Podcast
Questions and Answers
Individual professionals’ 'dangerous, reckless or impaired' behavior can harm patients.
Individual professionals’ 'dangerous, reckless or impaired' behavior can harm patients.
True
To cover up errors is acceptable in medical practice.
To cover up errors is acceptable in medical practice.
False
Reflective practice only includes formal reviews.
Reflective practice only includes formal reviews.
False
A culture of patient safety aims to minimize risks and learn from harm.
A culture of patient safety aims to minimize risks and learn from harm.
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Adverse events never result in unintended outcomes for patients.
Adverse events never result in unintended outcomes for patients.
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Gibbs’ Reflective Cycle was introduced in 1988.
Gibbs’ Reflective Cycle was introduced in 1988.
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Kolb’s learning Cycle was published in 1991.
Kolb’s learning Cycle was published in 1991.
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Driscoll’s Reflective Practice Model outlines the steps: What? So why? Now when?
Driscoll’s Reflective Practice Model outlines the steps: What? So why? Now when?
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The purpose of medical education is to help shape novices into effective practitioners.
The purpose of medical education is to help shape novices into effective practitioners.
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Greenaway’s model is known as ‘The Passive Reviewing Cycle’.
Greenaway’s model is known as ‘The Passive Reviewing Cycle’.
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Empathy is an important trait in building the patient-doctor relationship.
Empathy is an important trait in building the patient-doctor relationship.
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Gibbs' Reflective Cycle includes stages that do not require any helpful questions.
Gibbs' Reflective Cycle includes stages that do not require any helpful questions.
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A healthcare provider should always prioritize showcasing their authority over being empathetic.
A healthcare provider should always prioritize showcasing their authority over being empathetic.
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The conclusions phase of Gibbs' Reflective Cycle focuses on summarizing learning and positive changes.
The conclusions phase of Gibbs' Reflective Cycle focuses on summarizing learning and positive changes.
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Healthcare teams have no need to understand a patient's personal circumstances.
Healthcare teams have no need to understand a patient's personal circumstances.
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Schwartz rounds are primarily focused on solving clinical problems.
Schwartz rounds are primarily focused on solving clinical problems.
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Participants in Schwartz rounds report feeling less stressed and more connected to their colleagues.
Participants in Schwartz rounds report feeling less stressed and more connected to their colleagues.
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Building a reflective practice mindset requires a willingness to reflect.
Building a reflective practice mindset requires a willingness to reflect.
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The ERA model in reflective practice consists of Evaluation, Reflection, and Action.
The ERA model in reflective practice consists of Evaluation, Reflection, and Action.
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Reflective assignments include describing conflicts or disorienting dilemmas.
Reflective assignments include describing conflicts or disorienting dilemmas.
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Setting and reflecting on goals is not an important aspect of reflective practice.
Setting and reflecting on goals is not an important aspect of reflective practice.
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Schwartz rounds help to reinforce hierarchies among staff members.
Schwartz rounds help to reinforce hierarchies among staff members.
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The RESPECT Rubric is used for assessing reflective writing.
The RESPECT Rubric is used for assessing reflective writing.
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Concrete Experience is the first stage of Kolb's Learning Cycle.
Concrete Experience is the first stage of Kolb's Learning Cycle.
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Reflective Observation involves trying out what you have learned.
Reflective Observation involves trying out what you have learned.
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David Kolb proposed a model that includes four stages of reflection.
David Kolb proposed a model that includes four stages of reflection.
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Active Experimentation is the final stage in Kolb's Learning Cycle.
Active Experimentation is the final stage in Kolb's Learning Cycle.
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Kolb's Learning Cycle suggests that all stages must be used for effective learning.
Kolb's Learning Cycle suggests that all stages must be used for effective learning.
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Abstract Conceptualisation refers to understanding and learning from experiences.
Abstract Conceptualisation refers to understanding and learning from experiences.
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Sensing and Watching are part of Kolb's Learning Cycle model.
Sensing and Watching are part of Kolb's Learning Cycle model.
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Kolb's Learning Cycle promotes a learner-centered pedagogy.
