup>3</sup> Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand.
Conference/Journal: Adv Health Sci Educ Theory Pract
Date published: 2021 Jan 3
Other:
  Special Notes: doi: 10.1007/s10459-020-10022-x.   ,  Word Count: 255  
    Despite a variety of definitions of mindfulness, over the past 20 years there have been increasing claims that mindful practice is helpful in improving the accuracy of clinical diagnosis. We performed a systematic review and evidence synthesis in order to: determine the nature and definitions of mindful practice and associated terms; evaluate the quality of evidence for the benefits of mindful practice; and conclude whether mindful practice may reduce diagnostic error. We screened 14397 refereed reports from the five common literature databases, to include 33 reports related to the use of mindful practice in clinical diagnosis. Our evidence synthesis contained no randomised controlled trials (level I evidence) of mindful practice, the majority of supporting evidence (26 reports or 79%) comprised conceptual commentary or opinion (level IV evidence). However, 2 supporting reports constituted controlled studies without randomisation (level IIa), 1 report was quasi-experimental (level IIb), and 4 reports were comparative studies (level III). Thus, we may tentatively conclude that mindful practice appears promising as a method of improving diagnostic accuracy, but that further definitive studies of efficacy are required. We identified a taxonomy of 71 terms related to mindful practice, 7 of which were deemed core terms due to being each cited 5 times or more. The 7 core terms appear to be sufficient to describe the findings at higher levels of evidence in our evidence synthesis, suggesting that future definitive studies of mindful practice should focus on these common core terms in order to promote more generalisable findings.



Keywords: Clinical reasoning; Debiasing; Dual process theory; Metacognition; Mindful practice; Mindfulness; Reflective practice.



PMID: 33389234 DOI: 10.1007/s10459-020-10022-x