"Reflection is a skill that can be taught and developed in medical education. Evidence demonstrating the value of teaching reflection is emerging that substantiates longstanding educational theories. While a few educators have started to explore the use of reflection for emergency medicine (EM) learners, the potential for broader application exists. This review summarizes the literature regarding reflection in medical education and provides a basic primer for teaching reflection."
Whereas present theories of transformative learning tend to focus on the rational and reflective actor, in this article it is suggested that spontaneous action may play a decisive role in transformative learning too. In the spontaneity of action, novelty finds its way into life, gains momentum, is respected by others and reflected by the actor. Such transformation processes are investigated both with the means of theoretical reflection and of empirical inquiry. Based on nine narrative interviews typical phases of transformative learning processes are identified. Owing to the comparative nature of the study, it was also possible to develop an age-related typology that overlaps certain phases of the transformation process. These empirical findings constitute the background against which the nexus of spontaneous action and transformative learning is reflected theoretically. Theories drawn upon include John Dewey's Pragmatism and George Herbert Mead's Social Pragmatism. Both scholars provide rich theoretical concepts for reflecting on the nature of that what so often eludes from the control of both educators and learners: the spontaneity of the beginning.
The importance of reflection and reflective practice are frequently noted in the
literature; indeed, reflective capacity is regarded by many as an essential characteristic for
professional competence. Educators assert that the emergence of reflective practice is part
of a change that acknowledges the need for students to act and to think professionally as an
integral part of learning throughout their courses of study, integrating theory and practice
from the outset.
"Transformative learning theory provides a process for critical reflection which promotes learners to engage in critical discourse and share their knowledge and assumptions. The purpose of the article is to (1) explore the extent to which the simulation and debriefing process reflects transformative learning, as described by Mezirow; and (2) introduce a reflective conceptual framework for postsimulation debriefing."
"The duty of the teacher in this model is not to judge and rate but, rather, to read and tell what is seen. Our teachers, having been trained in the acts of close reading, are equipped not with rating rubrics but, rather, with a reading guide that prompts the reader to attend to several narrative features of a text. The reader/coach can thereby first see and then show the writer what is contained in the written text, at least from that reader's vantage point, helping along the process not only of the writing but also of the reflection the writing birthed. Multiple readers swell and complicate the lessons learned. As a dividend, we have observed, the group of readers/writers form strong, trusting, collaborative teams. And so our training for reflection also fulfills other difficult missions of medical education in teamwork, peer learning, trust, and care."
"Our study suggests there is no significant difference in themes addressed or levels of reflection achieved when students complete a similar assignment via online blogging or traditional essay writing. Given this, faculty staff should feel comfortable in utilising the blog format for reflective exercises. Faculty members could consider the option of using either format to address different learning styles of students."
" Reflective narratives reveal how students construe professional roles in practice. Mapping the content of reflections to a competency framework confirmed the mismatch between the formal and enacted curricula. "
"A simple teaching technique that helps students learn; now there's something few teachers would pass up! This particular technique involves a four-question set that gets students actively responding to the material they are studying. They analyze, reflect, relate, and question via these four prompts:"
The reflective writing of the group collectively demonstrated engagement with themes commensurate with deeper levels of
learning: the feelings, assumptions, beliefs and values of
clinical practice
"The use of painting in teaching reflective competence was well received. Our students found it an innovative and useful educational tool, an exciting 'out of the box' teaching modality. Moreover, students appreciated the plot, creativity and imagination employed in their fellow students' accounts.
Footnotes"
"The study results further indicated that VPs reduced cognitive load, focused attention, encouraged interaction, motivated participants, stimulated reflection, and supported analytical reasoning. The tutor played a significant role in promoting reflection-on-action and resolving cognitive conflict."
Interesting blog post from Cole Camplese of Penn State University which puts forward a model of the personal reflection process which includes the development of personal and academic goals, putting content into a private personal repository and then publishing elements of this into an e-portfolio.
"Using René Magritte's well-known painting The Treachery of Images (This is not a pipe), we argue that the current focus on competencies throughout medical education can sometimes lead educators to rely too heavily on scores, checkmarks, or other forms of assessment that come to be viewed as equivalents for the actual existence of what is being measured. Magritte insisted that the image he created on the canvas was not a pipe but rather a representation of a pipe, an important distinction for educators to remember as we seek ways to evaluate trainees' attainment of the fundamental knowledge and skills of the profession. We also urge that the focus on broader skills, values, flexibility, reflection, and insight development should fall outside the net of a competency orientation in a supportive environment spared from traditional assessment methods, using a classroom in undergraduate medical education as an example of working toward this end. "
Fifty-five word stories are brief pieces of creative writing that use elements of poetry, prose, or both to encapsulate key experiences in health care. These stories have appeared in Family Medicine1 and JAMA2 and have been used to teach family medicine faculty development fellows.3 Writers and readers of 55-word stories gain insight into key moments of the healing arts; the brevity of the pieces adds to both the writing and reading impact. Fifty-five word stories may be used with trainees to stimulate personal reflection on key training experiences or may be used by individual practitioners as a tool for professional growth.
"Limited opportunities may exist for students to develop insight into the challenges faced by doctors and patients presented with challenging or sensitive illness and difficult decisions. The use of patient and doctor narratives to facilitate discussion and encourage reflection on sensitive issues can offer a useful supplement to patient contact."
"Our aim was to understand the key variables influencing this educational process, identify gaps in the evidence, and to explore any implications for educational practice and research."
"The authors describe the use of the portfolio as a pilot project aimed at introducing reflective thinking and measuring clinical learning in undergraduate nursing education."