The art and skills of compassion in practice

Margie Sills-Maerov, Sofia Valanci
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Abstract

Empathy, or the ability to “feel” another person’s experience, evokes strong emotions and activates the neural pathways in the pain region of the brain. Compassion is empathy combined with purposeful action to relieve suffering and impacts the brain’s reward centres. What are the outward impacts of compassion? Compassion is human connection, reciprocity, feeling cared for and caring for another. It reduces stress and cortisol for the receiver and giver. It reduces suffering and impacts all areas of the Quadruple Aim. Yet nearly half of the population of America and 63% of providers believe that the health system is not compassionate.How do you build “compassion skills”? Being a compassionate clinician is not about knowledge, but the quality of communication and relational interactions. Many hold the belief that this ability is naturally acquired or inherent in medical practice, but this ability is technical, rooted in capabilities, intentional, and requires continuous practice and refinement. Healthcare practitioners are at a disadvantage: the rigours clinical learning and the perceived time pressures of practice take precedent, limiting the opportunity for refinement and practice of these interpersonal communication skills. Looking to bridge the gap on continuous professional development and learning from other sectors, the Royal College of Physicians and Surgeons of Canada has been considering approaches for practice improvement in compassion. To make compassion skills tangible, the presenters offered a “coaching skills” program for physicians. Early evidence is pointing towards the positive impacts of this type of communication skills training on the therapeutic alliance.
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实践同情的艺术和技巧
同理心,即 "感受 "他人经历的能力,会唤起强烈的情感,并激活大脑疼痛区域的神经通路。同情心是将同理心与有目的的行动相结合,以减轻痛苦,并影响大脑的奖赏中心。同情心的外在影响是什么?同情心是人与人之间的联系、互惠、被关心的感觉和对他人的关爱。它能减少接受者和给予者的压力和皮质醇。它能减少痛苦,并对 "四重目标 "的所有领域产生影响。然而,近一半的美国人和 63% 的医疗服务提供者认为医疗系统缺乏同情心。如何培养 "同情心技能"?作为一名富有同情心的临床医生,需要的不是知识,而是沟通和关系互动的质量。许多人认为,这种能力是自然习得的,或者是医疗实践中与生俱来的,但这种能力是技术性的,植根于能力之中,是有意为之的,需要不断实践和完善。医疗从业人员处于劣势:临床学习的严格性和实践中感知到的时间压力占了上风,限制了这些人际沟通技能的完善和实践机会。加拿大皇家内科和外科医生学院一直在考虑改进同情心实践的方法,以弥补在持续专业发展和向其他行业学习方面的差距。为了让同情技能具体化,主讲人为医生们提供了一个 "教练技能 "计划。早期证据表明,这种类型的沟通技巧培训对治疗联盟有积极影响。
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