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
3 2
Good
CONTENT FEEDBACK
1 Notes key Specifies several learning
issues raised by issues/themes with
reflection relevance to ongoing
professional development
2 Makes Poses questions likely to
suggestions for prompt further thinking
further, deeper about the experience or
learning from provides in‐‐‐depth
the experience discussion of learner’s
assumptions and/or
issues raised
REFLECTION FEEDBACK*
3 Notes Specifies at least one
reflection steps part/aspect of reflection
learner did well done well and how/ why it
supports reflective
learning
4 Suggests ways Specifies 1‐‐‐2next steps in
to improve building critical reflection
reflective skill skills which follow from
what was noted as being
done well by the learner
and/or 1‐‐‐2 ways to
improve steps done well
enough
GENERAL FEEDBACK
5 Clarity and Small digestible quantity –
focus easy to understand key
feedback point(s)
6 Tone Explicitly supportive /
acknowledges learners’
efforts/emotions
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Total Score
Criteria Score
1 0
Adequate Inadequate Problematic
Specifies just one Vague mention of No mention of
learning issue/theme themes or narrowly key issues or
with relevance to focused on theme(s) themes
ongoing professional raised by learner and/or
development issues unlikely to have
significance to ongoing
professional
development
Directive comments Offers unrealistic or Makes no
about the experience vague suggestions for suggestions
or too many further learning to prompt
suggestions/ only one further
suggestion for further consideration
learning from the of the
experience experience
Specifies at least one Vague mention of No mention of
part/aspect of strengths in reflection reflective skills
reflection done well
without clarifying
how/why it supports
reflective learning
Specific comments on Suggestions made but Makes no
most or all specific next steps in suggestions
components of reflective skill for next steps
reflective skill which development not entirely to build
may be helpful but clear or next step does reflective skill
with potential to not follow from what was
dilute message or noted as being done well
overwhelm learner by the learner
Requires effort to Too many points or No
understand key points too diffuse – likely identifiable
feedback points to overwhelm or be feedback
unclear to learner point(s)
Professional and Abrupt or curt Offensive,
courteous aggressive, or
inappropriate
 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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