In considering what makes great teachers great, I thought about the many mentors who have inspired me and the impact of reflection as a teaching technique.  There is growing literature suggesting that reflection improves learning and performance in essential competencies, specifically professionalism and clinical reasoning, and can contribute to continuous practice improvement and life-long learning.^1,2 

Reflection as a pedagogical approach is not merely thoughtful looking back to consider something.  While this might result in insight and learning, it does not automatically lead to the high level analysis, questioning, and reframing required for transformative learning.  Critical reflection, by contract, is the process of analyzing, questioning, and reframing an experience in order to make an assessment of it for the purposes of learning (reflective learning) and/or to improve practice (reflective practice).

Clinical reasoning is a complex skill that learners hope to acquire through their educational training and beyond.  It is the thought process the guides practice and is melded from core knowledge, awareness of outcome probability, situational stress and life experience, which contribute to expertise. Learners are motivated to develop the expertise they see in their mentors, such as subject matter excellence, clinical pattern recognition, speed of problem solving and problem analysis. Experts are noted for their strong self-motivating skills and the possession of the affective dispositions necessary to learn from their experiences, such as, inquisitiveness, open mindedness, honesty, diligence, self-confidence, flexibility, empathy and humility.  

 Reflection must be properly executed for maximum effectiveness and to avoid pitfalls. For those wishing to explore this teaching technique further, Louse Aronson, an associate professor of medicine at the University of California, has described twelve tips for teaching reflection.³  These tips are intended to ensure that reflective exercises produce meaningful educational outcomes.  In other words, to enable greater learning from the experience being reflected upon and to develop reflective skills for life-long learning. 

Lawrence Jackson BScPhm

  

1.http://www.acgme.org/acgmeweb/Portals/0/PDFs/commonguide/IVA5c_EducationalProgram_ACGMECompetencies_PBLI_Documentation.pdf

2.     Mann K, Gordon J, MacLeod A. Reflection and reflective practice in health professions education. A systematic review. Adv Health Sci Edu Theory Pract 2007;14:595-621.

3.     Aronson L. Twelve tips for teaching reflection at all levels of medical education. Medical Teacher 2011;33:200-205.