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WRITE DOWN YOUR ANSWERS – 5 MINUTES

• WHAT IS REFLECTION?
• WHY DO YOU NEED REFLECTIVE
PRACTICE AS A MEDICAL STUDENT?
• HOW DO YOU DO YOUR REFLECTIVE
WRITING?

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WRITE DOWN YOUR ANSWERS – 5 MINUTES

• Latin origins: “to bend” or “turn back”


Reflection is a metacognitive process that creates
greater understanding of self and situations to
inform future action.

• Intended outcomes  enhance your learning skills:


self-regulated, lifelong learning, therapeutic
relationship & professional expertise.

• Reflective writing  variety of methods

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REFLECTION &
REFLECTIVE WRITING
By: Rose Feri
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AGENDA

1. Learning goals
2. Define reflection
3. Reflection process
4. Reflection on Action Rubric
5. Feedback Giver: Reflection Feedback Scoring Rubric
6. Exercise “Reflective Writing”
7. Role-play: Reflector-Feedback Giver

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LEARNING GOALS

After the interactive lecture, students are able to:


1. Understand the definition of reflection
2. Use and write reflective writings to enhance their
learning
3. Internalize their learning in both cognitive and affective
domains

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WHAT
is REFLECTION?

“an active and intentional process that can begin with


some discomfort with an experience and end with
learning and deeper insights.” - Dewey 1938 (in
Desjar 2011)

“a generic term for those intellectual and affective


activities in which individuals engage to explore the
experiences in order to lead to a new understanding
and appreciation.” - Boud 1985

“a metacognitive process that occurs before, during and


after situations with the purpose of developing greater
understanding of both the self and the situation so that
future encounters with the situation are informed from
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previous encounters.” – AMEE Guide No.44
WHAT
is
REFLECTIVE WRITING

“the process of internally examining & exploring an issue


of concern, triggered by an experience, which creates &
clarifies meaning in terms of self & which results in a
changed conceptual perspective” - Boyd & Fales (1983,
p.100)

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WHAT
FOR REFLECTION?

Helps you to:


1. Understand what you have already known - INDIVIDUAL
2. Identify what you need to know in order to advance
understanding of the subject - CONTEXTUAL
3. Make sense of new information and feedback in the
context of your own experience - RELATIONAL
4. Guide choices for further learning - DEVELOPMENTAL
Hinett, 2002

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REFLECTION METHODOLOGY
By Melissa Desjarlais & Peter Smith (2011)

Step 1: Recognize a need


Step 2: Pick a time and place
Step 3: Play back the experience
Step 4: Document all insights
Step 5: Play what – if games
Step 6: Organize insights into common themes
Step 7: Identify key insight(s)
Step 8: Generalize key insights
Step 9: Determine the need for other processes
Step 10: Assess the quality of the reflection process
WHY REFLECTION?

Why is reflective writing important for medical students?


It helps you to
• Integrate theoretical learning & clinical practice
• Prepare medical students for dealing with messy ill-defined
issues

ALSO…..It is
• Part of student-centered learning, action research &
experiential learning

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REFLECTION PROCESS

Schon -1983
• Reflection-in-action
• Reflection-on-action

Reflection Methodology
Reflection process

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REFLECTION PROCESS
By Boud, Keogh & Walker (1996)

What have your


How did it
What happened? learned? What
happen?
changed?
• Behavior • Returning to • New perspective
• Ideas experience on experience
• Feelings • Attending to • Change in
EXPERIENCES experience behavior
• Re-evaluating • Readiness for
experience application
• Commitment to
action
REFLECTION FEEDBACK SCORING RUBRIC
Category Criteria Score
3 2 1 0
Good Adequate Inadequate Problematic
CONTENT FEEDBACK

1 Notes key Specifies several learning Specifies just one Vague mention of No mention of
issues raised by issues/themes with learning issue/theme themes or narrowly key issues or
reflection relevance to ongoing with relevance to focused on theme(s) themes
professional development ongoing professional raised by learner and/or
development issues unlikely to have
significance to ongoing
professional
development

2 Makes Poses questions likely to Directive comments Offers unrealistic or Makes no


suggestions for prompt further thinking about the experience vague suggestions for suggestions
further, deeper about the experience or or too many further learning to prompt
learning from provides in‐‐‐depth suggestions/ only one further
the experience discussion of learner’s suggestion for further consideration
assumptions and/or learning from the of the
issues raised experience experience

REFLECTION FEEDBACK*

3 Notes Specifies at least one Specifies at least one Vague mention of No mention of
reflection steps part/aspect of reflection part/aspect of strengths in reflection reflective skills
learner did well done well and how/ why it reflection done well
supports reflective without clarifying
learning how/why it supports
reflective learning

4 Suggests ways Specifies 1‐‐‐2next steps in Specific comments on Suggestions made but Makes no
to improve building critical reflection most or all specific next steps in suggestions
reflective skill skills which follow from components of reflective skill for next steps
what was noted as being reflective skill which development not entirely to build
done well by the learner may be helpful but clear or next step does reflective skill
and/or 1‐‐‐2 ways to with potential to not follow from what was
improve steps done well dilute message or noted as being done well
enough overwhelm learner by the learner

GENERAL FEEDBACK

5 Clarity and Small digestible quantity – Requires effort to Too many points or No
focus easy to understand key understand key points too diffuse – likely identifiable
feedback point(s) feedback points to overwhelm or be feedback
unclear to learner point(s)

6 Tone Explicitly supportive / Professional and Abrupt or curt Offensive,


acknowledges learners’ courteous aggressive, or
efforts/emotions inappropriate

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Total Score
REFLECTION ON ACTION RUBRIC

Developed by O’Sullivan et al., translated by Diantha Soemantri & Estivana Felaza

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Exercise
“Reflective Writing”

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Instruction

1. Choose one of your experiences as a medical


students.
2. Write down your reflection (Arial 12, Line spacing
1.5, A4 2 pages)
3. You can use reflection methodology or reflecting
process to develop your reflective writing
Examples

A student procrastinated on a web design assignment


My reflection as a medical teacher
Role Play
“One Reflector & Two
Westberg J. Helping learners become
reflective practitioners. EDUCATION FOR
HEALTH-ABINGDON-CARFAX PUBLISHING
Assessors as Feedback
LIMITED-. 2001 Jul;14(2):313-22.
Giver”

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References

1. Sandars J. The use of reflection in medical education: AMEE Guide No. 44.
Medical teacher. 2009 Jan 1;31(8):685-95.
2. Hinett K, Varnava T. Developing reflective practice in legal education.
Coventry: UK Centre for Legal Education; 2002.
3. Desjarlais M, Smith P. A comparative analysis of reflection and self-
assessment. International Journal of Process Education. 2011;3(1):3-18.
4. Aronson L, Kruidering M, Niehaus B, O’Sullivan P. UCSF LEaP (Learning from
your Experiences as a Professional): guidelines for critical reflection.
MedEdPORTAL www. mededportal. org/publication/9073. 2012 May 6.
Thank You
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