Kolb's Learning Cycle promotes a learner-centered pedagogy.
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Gibbs' Reflective Cycle includes stages such as Evaluation and Action.
Gibbs' Reflective Cycle includes stages such as Evaluation and Action.
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In reflective practice, one should never evaluate their own contributions to a situation.
In reflective practice, one should never evaluate their own contributions to a situation.
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Feelings can impact the quality of care provided by a professional.
Feelings can impact the quality of care provided by a professional.
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Gibbs' Reflective Cycle was developed in 1998.
Gibbs' Reflective Cycle was developed in 1998.
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Reflection is solely about analyzing the actions of others in a situation.
Reflection is solely about analyzing the actions of others in a situation.
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The Evaluation stage is meant to identify what worked and what didn’t during an experience.
The Evaluation stage is meant to identify what worked and what didn’t during an experience.
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It is mandatory to use all the prompts provided in Gibbs' Reflective Cycle.
It is mandatory to use all the prompts provided in Gibbs' Reflective Cycle.
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Reflective practice only takes place after an event has occurred.
Reflective practice only takes place after an event has occurred.
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Experience is an essential tool for updating professional theories.
Experience is an essential tool for updating professional theories.
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Kolb formalized the concept of reflective observation in 1984.
Kolb formalized the concept of reflective observation in 1984.
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Kolb's Experiential Learning Cycle emphasizes learning through ________ experience.
Kolb's Experiential Learning Cycle emphasizes learning through ________ experience.
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Metacognition involves understanding one's own thought processes.
Metacognition involves understanding one's own thought processes.
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In Andragogy, adults learn best when they are ________ independent.
In Andragogy, adults learn best when they are ________ independent.
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Reflection does not aid in problem-solving processes.
Reflection does not aid in problem-solving processes.
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Feedback is generally less important in adult learning as compared to traditional education.
Feedback is generally less important in adult learning as compared to traditional education.
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Loughran identifies five areas where reflection can be beneficial.
Loughran identifies five areas where reflection can be beneficial.
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Kolb's Learning Cycle includes stages that promote learner-centered pedagogy.
Kolb's Learning Cycle includes stages that promote learner-centered pedagogy.
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Abstract Conceptualization involves applying learned concepts in real scenarios.
Abstract Conceptualization involves applying learned concepts in real scenarios.
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Experiential learning encourages ________ experimentation.
Experiential learning encourages ________ experimentation.
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Reflection can empower individuals within their social group.
Reflection can empower individuals within their social group.
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Reflection only pertains to observing the behavior of others.
Reflection only pertains to observing the behavior of others.
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Andragogy recognizes that adult learners have a variety of motivations and ________ expectations.
Andragogy recognizes that adult learners have a variety of motivations and ________ expectations.
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All learners inherently learn the same way regardless of their individual learning styles.
All learners inherently learn the same way regardless of their individual learning styles.
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Schwartz rounds aim to foster compassion in healthcare.
Schwartz rounds aim to foster compassion in healthcare.
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Reflective practice includes only formal reviews.
Reflective practice includes only formal reviews.
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Reflective practice can help identify patterns over an extended period.
Reflective practice can help identify patterns over an extended period.
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Setting and reflecting on goals is an essential part of reflective practice.
Setting and reflecting on goals is an essential part of reflective practice.
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Schwartz rounds are focused on resolving clinical problems.
Schwartz rounds are focused on resolving clinical problems.
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Building a reflective practice mindset does not require a willingness to learn.
Building a reflective practice mindset does not require a willingness to learn.
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Being aware of one's own behavior and body language can influence a patient's behavior.
Being aware of one's own behavior and body language can influence a patient's behavior.
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Gibbs' Reflective Cycle has five stages: Description, Evaluation, Action, Plan, and Conclusion.
Gibbs' Reflective Cycle has five stages: Description, Evaluation, Action, Plan, and Conclusion.
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Empathy is essential for effective interactions between healthcare providers and patients.
Empathy is essential for effective interactions between healthcare providers and patients.
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Using personal nouns like 'I' is encouraged in Academic Reflections.
