Reflection Win May Reflection Purposeful form of thought

Reflection Win May

Reflection Purposeful form of thought provoked by unease in the learners when they realize that their understanding is incomplete John Dewey (1933)

Reflection n Metacognitive activity n Provides a means for practitioners to consider reasons for success or lack of it n Allows tacit knowledge to become explicit

Reflection Purposeful thinking about medical practice

Cycle of Reflection

Why Reflect? n Adapt professional functioning to patient’s needs or new circumstances n Transformation into new knowledge and practice n Lifelong personal and professional learning Aukes et al. (2007)

Why Reflect? n Develop deeper and more integrated style of learning n Connects new to prior learning n Promotes critical thinking n Exposes pattern of reasoning n Provides insight into attitudes

Reflective practitioner 3 cognitive-emotional levels n Clinical reasoning (reflection-in-action) n Scientific reflection (reflection-on-action) n Personal reflection (reflection-on-experience) Aukes et al. (2007)

Groningen Reflection Ability Scale (GRAS) 3 factors: n Self-reflection n Empathetic reflection n Reflective communication Aukes et al. (2007)

Levels of reflection n Descriptive n Comparative n Personal n Critical Jay, J. (2002)

Activity In pairs, determine the level of reflection of the learners, from their written self-reflections.

Reflective practice in medicine 5 sets of behaviors 1. Deliberate induction 2. Deliberate deduction 3. Test predictions and synthesize new understanding 4. Openness towards reflection 5. Meta-reasoning Mamede et al. (2008)

Research findings n Reflective practice - positive effect on diagnosis of complex, unusual cases. n For routine clinical cases - non-analytic reasoning just as effective Mamede at al. (2008)

Attention With expertise Some cognitive activities become automatic More cognitive space for reflection Moulton et al. (2007)

“Slow down when you should” Moulton et al. (2007)

Summary n Reflection deepens learning n Reflective practice – improves diagnostic accuracy – minimizes error n “Slow down when you should”