“The important thing is to make the lesson of each case tell on your education.”
Sir William Osler
Much attention is given to the loss of idealism and erosion of professionalism during the clinical years of medical training. (In fact a 4th year medical student wrote one of the most influential and frequently cited references on this subject.) Lack (or loss) of reflection appears to be a key factor in this problem.
- Self-aware physicians are more effective, efficient, and satisfied.
- Patient satisfaction and compliance are directly related to a physician’s humanism.
- Students with higher reflection-in-learning scores had higher GPAs according to one study.
In the medical profession we are privileged to interact with people in the most private, intimate, and often stressful situations. Unfortunately, these interactions do not always go as planned and medical students, in particular, can find themselves witnessing or even feeling pressured to participate in interactions that are troubling.
You will also have the opportunity to work with outstanding colleagues and you will take care of extraordinary patients who will move you and hopefully influence your professional development. Unfortunately, without active reflection on these seminal, “unforgettable” experiences, we do forget.
Pick something that happened during medical school that affected you strongly; something that you keep thinking about or feeling like you should talk about (whether or not you do). You do not need to limit yourself to negative experiences. There are positive critical incidents too.
Whether you choose a positive or negative experience, make sure you include the following key features:
1. Brief description of the incident
2. Reflection on why you think it affected you
3. Comment on how you think this will affect your future practice
4. Optionally, you may choose to reference some literature (medical or non-medical) that you think would be relevant or enhance the discussion.
- Do not use real patient names.
- You may present the case in the 3rd person as something witnessed rather than directly experienced by you if needed for your own comfort.
- You are not limited to occurrences during the Medicine Clerkship.
- This is not a creative writing assignment, but creativity is welcomed (poem, mini-play, visual art, or some other type of creative expression.)
- There is no length requirement but 1-2 pages is the average.
Participation in one small (5-6 people) discussion group is mandatory and will last ~ 90 minutes and homemade snacks are provided. During this time you will read your reflection and a group discussion will follow that is facilitated by Dr. Harrell, Dr.Nall, and Dr. Lynch. You are welcome to attend any of the discussion sessions, though you only will read at one. There is a sign up sheet on the door of the clerkship office 4108. (Students in Jacksonville the second half of the rotation who do not sign up for the discussion week 4 will participate in the final group discussion.)
Full credit is given for participation. Lack of participation will lower you overall professionalism evaluation.
(Obviously these were polished for publication and yours does not need to be this well-edited.)
Wilmer E. Nonadherent: A Four-Letter Word. Ann Intern Med. 2013; 158:217