Complementary Approaches, Stress Management Practices for Future Physicians, a Way to Cultivate a “Savoir-être” and Contribute to Becoming a Better Physician?
Purpose: Awakening the “Sensible” Being (ASB), a complementary approach, is a formative practice that examines how use and movement of the body allow for the development of one’s awareness, sense of self and of others, which are desirable qualities for healthcare professionals. Our goal was to explore if and how ASB training followed by healthcare practitioners modifies the quality of their self-awareness, their presence to others, as well as their relationship with respect to health and their medical practice. Methods: Qualitative research based on two types of semi-structured interviews (comprehensive and elicitation) conducted with six physicians from France having completed their ASB training (500hours over 4 years). The content of the interviews was first analyzed thematically then grouped into categories linked by items and sub-items. Results: A summary of the results is presented in relation to transformation in both the personal and professional spheres of physicians. Thereafter, we describe the identity-transforming effects of education creating favorable conditions for the emergence of a quality of “savoir-être”. We then discuss the relevance and necessity of “savoir-être” both in the learning path of future physician and in medical practice. Conclusion: We conclude with the positive impacts of this learning: on stress management, a way to cultivate a “savoir-être”, an identity construction of the health-promoting professional and the need for an ethical posture enriched by a new perspective. It seems that ASB training is ideal for building the artistic part of the medical profession.
References
[1]
Angibaud, A., Duprat, E., & Bois, D. (2013). La voie du corps sensible dans le traitement du mal être [The Path of the Sensible Body in the Treatment of Uneaset]. Réciprocités, 8, 26-35.
[2]
Beckman, H. B., Wendland, M., Mooney, C., Krasner, M. S., Quill, T. E., Suchman, A. L., & Epstein, R. M. (2012). The Impact of a Program in Mindful Communication on Primary Care Physicians. Academic Medicine, 87, 815-819.
https://doi.org/10.1097/ACM.0b013e318253d3b2
[3]
Berger, E. (2009). Rapport au corps et création de sens, étude à partir du modèle somato-psychopédagogique [Relationship to the Body and Creation of Meaning, Study Based on the Somato-Psychopedagogical Model]. Ph.D. Thesis, Université Paris 8.
[4]
Bertrand, I. (2013). Accompagnement en somato-psychopédagogie et renouvellement du rapport à soi [Accompaniment in Somato-Psychopedagogy and Renewal of the Relationship with Oneself]. Réciprocités, 8, 36-44.
[5]
Bois, D. (2007). Le corps sensible et la transformation des représentations chez l’adulte [The Sensible Body and the Transformation of Mental Representations in Adults]. Ph.D. Thesis, Sevilla University.
https://www.cerap.org/sites/default/files/public-downloads/doctorats/these_danis-bois-2007.pdf
[6]
Bois, D., & Eschalier, I. (2019). La méditation pleine présence. Les sept voies d’accès à la chaleur humaine [Full-Presence Meditation. The Seven Paths to Human Warmth]. Eyrolles.
[7]
Bourassa, B., Serre, F., & Ross, D. (1999). Apprendre de son expérience [Learn from Experience]. Presses de l’Université du Québec. https://doi.org/10.2307/j.ctv18phgbj
[8]
Brazeau, C., Schroeder, R., Rovi, S., & Boyd, L. (2010). Relationships between Medical Student Burnout, Empathy and Professionalism Climate. Academic Medicine, 85, 33-36.
https://doi.org/10.1097/ACM.0b013e3181ed4c47
[9]
Centre Duke de Médecine Intégrée, & Servan-Schreiber, D. (2007). Encyclopédie pratique de la nouvelle médecine occidentale et alternative pour tous les ages. Robert Laffont.
[10]
Charmillot, M., & Dayer, C. (2007). Démarche compréhensive et méthodes qualitatives: clarifications épistémologiques [ComprehensiveApproach and Qualitative Methods: Epistemological Clarifications]. In C. Royer (Ed.), Recherches Qualitatives Collection hors série, 3 “Les actes” Bilan et Prospectives de la recherche qualitative en sciences humaines et sociales (pp. 126-138).
[11]
Colombat, P., Altmeyer, A., Barruel, F., Bauchetet, C., Blanchard, P., Colombat, P., Copel, L., Ganem, G., Rodrigues, M., & Ruszniewski, M. (2011). Syndrome d’épuisement professionnel des soignants [Caregiver Burnout Syndrome]. Oncologie, 13, 845-863.
https://doi.org/10.1007/s10269-011-2098-5
[12]
Courraud, C. (2012). Au carrefour de la kinésithérapie et de la fasciathérapie—Approche exploratoire des reconfigurations identitaires des kinésithérapeutes formés à la fasciathérapie [At the Crossroads of Physiotherapy and Fasciatherapy—Exploratory Approach to Identity Reconfigurations of Physiotherapists Trained in Fasciatherapy]. Réciprocités, 6, 20-35.