Using personal nouns like 'I' is encouraged in Academic Reflections.
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The past tense is rarely used in reflective writing.
The past tense is rarely used in reflective writing.
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Healthcare providers should ignore their own feelings to maintain professionalism.
Healthcare providers should ignore their own feelings to maintain professionalism.
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Gibbs' Reflective Cycle includes a stage for Planning.
Gibbs' Reflective Cycle includes a stage for Planning.
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The Action Plan stage includes questions about how to act differently in future situations.
The Action Plan stage includes questions about how to act differently in future situations.
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Critical reflection focuses on habitual actions without deeper thought.
Critical reflection focuses on habitual actions without deeper thought.
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A patient’s personal circumstances are not important for healthcare teams to understand.
A patient’s personal circumstances are not important for healthcare teams to understand.
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Subject-specific language and terminology are discouraged in reflective writing.
Subject-specific language and terminology are discouraged in reflective writing.
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The conclusion phase of Gibbs' Reflective Cycle focuses on criticizing past actions.
The conclusion phase of Gibbs' Reflective Cycle focuses on criticizing past actions.
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Description in Gibbs' Reflective Cycle should detail what happened in a situation.
Description in Gibbs' Reflective Cycle should detail what happened in a situation.
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Helpful questions in Gibbs' Reflective Cycle can enhance the reflective practice process.
Helpful questions in Gibbs' Reflective Cycle can enhance the reflective practice process.
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Reflection should only focus on personal thoughts and feelings, ignoring external circumstances.
Reflection should only focus on personal thoughts and feelings, ignoring external circumstances.
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Concluding in Gibbs' Reflective Cycle is about summarizing learning and planning for improvements.
Concluding in Gibbs' Reflective Cycle is about summarizing learning and planning for improvements.
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Excessive on-call shifts can negatively affect a medical intern's performance.
Excessive on-call shifts can negatively affect a medical intern's performance.
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The Clinical Director's request for additional on-call shifts was unrelated to staff shortages.
The Clinical Director's request for additional on-call shifts was unrelated to staff shortages.
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Reflective practice is not necessary in the medical profession.
Reflective practice is not necessary in the medical profession.
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Interns are expected to perform procedures flawlessly, regardless of their shift length.
Interns are expected to perform procedures flawlessly, regardless of their shift length.
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Feelings during a situation play a role in reflective practice.
Feelings during a situation play a role in reflective practice.
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Poor performance during training can be solely attributed to a lack of skill.
Poor performance during training can be solely attributed to a lack of skill.
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Critical reflection can enhance the learning experiences of healthcare providers.
Critical reflection can enhance the learning experiences of healthcare providers.
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The process of learning in medical education does not include analyzing personal experiences.
The process of learning in medical education does not include analyzing personal experiences.
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Gibbs' Reflective Cycle outlines six stages, including description and action plan.
Gibbs' Reflective Cycle outlines six stages, including description and action plan.
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The evaluation stage of Gibbs' Reflective Cycle is focused solely on positive aspects of an experience.
The evaluation stage of Gibbs' Reflective Cycle is focused solely on positive aspects of an experience.
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An action plan in Gibbs' Reflective Cycle is meant for dealing with future similar situations.
An action plan in Gibbs' Reflective Cycle is meant for dealing with future similar situations.
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Gibbs' Reflective Cycle can only be used in the healthcare profession.
Gibbs' Reflective Cycle can only be used in the healthcare profession.
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Feelings are a critical part of Gibbs' Reflective Cycle.
Feelings are a critical part of Gibbs' Reflective Cycle.
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The 4F’s Model includes the stages: Facts, Feelings, Findings, and Future.
The 4F’s Model includes the stages: Facts, Feelings, Findings, and Future.
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Greenaway's model is primarily geared towards healthcare professionals.
Greenaway's model is primarily geared towards healthcare professionals.
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The stage 'Now what?' refers to the action plan in reflective practice.
The stage 'Now what?' refers to the action plan in reflective practice.
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Feelings are not considered important in the reflective practice process.
Feelings are not considered important in the reflective practice process.
