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Table 2 Description of SeRenE training package exercises

From: Can stoic training develop medical student empathy and resilience? A mixed-methods study

Training exercise

Description

Exercise 1: Predicting Misfortune

Promotes practice of negative visualisation. This exercise asked students to predict what they might find difficult, challenging, or what could go wrong in the day ahead. It promoted planning for what could go wrong and encouraged reflection as to how students might deal with negative turns of events.

Exercise 2: Examining Judgments

A core principle within this exercise is the assumption that we have a certain degree of control over the way we feel, and that it is our interpretation of events around us that make them good or bad. This exercise promotes the practice of Stoic mindfulness. Students were asked to note down some of their impressions or judgments from the previous day, or the current day, and examine each of the judgments that have made in turn that have led to the way they have interpreted events in their life.

Exercise 3: Developing Empathic Reserves

This was an additional exercise developed to suit the purpose of this study as also interested in the cultivation of empathy. This exercise was developed in consultation with two qualified psychotherapists (AM and TL). Exercise 3 was a more targeted and specific version of exercise 1. Students were asked to consider a situation where they may need to offer empathy to a patient, think about what could go wrong and how they could prepare for the possibility of such issues. We hoped this exercise would challenge students’ negative experiences of empathy and promote emotional preparedness.

Exercise 4: Evening Reflection

The aim of this exercise was to promote Stoic reflection. Ideally, this exercise would be completed at the end of the day, summing up the thoughts and actions of the day. The focus was on what had been unhelpful, what was left undone that students wanted to do, and a list of things done well. We hoped this exercise would promote honest appraisal of thoughts and actions and offer a chance to prepare for troublesome of problematic ways of thinking the next day.