[13]
Cruess, R. L., Cruess, S. R., & Steinert, Y. (2016). Amending Miller’s Pyramid to Include Professional Identity Formation. Academic Medicine, 91, 180-185.
https://doi.org/10.1097/ACM.0000000000000913
[14]
Dobkin, P. L., & Hutchinson, T. A. (2013). Teaching Mindfulness in Medical School: Where Are We Now and Where Are We Going? Medical Education, 47, 768-779.
https://doi.org/10.1111/medu.12200
[15]
Duval, T. (2010). Fasciathérapie et transformation du rapport à la santé. étude auprès de patients suivis en fasciathérapie [DBM Fascia Therapy and Transformation of the Relationshipto Health. Study among DBM Fascia Therapy Patients]. MSc. Thesis, Fernando Pessoa University. http://bdigital.ufp.pt/bitstream/10284/1548/1/dmDuvalThierry.pdf
[16]
Duval, T., Duprat, E., & Berger, E. (2013). Fasciathérapie et transformation du rapport à la santé [DBM Fascia Therapy and Transformation of the Relationship to Health]. Réciprocités, 8, 45-55.
[17]
Fortin, S., & Vanasse, C. (2011). The Feldendrais Method and Woman with Eating Disorders. Journal of Dance & Somatic Practices, 3, 127-141.
https://doi.org/10.1386/jdsp.3.1-2.127_1
[18]
Giorgi, A. (1997). De la méthode phénoménologique utilisée comme mode de recherche qualitative en sciences humaines: Théorie, pratique et évaluation [Phenomenological Method Used as Qualitative Research Mode in Human Sciences: Theory, Practice and Evaluation]. In La recherche qualitative: Enjeux épistémologiques et méthodologiques (pp. 341-364.). Gaetan Morin.
[19]
Goldmann, L. (1966). Sciences Humaines et Philosophie. Qu’est-ce que la sociologie [Human Sciences and Philosophy. What Is Sociology]? Gonthier.
[20]
Hafler, J. P., Ownby, A. R., Thompson, B. M., Fasser, C. E., Grigsby, K., Haidet, P., Kahn, M. J., & Hafferty, F. W. (2011). Decoding the Learning Environment of Medical Education: A Hidden Curriculum Perspective for Faculty Development. Academic Medicine, 86, 440-444. https://doi.org/10.1097/ACM.0b013e31820df8e2
[21]
Hodges, B. D., & Lingard, L. (2012). Introduction. In B. D. Hodges, & L. Lingard (Eds.), The Question of Competence. Reconsidering Medical Education in the Twenty-First Century (pp. 1-13). Cornell University Press.
https://doi.org/10.7591/9780801465802-004
[22]
Holden, M. D., Buck, E., Luk, J., Ambriz, F., Boisaubin, E. V., Clark, M. A., Mihalic, A. P., Sadler, J. Z., Sapire, K. J., Spike, J. P., Vince, A., & Dalrymple, J. (2015). Professional Identity Formation: Creating a Longitudinal Framework through TIME (Transformation in Medical Education). Academic Medicine, 90, 761-767.
https://doi.org/10.1097/ACM.0000000000000719
[23]
Honoré, B. (2003). Pour une philosophie de la formation et du soin; la mise en perspective des pratiques [For a Philosophy of Training and Care; Putting Practices into Perspective]. L’Harmattan.
[24]
Huber, M., Knottnerus, J. A., Green, L., Van der Horst, H., Jadad, A. R., Kromhout, D., Leonard, B., Lorig, K., Loureiro, M. I., Van der Meer, J. W. M., Schnabel, P., Smith, R., Van Weel, C., & Smid, H. (2011). How Should We Define Health? British Medical Journal, 343, Article No. d4163. https://doi.org/10.1136/bmj.d4163
[25]
Irving, J. A., Park-Saltzman, J., Fitzpatrick, M., Dobkin, P. L., Chen, A., & Hutchinson, T. (2014). Experiences of Health Care Professionals Enrolled in Mindfulness-Based Medical Practice: A Grounded Theory Model. Mindfulness, 5, 60-71.
https://doi.org/10.1007/s12671-012-0147-9
[26]
Ishak, W., Nikravesh, R., Lederer, S., Perry, R., Ogunyemi, D., & Bernstein, C. (2013). Burnout in Medical Students: A Systematic Review. The Clinical Teacher, 10, 242-245.
https://doi.org/10.1111/tct.12014
[27]
Jarvis-Selinger, S., Pratt, D. D., & Regehr, G. (2012). Competency Is Not Enough: Integrating Identity Formation Into the Medical Education Discourse. Academic Medicine, 87, 1185-1190. https://doi.org/10.1097/ACM.0b013e3182604968
[28]
Josso, C. (1991). L’expérience formatrice: Un concept en construction [The Formative Experience: A Concept under Construction]. In B. Courtois, & G. Pineau (Eds.), La Formation Expérientielle des Adultes (pp.191-199). La Documentation Francaise.