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The initial model by Dr Roger Greenaway consisted of three steps: Do, Review, and Plan.
The initial model by Dr Roger Greenaway consisted of three steps: Do, Review, and Plan.
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Schwartz Rounds focus specifically on enhancing technical skills in a clinical setting.
Schwartz Rounds focus specifically on enhancing technical skills in a clinical setting.
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The 'Findings' stage in the 4F’s Model deals with emotional reactions.
The 'Findings' stage in the 4F’s Model deals with emotional reactions.
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Reflective practice can be enhanced through the use of prompts at each stage.
Reflective practice can be enhanced through the use of prompts at each stage.
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John Dewey defines reflective thought as passive and uncritical engagement with knowledge.
John Dewey defines reflective thought as passive and uncritical engagement with knowledge.
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Reflection helps in transforming surface learning into deep learning.
Reflection helps in transforming surface learning into deep learning.
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Self-reflective practice is a meta-cognitive ability that involves thinking about one’s mental processes.
Self-reflective practice is a meta-cognitive ability that involves thinking about one’s mental processes.
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According to the reflective thought paradigm, clarity and coherence are outcomes that should be sought after.
According to the reflective thought paradigm, clarity and coherence are outcomes that should be sought after.
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Piaget's Constructivist Learning Theory suggests that reflection has no impact on student engagement.
Piaget's Constructivist Learning Theory suggests that reflection has no impact on student engagement.
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Reflective thought is regarded as a cognitive process that offers insights into one’s practices and experiences.
Reflective thought is regarded as a cognitive process that offers insights into one’s practices and experiences.
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The primary function of reflective thought is to create more confusion in problem-solving situations.
The primary function of reflective thought is to create more confusion in problem-solving situations.
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Marton & Saljo's research indicates that deeper learning is less effective compared to superficial learning.
Marton & Saljo's research indicates that deeper learning is less effective compared to superficial learning.
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Reflective Observation is the stage where one learns from their experiences.
Reflective Observation is the stage where one learns from their experiences.
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Active Experimentation is about trying out what you have learned.
Active Experimentation is about trying out what you have learned.
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Kolb's Learning Cycle includes three stages.
Kolb's Learning Cycle includes three stages.
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Gibb’s Reflective Cycle is often utilized in developing reflective practice.
Gibb’s Reflective Cycle is often utilized in developing reflective practice.
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Abstract Conceptualization occurs after Active Experimentation in Kolb's Learning Cycle.
Abstract Conceptualization occurs after Active Experimentation in Kolb's Learning Cycle.
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Experiential learning is limited to theoretical concepts only.
Experiential learning is limited to theoretical concepts only.
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Kolb's Learning Cycle promotes a one-size-fits-all approach to learning.
Kolb's Learning Cycle promotes a one-size-fits-all approach to learning.
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Excessive 'On-call' shifts can negatively affect performance.
Excessive 'On-call' shifts can negatively affect performance.
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Reflective practice is only about evaluating the actions of others in a situation.
Reflective practice is only about evaluating the actions of others in a situation.
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The statement 'What? So what? Now what?' is an important reflective practice model.
The statement 'What? So what? Now what?' is an important reflective practice model.
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A healthcare provider's feelings do not impact their performance.
A healthcare provider's feelings do not impact their performance.
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Interns often face challenges due to under-recruitment of trainees.
Interns often face challenges due to under-recruitment of trainees.
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In reflective practice, individuals should only focus on the positive aspects of an experience.
In reflective practice, individuals should only focus on the positive aspects of an experience.
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Reflective practice requires no consideration of the consequences for others involved in a situation.
Reflective practice requires no consideration of the consequences for others involved in a situation.
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An intern's performance in a learning environment can degrade due to fatigue.
An intern's performance in a learning environment can degrade due to fatigue.
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Gibbs' Reflective Cycle includes an evaluation stage.
Gibbs' Reflective Cycle includes an evaluation stage.
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The planning phase in Gibbs' Reflective Cycle is concerned with summarizing past learning.
The planning phase in Gibbs' Reflective Cycle is concerned with summarizing past learning.
