[Mindfulness and the clinical relationship: steps to a resilience in medicine]

Medical resilience is a dynamic capacity, which has the potential to improve the well-being of physicians and to enhance the quality of the clinical relationship. Strategies to promote resilience are important to achieve a sustainable medical practice and improve patient care. Mindfulness training has demonstrated to be an effective tool to promote resilience in physicians. This paper contextualizes the place of mindfulness in medical practice and describes the ways through which it can contribute to resilience in medicine. The concept of mindfulness, its relationship with health practice is reviewed and the benefits of the practice of mindfulness in the clinical relationship are described. We suggest that the benefits achieved through a mindfulness-based medical practice are mediated by two axes. One is the nonspecific and specific effect of mindfulness-based practices and the other is the integration of explicit and implicit knowledge of clinical practice. We conclude that medical practice that integrates mindfulness can contribute to the challenge of achieving greater levels of individual, staff and institutional resilience. There is a need to have continuing mindfulness training programs for health professionals and to integrate this concept in the curriculum of health care professionals.