[29]
Kaufmann, J.-C. (2011). L’Enquête et Ses Méthodes: L’Entretien Compréhensif [The Survey and Its Methods: The Comprehensive Interview]. (3rd ed.). Armand Colin.
[30]
Lachance, J. (2016). étude exploratoire auprès de médecins des effets percus d’une formation corps/esprit fondée sur les pratiques du sensible [Exploratory Study with Physicians of the Perceived Effects of Body/Mind Training Based on Awakening the Sensible Being]. Ph.D. Thesis, Université de Sherbrooke.
https://savoirs.usherbrooke.ca/handle/11143/8838
[31]
Lachance, J., & Desbiens, J.-F. (2022). An Identity Transformation Leads to an Inner Construction. Journal of Adult and Continuing Education, 28, 272-290.
https://doi.org/10.1177/14779714211021429
[32]
Lachance, J., & Desbiens, J.-F. (2020). L’émergence d’un “savoir-être” personnel et professionnel chez les médecins suite à une formation corps-esprit [The Emergence of a Personal and Professional “Savoir-être” among Phycisians Following a Body-Mind Training]. La pédagogie médicale. Submitted.
[33]
Lachance, J., Emond, G., & Vignit, F. (2019). Learning to Be a Sensitive Professional: A Life-Enhancing Process Grounded in the Experience of the Body. Adult Education Quarterly, 69, 24-41. https://doi.org/10.1177/0741713618807752
[34]
Lachance, J., Paillé, P., Desbiens, J.-F., & Xhignesse, M. (2016). Incidences des transformations du rapport au corps dans la sphère personnelle et professionnelle de médecins suite à une formation corps/esprit, les pratiques du Sensible [Impacts of the Transformations of the Relationship to the Body in the Physicians’ Personal and Professional Lives Following a Body/Mind Training Using Awakening the Sensible Being Practices]. In F. Vinit, & J. Quintin (Eds.), La place du corps dans la rencontre de soi et l’acco- mpagnement (pp. 163-199). Cercle Interdisciplinaire de Recherches Phénoménologiques (CIRP).
[35]
Large, P. (2007). Corps Sensible et transformation en somato-psychopédagogie [The Sensible Body and Transformation in Somato-Psychopedagogy]. Qu’en disent des Praticiens d’expérience? MSc. Thesis, Université Moderne de Lisbonne.
[36]
Large, P. (2009). Corps sensible et processus de transformation [The Sensible Body and Its Transformation Process]. In D. Bois, M.-C. Josso, & M. Humpich (Eds.), Sujet Sensible et Renouvellement du Moi (pp. 403-415). Point d’Appui.
[37]
Leung, A. S. O., Epstein, R. M., & Moulton, C.-A. E. (2012). The Competent Mind: Beyond Cognition. In B. D. Hodges, & L. Lingard (Eds.), The Question of Competence. Reconsidering Medical Education in the Twenty-First Century (pp. 155-176). Cornell University Press. https://doi.org/10.7591/9780801465802-011
[38]
Llera, J., & Durante, E. (2014). Correlation between the Educational Environment and Burnt-Out Syndrome in Residency Programs at a University Hospital. Archivos Argentinos Pediatria, 114, 6-11.
[39]
Maranda, M. F., Gilbert, M. A., Saint-Arnaud, L., & Vézina, M. (2006). La détresse des médecins: Un appel au changement. Rapport d’enquête de psychodynamique du travail [Doctors’ Distress: A Call for Change. Investigative Report on Occupational Psychodynamics Approach]. Presses de l’Université Laval.
[40]
Mavor, K. I., McNeill, K. G., Anderson, K., Kerr, A., O’Reilly, E., & Platow, M. J. (2014). Beyond Prevalence to Process: The Role of Self and Identity in Medical Student Well-Being. Medical Education, 48, 351-360. https://doi.org/10.1111/medu.12375
[41]
McNaughton, N., & LeBlanc, V. (2012). Perturbations: The Central Role of Emotional Competence in Medical Training. In B. D. Hodges, & L. Lingard (Eds.), The Question of Competence. Reconsidering Medical Education in the Twenty-First Century (pp. 70-96). Cornell University Press. https://doi.org/10.7591/9780801465802-007
[42]
Melo da Silva, M. C. (2013). La Psychopédagogie perceptive et son influence sur ma (Trans)formation professionnelle en tant qu’enseignante [Perceptual Psychopedagogy and Its Influence on My (Trans)Training as a Teacher]. Réciprocités, 8, 56-68.