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Patients suffering from dementia may exhibit confusion and aggressive behavior.
Patients suffering from dementia may exhibit confusion and aggressive behavior.
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The action phase in Gibbs' Reflective Cycle is about setting goals for future practice.
The action phase in Gibbs' Reflective Cycle is about setting goals for future practice.
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A reflective practice mindset requires a willingness to reflect.
A reflective practice mindset requires a willingness to reflect.
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In reflective practice, evaluating one’s own contributions is not important.
In reflective practice, evaluating one’s own contributions is not important.
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Study Notes
Reflective Practitioner BMF MED1
- Presented by Prof. Denis Harkin (MB, MD, FRCSI), Consultant Vascular Surgeon, Chair of Medical Professionalism, RCSI, and Dr Sally Doherty (Dept Psychology, Academic lead in Bahrain, for Professionalism, RCSI)
- Learning objectives include defining reflective practice, describing reflective practice theory (including Gibbs' Reflective Cycle), understanding the role of reflection in continuous professional development, and discussing reflection's application to learning from clinical scenarios.
Reflective Practice
- A cognitive process to gain insights, rethink practice, learn from experiences, and cope with similar situations in the future.
- This helps create better understanding of situations, leading to improvements.
To Err Is Human
- In the USA, 98,000 people die annually from medical errors in hospitals.
- Medication errors are more frequent than workplace injuries.
- The issue isn't bad people in healthcare, but rather flawed systems.
- Individual professional behavior sometimes leads to patient harm.
Reflective Practice: IMC
- The behaviors and processes that form the foundation for good care standards.
- Developing insight into professional practice is crucial for improving care.
- Formal reviews (e.g., audit, outcome data) and informal reflection (on personal values impacting communication with patients, colleagues, and others) are aspects of reflective practice.
Learning Culture & Safety: IMC
- Medical treatment involves some risk.
- Minimizing risk and learning from harm are essential for patient safety culture.
- Reporting adverse events, learning from them, and participating in reviews is vital.
Reflective Practice: AoMRC
- Reflection is the analytic process of considering professional practice to gain insight and improve practice.
- Reflection involves observed, directly involved, or formally learned situations.
- It can relate to both positive and negative events for behavior reinforcement or change.
Reflective Practice: GMC, AoMRC & COPMED
- Doctors need open and honest discussion about clinical events and confidence in reflection's value.
- Reflection improves learning opportunities, self-development, and patient care (where needed).
- Reflection should focus on gaining understanding, not blame.
Royal College of Surgeons in Ireland Definition
- Medical professionalism is defined as values, behaviours, and attitudes that promote professional relationships, public trust, and patient safety.
Continuous Improvement
- Continuous Quality Improvement (CQI) is a structured process involving healthcare professionals in planning and implementing improvements in care processes to ensure quality health care outcomes.
Reflective Practice Theory
- This section details different theories of reflective practice, covering various aspects like different cognitive processes, learning styles, and the critical role of reflection.
What is Reflection
- Reflection allows learning and knowledge to benefit from conscious thought.
- Reflection on experience uses experiences to update understanding of existing theories.
- Reflection as metacognition focuses on problems, concepts, or ideas.
Reflective Thought (Dewey)
- Reflective thought is described as active, persistent, and careful consideration of any belief or kind of knowledge, examining its support and conclusions.
- It transforms obscurity into clarity and harmony, converting appetitive and impulsive actions to intelligent ones.
Reflection: Active Learning and Consolidation
- Piaget's and Marton & Saljo's theories underpin the importance of reflection in active learning and knowledge retention, contextualising learning with personal experiences.
Reflection: Metacognition
- Metacognition is awareness and understanding of one's own thought processes.
- Reflection is useful for understanding the content and premise of a problem and the problem-solving process itself ("thinking about thinking").
Reflection: Critical Thought (Moon)
- Reflection has six helpful areas: reviewing own/others' behavior/work, building theories from observing practice, resolving uncertainty, reflecting on learning and metacognition, empowering self-development, and empowering individuals within a social group.
