The UCSF Faculty Development Workshop on Critical Reflection in Medical Education: Training Educators to Teach and Provide Feedback on Learners’ Reflections
|Presentation, Reference||9086||1||January 24, 2012|
This guide describes a literature-derived workshop to train faculty in the skill of critical reflection and to teach them to foster the skill in their learners. The basic workshop lasts two hours, and we provide options for two different three hour workshops and one four hour long workshop as well. All versions of the workshop encourage participant interaction throughout through the use of multiple teaching modalities: individual, small and large group exercises; use of written materials, white board/flip charts and PowerPoint. Participants apply their skill as educators to analyze more and less effective reflections, are introduced to the concepts and data surrounding critical reflection in medical education and a structured approach for promoting effective and educational reflection, practice giving feedback on critical reflections.
In the longer workshops, they may also write critical reflections themselves, gain additional feedback experience, and draft approaches to incorporating reflection in the courses and curricula to assess competencies. Materials include: a PowerPoint slide set; two sets of sample reflections (5 total), each with an annotated presenter’s guide; a sheet for rating and evaluating sample reflection quality; the UCSF LEaP Guide, a structured approach to critical reflection; guidelines for providing feedback on both content and reflective skill of critical reflections; a prompt for faculty critical reflection; and a workshop evaluation form.
Aronson L, Kruidering M, O'Sullivan P. The UCSF Faculty Development Workshop on Critical Reflection in Medical Education: Training Educators to Teach and Provide Feedback on Learners’ Reflections. MedEdPORTAL; 2012. Available from: www.mededportal.org/publication/9086
- To define critical reflection as used by educators.
- To list the components of more and less effective critical reflections.
- To describe the uses of critical reflection in medical education.
- To practice providing feedback on both the content and reflective skill demonstrated in a critical reflection.
- To write a critical reflection and discuss the challenges of critical reflection.
- To identify milestones or competencies for which critical reflection would improve your ability to assess learners’ progress and where they might be located in the curriculum.
- Reflection, Feedback (MeSH), Progress
- Interpersonal & Communication Skills
- Practice-based Learning & Improvement
- Communication Skills
- Curriculum Development/Evaluation
- Instructional Materials/Methods
- Teaching Skills
- Professional & Faculty Development
Authors & Co-Authors
Louise Aronson, MD
Marieke Kruidering, PhD
Patricia S O'Sullivan, EdD
Sponsorship or Funding Source
Project supported by the AOA National Honor Medical Society Edward D. Harris Professionalism Award and by a UCSF Medical Education Research Fellowship.
Effectiveness and Significance
As of August 2011, the authors had given this workshop 19 times, receiving consistently high ratings (mean overall rating 4.6 on a 5 point scale), moderately high rates of self-efficacy (4.2 out of 5), and leading to substantial implementation of critical reflection by trained faculty (74%) and broad dissemination locally and at other institutions across the United States. At UCSF, the impact of the workshop has included greater teaching of critical reflection throughout the medical curriculum (e.g. in pre-clerkship lab exercises for first year medical students, in many core clerkships, and in the medical student portfolios for competency milestone assessment; in residencies from Emergency Medicine to Psychiatry and in several fellowships), greater consistency in using reflection and critical reflection accurately and appropriately, coordination of reflective skills training across courses and clerkships, and more consistent feedback to learners on their reflective exercises.
Participants from other institutions, including Stanford, the University of Colorado, FSU, Hofstra, and the University of Toronto, who took the workshop at regional and national meetings have contacted us and indicated that they have adopted our approach to critical reflection. Importantly, while there have been brief reports about faculty training in reflection, we have not found other workshops based on the literature and extensive medical education experience which have been thoroughly described, broadly disseminated, and evaluated across learner levels and institutions (paper in progress) as this one has.
