Stimulating Reflective Practice Among Your Learners

“There are three methods to gaining wisdom. The first is reflection, which is the highest. The second is imitation, which is the easiest. The third is experience, which is the bitterest.”Confucius Educational organizations, including the Council on Medical Student Education in Pediatrics, recognize that the development of the reflective practitioner is a fundamental element of professional training. The Royal College of Physicians and Surgeons of Canada articulate in their CanMEDS competency framework that physicians must “demonstrate a lifelong commitment to reflective learning” and “recognize and reflect learning issues in practice.”1 Similarly, the Accreditation Council for Graduate Medical Education requires graduating residents to continuously improve patient care based on constant self-evaluation and life-long learning.2 As part of the ongoing Council on Medical Student Education in Pediatrics series on skills and strategies used by great clinical teachers, this article focuses on reflection, a skill that should be modeled and taught to medical students so that they may practice and refine a reflective approach throughout their careers. Reflection means to “turn back” or think back on experiences. The definition takes on an added meaning when applied to clinical experiences and refers to the process of “slowing down” (not physically, but at an emotional or cognitive level) to analyze, in a deliberate manner, surprising or disconcerting events to make sense of them and understand why they occurred.3 Critical reflection occurs when one not only explores one’s own beliefs, biases, and approaches but also those of others who may have contributed to the way events unfolded. This may … Address correspondence to Lavjay Butani, MD, Department of Pediatrics, University of California Davis Medical Center, Ticon 2, Room 348, 2516 Stockton Blvd, Sacramento, CA 95817. E-mail: lbutani{at}ucdavis.edu