Moving from awkward to “aha!”: Strategies for building reflective capacity among health science students and faculty. The Health Sciences Education and Research Commons collaborates to develop and deliver interprofessional education (IPE) for students from eight health science faculties. Curriculum is based on four interprofessional (IP) competencies: communication, collaboration, role clarification and reflection.
Students struggled with reflection
assignments in IPE courses. • Expected to be struck by an elusive “aha” moment • Failed to see the value in reflection as a process to facilitate their learning
Reflection Guide
This tool was made available to students enrolled in two IPE courses and online to all students and faculty. It was developed to explain the rationale for reflection and support development of reflection skills. Observations: • Improved quality of reflection • Fewer negative comments from students in course evaluations • Instructors reported increased confidence in integrating reflection Table excerpted from Reflection Guide Components of Reflection
Description
Questions to consider
Description
Describe the “event, issue or situation”(Williams & Wessel, 2004)
What happened? Who was involved? What was your role in the event? What role or roles did other team members play, including the patient and/or family?
Analyze the event “in relation to prior knowledge, feelings of attitudes” (Williams & Wessel, 2004)
How do you interpret the event? What was your emotional response to the event? What factors may have affected the event? What are the broader implications of the event?
Analyze the event in the context of external sources of information
What evidence supports or refutes your interpretation? What feedback did you receive from patients, community members, facilitators, team members or other peers? How does your interpretation fit within the literature? How does the event relate to your profession’s standards of practice or code of ethics? How does the event relate to your personal ethics or values? What organizational, historical or sociological implications does the event have? What were your personal or professional strengths and limitations in relation to the event?
Course facilitators felt ill-prepared to
support struggling students. Variation in assignment expectations and grading was observed across course sections.
Personal Analysis
Facilitators and students often lacked clear understanding of the purpose and/or process of reflection. In response, we developed and implemented • Reflection guide • Three approaches to faculty development
Context Analysis
Practice Implications
Selected References Mann, K., Gordon, J., & MacLeod, A. (2009). Reflection and reflective practice in health professions education: A systematic review. Advances in Health Sciences Education: A Theory and Practice, 14, 595-621. doi:10.1007/s10459-007-9090-2 Reis, S.P., Wald, H.S., Monroe, A.D., Borkan, J.M. (2010). Begin the BEGAN (The Brown Educational Guide to the Analysis of Narrative) - a framework for enhancing educational impact of faculty feedback to students’ reflective writing. Patient Education and Counseling, 80(2):253-9. Epub 2010 Jan 6. Sandars, J. (2009). The use of reflection in medical education: AMEE guide no. 44. Medical Teacher, 31(8), 685-695. doi:10.1080/01421590903050374 Schön, D. A. (1983). The reflective practitioner: How professionals think in action. New York: Basic Books. Wald, H.S., Borkan, J.M., Taylor, J.S., Anthony, D., Reis, S.P. (2011). Fostering and Evaluating Reflective Capacity in Medical Education: Developing the REFLECT Rubric for Assessing Reflective Writing. Academic Medicine, in press.
Use your analysis to identify learning needs or changes to practice
What knowledge or expertise will you seek to support your practice? How will you acquire that knowledge or access expertise? How will you approach a similar event in the future? What other implications does the event have for your future practice?
Students • Structured guide provides support for early learners Faculty • Diverse delivery approaches with practical, relevant tools build capacity • Experiential workshops facilitate relationship building • Walk the talk: presenters from different disciplines provide robust exploration of reflection
Tara Hatch1, Renate Kahlke1, Sharla King1, Barbara Gitzel2 and Hedy S. Wald3 Health Sciences Education and Research Commons, University of Alberta, Edmonton, AB 2 Dental Hygiene Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB 3 Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI 1
Faculty Development
Three interactive workshops focused on literature on reflection, frameworks for feedback, and assessment. Each was tailored to a unique audience.
Course specific training delivered by four disciplines to 63 facilitators of a required IPE course and covered: • Purpose of reflection • Practice applying reflection rubric • Practice providing feedback with student team
Observations: • More consistency in grading, fewer negative comments from students • Facilitators reported increased confidence in integrating reflection
Inter-institutional IP approach developed to build instructor capacity in inte-
grating reflection across degree, diploma and certificate health science programs. Participants represented 15 disciplines from academic and practice setting. Visiting scholar and clinical psychologist from Alpert Medical School (AMS) of Brown University delivered: 1. Foundational seminar with didactic and interactive learning 2. Skills practice workshop • Shared local initiatives on reflective learning • Applied tools developed at AMS of Brown University to analyze student reflections Observations: • Step forward in building community of reflective practice • Learning integrated into course curriculum and clinical practice
Program specific workshop for Dental Hygiene instructors delivered by 2 disciplines: • Focused on verbal and written reflection • Applied tools for constructing verbal/written feedback • Applied advocacy inquiry debriefing method
Observations: • Team building facilitated by interactive presentation • Instructors engaged through examples relevant to teaching context • Future integration supported by practical tools
Next Steps:
Move beyond review of process; formally evaluate impact of reflection guide.