|
Example 1
Scenario: Incorporating Reflective Practice (RP) in bimonthly resident meetings to foster Professionalism, Practice-based Learning and Improvement, and Systems-based Practice.
As program director, you conduct bimonthly group meetings during which residents are free to raise concerns or problems without fear of reprisal or retaliation. Attendance has generally been very good, and comments from residents about the sessions have been excellent. Although the meetings are informal and have no agenda, you recognize their potential as part of your formal educational program.
The illustration below describes how you may use RP to address several competencies during group meetings by focusing on the following learning objectives. Residents will be able to: 1) identify their professional behaviors in everyday encounters with patients and other staff (Professionalism); 2) demonstrate their ability to reflect on how various professional behaviors might be improved (Practice-based Learning and Improvement; Professionalism); and, 3) recognize how their patient care and all their professional practices might affect other health care professionals and the health care organization (Systems-based Practice)
Illustration:
These “unplanned” sessions offer a perfect opportunity to reinforce RP skills. Issues raised during the meetings often provide concrete examples of challenges to various elements of professionalism, such as demonstrating respect, compassion, and sensitivity to diverse patients. For example, a resident might describe “losing her cool” with an elderly patient in the outpatient clinic who failed to take medication properly. A nurse who observed this interaction subsequently berated the resident in front of colleagues. You ask the resident to identify components of her professional behavior in the case, such as respect for the patient and collegiality with the nurse. You encourage the resident to “think aloud” about how she resolved the issue, identifying the reasons why she chose a particular course of action, or no action at all. You engage all residents to participate in the discussion. You seek reasons for the patient’s action and the nurse’s response. As part of the discussion, you provide a similar example from your own experience that points to how one may improve behavior by taking responsibility for one’s own actions. In the course of discussion, you help residents identify the possible system issues in the case; i.e., the potential impact on the nursing staff, the possible undeserved effect on the resident’s reputation, even the possibility of a patient’s transferring out of the clinic. You maintain the “safe environment” without blaming the resident, the nurse, or the patient, and you help point to possible improvements, not only in professional behavior, but also in how to relate to an elderly patient population. The key to using RP in these sessions is to maintain focus on the learning objectives while using the content inherent in the issues raised by the residents. The competencies provide the framework for reflection; the content varies by session, and RP supports the learning process.
|
 |
 |
|