Special Implementation Guidelines or Requirements
Large multiple-purpose room able to accommodate:
All learners in a single room to support large group directions/discussion and small group breakouts for the exercises:
A. If possible, a room with movable chairs so subgroups of 4-6 can be formed easily.
B. Black board/white board (with markers) or flip chart.
C. Tables so participants can write/type their ratings/feedback/(reflections).
A. LCD for laptop display of PowerPoint presentation.
B. Sound system depending on size of group.
C. If doing the 180 or 240 minute versions, an email notice to participants they might want to bring their laptop for the writing assignments.
Required Resources/ Instructional Materials (Equipment, space, room set up):
- Check LCD projector and PowerPoint slides.
- Handouts stapled as single packet (Table 1 of instructor’s guide).
- Arrange tables so all participants can see PowerPoint projection, black/white board, and can easily arrange themselves into small groups of 4-6.
- Make copies (with 10% over the anticipated number of participants) of packets as described in Table 1.
- Create a detailed agenda for yourself (see “detailed instructional plan” with agenda prompts and desired outcomes).
- Refresh your knowledge of key concepts, check literature, re-read the reflections and PowerPoint, review detailed agenda.
- If co-facilitating, assign roles for each task.
Even though they take more time, doing one of the longer workshops offers two advantages.
A. First, having participants write a critical reflection as part of the workshop gives them an understanding of the difficulty posed by critical reflection in a way discussion cannot. Thus, they better appreciate the challenge to their learners and how much time it might take learners to develop skill in critical reflection.
B. Second, providing feedback to other participants on their critical reflection both allows another opportunity to practice that skill and introduces the added, real-life difficulty of a person who will receive the feedback forcing participants to engage not only with the content of the feedback but how to deliver it sensitively and effectively.
- We have been queried on occasion as to whether reflection should be the purview of psychiatrists or other specialists. If this issue is raised, it is important to emphasize that critical reflection is not therapy but professional development which fosters skills including self-assessment, analytic reasoning, and creating effective learning plans. As such it is applicable across contexts and specialties and can be taught by any trained educator.
- When small groups gather to provide feedback in Exercise 2, it is important to circulate and encourage them to follow the feedback guidelines and consider reflective skill rather than spending the allotted time discussing the content/topic of the reflection.
- In previous sessions, many participants wanted guidance on the best “curriculum” into which to insert a reflective exercise. This is impossible to answer. The exercise needs to relevant to current learning activities and goals and the timing for reflective exercises needs to be such that feedback can be provided to all learners, but CR can be useful in many different ways within courses, clerkship and departments within institutions.
- Co-facilitation works better for larger groups of learners so facilitators can monitor small groups.
This information is made available under the Creative Commons license.
Publications, Presentations, and/or Citations for this Publication
- Aronson L, Chittenden E, O’Sullivan P. A Faculty Development Workshop in Teaching Reflection, Medical Education, 2009;43(5):499.
- Aronson L, Niehaus B, DeVries C, Siegel J, O’Sullivan P. Do Writing and Storytelling Skill Influence Assessment of Reflective Ability in Medical Students’ Written Reflections? Academic Medicine 2010; 85(10): S29-S32
- Aronson L. 12 Tips for Teaching Reflection at All Levels of Medical Education. Medical Teacher. 2011;33(3):200-5.
- O‘Sullivan, P., Aronson, L., Chittenden, E., Niehaus, B., Learman, L., (2010). Reflective Ability Rubric and User Guide. MedEdPORTAL: http://services.aamc.org/30/mededportal/servlet/s/segment/mededportal/?subid=8133
- Aronson L, Niehaus B, Lindow J, Robertson P, O’Sullivan P. Development and Pilot Testing of a Reflective Learning Guide for Medical Education. Med Teach. 2011;33(10):e515-21.
- Aronson L, Niehaus B, Hill-Sakurai L, Lai C, O’Sullivan P. A Randomized Trial of Reflective Learning Guidelines and Feedback among Third Year Medical Students. (submitted) Critical Reflection Faculty Development Workshop given 19 times including at UCSF (7 times), Stanford, WGEA and other meetings.