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Reflective Practice (RP):
Professionals engage in Reflective Practice (RP) when they: 1) examine their own reasoning and decision making in a disciplined manner; 2) make their reasoning explicit (i.e., open to review and critique); and, 3) modify their professional practice according to the insights they acquire through this process. When clinical educators apply RP in teaching, they “think out loud” by describing the basic processes involved in how they make clinical judgments, how they learn from experience to improve their performance over time, and how they learn to adjust to ambiguous and changing situations. In this way, RP distinguishes between thoughtful action and rote completion of task.
Effective program directors and faculty routinely encourage RP in residents through a variety of methods. For example, they promote RP when they use questions to help residents articulate their diagnostic and therapeutic reasoning rather than simply dictate orders. Residents welcome opportunities to hear seasoned clinicians and surgeons “think out loud” as they work through a complex case. The following points illustrate how Reflective Practice is an important and useful method when teaching for competency:
- When faculty use RP during teaching, they describe: 1) why they engage in a particular activity; 2) what specific actions they perform as part of the activity; and, 3) how the activity links to what the residents need to learn; i.e., the learning objectives (Explicit).
- Teaching with RP can occur through thinking-aloud about real patient cases; for example, during teaching at the bedside, light box, operating table, or in the laboratory. (Real-world).
- RP entails internalized self-questioning about one’s own behaviors and practices, including their appropriateness, efficiency, and effectiveness, and whether errors or omissions (other professional lapses) have occurred. Also, a public accounting of performance occurs as one thinks aloud about these issues when among teachers and peers. (Self Assessment and Accountability)
- Faculty provide more individualized educational guidance to the residents as they use RP to clarify residents’ current capabilities, reasoning, and learning needs. (Individualized)
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