[43]
Michalec, B., & Hafferty, F. W. (2013). Stunting Professionalism: The Potency and Durability of the Hidden Curriculum within Medical Education. Social Theory & Health, 11, 388-406. https://doi.org/10.1057/sth.2013.6
[44]
Miller, G. (1990). Invited Reviews: The Assessment of Clinical/Skills/Competence/Perfor- mance. Academic Medicine, 65, 63-67.
https://doi.org/10.1097/00001888-199009000-00045
[45]
Mongeau, P., & Tremblay, J. (2002). Survivre. La dynamique de l’inconfort [To Survive. The Dynamics of Discomfort]. Presses de l’Université du Québec.
[46]
Myers, G. E., & Myers, M. T. (1990). Les bases de la communication humaine, une approche théorique et pratique [The Basics of Human Communication, a Theoretical and Practical Approach]. (2nd ed.). Chenelière éducation.
[47]
National Center for Complementary and Integrative Health (2022). Site téléaccessible à l’adresse. http://nccam.nih.gov/health/whatiscam/
[48]
Newman, M. A. (1990). Newman’s Theory of Health as Praxis. Nursing Science Quarterly, 3, 37-41. https://doi.org/10.1177/089431849000300109
[49]
Newman, M. A. (1997). Experience the Whole. Advances in Nursing Science, 20, 34-39.
https://doi.org/10.1097/00012272-199709000-00006
[50]
Paillé, P. (1994). L’analyse par théorisation ancrée [Grounded Theory Data Analysis Method]. Cahiers de Recherche Sociologique, 23, 147-181.
https://doi.org/10.7202/1002253ar
[51]
Pourtois, S. P., & Desmet, H. (2009). épistémologie des méthodes qualitatives. [Epistemology of Qualitative Methods]. In A. Mucchielli (Ed.) Dictionnaire des Méthodes Qualitatives en Sciences Humaines et Sociales (p. 71-76). Armand Colin.
https://doi.org/10.3917/arco.mucch.2009.02.0165
[52]
Rodrigues, M., Albiges, L., & Blanchard, P. (2012). Les internes et le burnout. Oncologie, 14, 343-344. https://doi.org/10.1007/s10269-012-2164-7
[53]
Rondeau, K. (2014). Modélisation de l’expérience du travail de nature identitaire d’enseignantes en contexte de formation expérientielle continue à la maitrise renouvelée en enseignement au préscolaire et au primaire [Modeling of the Work Experience of an Identity-Based Nature of Teachers in the Context of Continuing Experiential Training for a Renewed Master’s Degree in Preschool and Primary Education]. Ph.D. Thesis, University of Sherbrooke.
https://savoirs.usherbrooke.ca/bitstream/handle/11143/5440/Rondeau_Karine_PhD_2014.pdf?sequence=4&isAllowed=y
[54]
Schon, D. (1994). Le praticien réflexif: à la recherche du savoir caché dans l’agir professionnel [The Reflective Practitioner: In Search of Knowledge Hidden in Professional Action]. Les éditions Logiques.
[55]
Shapiro, J. (2008). Walking a Mile in Their Patients’ Shoes: Empathy and Othering in Medical Students’ Education. Philosophy, Ethics, and Humanities in Medicine, 3, Article No. 10. https://doi.org/10.1186/1747-5341-3-10
[56]
Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998). Effects of Mindfulness-Based Stress Reduction on Medical and Premedical Students. Journal of Behavioral Medicine, 21, 581-599. https://doi.org/10.1023/A:1018700829825
[57]
St-Arnaud, Y. (1999). Le changement assisté. Compétences pour intervenir en relations humaines [Assisted Change. Skills to Intervene in Human Relations]. Gaetan Morin.
Vermersch, P. (2012). Explicitation et phénoménologie. Formation et pratiques professionnelles [Explicitation and Phenomenology. Training and Professional Practices]. Presses Universitaire de France.
[60]
Villeneuve, C. (2013). Les apports de la somato-psychopédagogie pour l’enseignant du primaire [The Contributions of Somato-Psychopedagogy for the Primary School Teacher]. Réciprocités, 8, 69-81.
[61]
Wald, H. S. (2015). Professional Identity (Trans)Formation in Medical Education: Reflection, Relationship, Resilience. Academic Medicine, 90, 701-706.
https://doi.org/10.1097/ACM.0000000000000731
