Active Learning – Reflection

I decided that reflection deserved an article on its own. Reflection is an important aspect of helping students and residents develop a deeper understanding of the medical curriculum that is frequently avoided because it is perceived as being difficult to teach/assess. Deliberately practicing the art and skill of medicine requires reflection yet medical students and residents have to spend most of their time being in the moment; paying attention and responding rapidly to immediate stimulus within the environment. Fatigue at the end of a shift makes end of the day reflection difficult.
I thought I would start this discussion with an image provided to me by Bronwyn Hegarty
reflection.jpg
Take notice and describe the experience
There are three ways to do this actively in a clinical setting:
1. Videotape
Videotaping teamwork and patient interactions provides an artifact of the encounter that can be examined later to check perceptions and assumptions about an event.
2. Written records
Patient records, student encounter cards, diaries, blogs can record both immediate information and patterns over time.
3. Feedback
Asking the student to state what they did well, could improve and want to know more about before they receive feedback from peers and faculty provides an opportunity for students to reflect on their knowledge/skill/understanding.
Analyze the experience
Two clinical teaching techniques could prove useful in helping students become more reflective:
Precepting Using MicroSkills (one minute preceptor) http://www.practicalprof.ab.ca/teaching_nuts_bolts/one_minute_preceptor.html and Chart Stimulated Recall http://www.practicalprof.ab.ca/teaching_nuts_bolts/chart_stimulated_recall.html
Remember when using these techniques to focus on helping the student be more reflective by using open ended, analytic questions at the beginning of the encounter.
Take action
Every reflective experience should be concluded with a plan for how this experience will be used to improve learning, interactions in the future.