Reflecting on Experience
- Models like Gibbs' "Reflective Cycle," Driscoll's/Rolfe's model ("What? So what? Now what?"), Kolb's learning cycle, Schon's reflective practitioner, and Bassot and Greenaway's models offer structures for reflection.
Reflection and Professional Development
- Reflection improves self-awareness and decision-making in professional and personal development.
- Structured reflection on clinical practice can help identify areas for improvement and implement positive changes within professional practice.
The Task of Medical Education
- The goal of medical education is to transform medical novices into effective practitioners by providing them with the best knowledge, skills, and a strong professional identity.
Principles of Adult Learning
- Andragogy is the art and science of helping adults learn, emphasizing independent learners with diverse motivations, expectations, and learning styles.
Life Long Learning
- Life-long learning is any learning activity aimed at improving knowledge, skills, and competencies in personal, civic, social, and employment contexts.
Clinical Learning Environment: Definition
- Clinical learning environments (CLEs) are defined by the Macy Foundation (2018) as social interactions, organizational structures, and physical/virtual spaces that shape learning experiences.
- For healthcare professionals, clinical context is foundational, and efficient, supportive CLEs are essential for high-quality patient care, workforce well-being, and trainee development.
Reflection for Self-awareness
- Self-reflection enhances self-awareness of strengths and weaknesses, leading to improved effectiveness.
- Targeted questions (direct, indirect) and feedback (critical friend, mentor, multi-source feedback) are tools for self-reflection.
Reflection: on Feedback
- Reflection is a pathway for understanding and using feedback, especially concerning self-belief mismatches.
Reflection: Professional Development
- Reflection leads to increased self-awareness, enabling better planning of professional and personal development.
- Cunningham and Moore's work highlights how reflection allows for the identification of areas for improvement in healthcare practice, and how reflecting on these areas helps professionals improve.
Employability
- Employability is a set of achievements, skills, and attributes that make graduates more likely to gain employment and succeed in their chosen fields, benefiting themselves, the workforce, the community, and the economy.
Learning Health System: Learning Cycle
- Learning Health Systems (LHS) embed knowledge generation within daily healthcare practice, fostering continuous improvement in care for all.
- The LHS framework relies on organizational architecture that supports patient, healthcare professional, and researcher engagement within large electronic health systems, quality improvement at the point of care from generated research data, and research-centric healthcare settings.
Quality Improvement and PDCA Cycle
- The Deming/PDSA cycle (Plan-Do-Study-Act) is a systematic process for improving products, processes, and services
- It was introduced by Walter Shewhart, and refined by Deming, used to achieve valuable learning and knowledge for ongoing improvement.
Reflections as Evidence: GMC
- Gross negligence manslaughter in healthcare contexts should be explored and understood by medical practitioners.
Reflective Practice Models (Gibbs')
- Different models, including Gibbs' reflective cycle, support structured reflection and improve practice.
Kolb's Learning Cycle
- Kolb's model (1984) is a learner-centered cycle that has four stages: Concrete Experience, Reflective Observation, Abstract Conceptualization, and Active Experimentation.
- This framework is easily adapted for healthcare professionals.
Gibbs' Reflective Cycle
- Developed by Graham Gibbs (1988), this cycle (with its six stages) offers a structured way to learn from experiences: Description, feelings, evaluation, analysis, conclusion, and action plan.
- Each stage has helpful questions. Using these questions alongside a structured framework can improve one's understanding from the experiences gained.
Schon's Reflective Practitioner
- Schon (1991) describes effective practice as an interplay of knowing-in-action and reflection-in-action occurring simultaneously.
- This iterative cycle allows professionals to adjust their practice in response to immediate situations while also considering the knowledge and reflection accumulated after the fact.
What? So What? Now What?
- Based on simple questions, this framework guides reflection and learning from experience.
- The framework has three simple questions What? So what? Now what?
Conclusions
- This presentation concluded with the benefits of reflection and Learning Health Systems.
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Description
Test your knowledge on reflective practices in medical education. This quiz covers key models like Gibbs' Reflective Cycle and Kolb's Learning Cycle, as well as the importance of patient safety. Discover how these concepts help shape effective healthcare practitioners.
