Clinicians (physicians and nurses) who care for patients with serious illness face significant challenges, both intra-personal and inter-personal, that if unaddressed result in stress, burnout, and exacerbation of patient suffering. Recent developments in contemplative neuroscience and theories of compassion indicate that the time is ripe to build a better understanding of how contemplative practice could inform the clinical care provided by physicians and nurses. What is missing is a theory of “contemplative interactions” that links contemplative practice to mental qualities to medical interactions. In this proposal, we will build a theory of contemplative interactions in health care from lived experiences of an expert group of clinicians who have an established contemplative practice and work with life-threatening illness. The specific aims are to: (1) to collect qualitative data through participant observation and semi structured interviews that build a “thick description” of the lived experience of clinicians who work upstream of hospice and (2) analyze the data using the constant comparative method to develop a theory of contemplative interaction in the medical context of life-threatening illness. The ultimate goal of this inquiry and research is to understand how contemplative practice could be relevant to increasing the quality of medical care.

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