Council on Medical Student Education in Pediatrics


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COMSEP Meeting in Ottawa, ON

Poster Presentation:

Reflection-on-Action in the Pediatric Clerkship

Meghan Treitz,University of Colorado,Aurora ,CO,Nancy D. Heavilin,University of Colorado,Aurora,COLORADO,Jennifer Soep,University of Colorado,Aurora ,CO,Jason Owens,University of Colorado,Aurora ,CO,Janice L. Hanson,University of Colorado,Aurora,CO

Background:  Reflection is essential to professional development and is a key component of Kolb’s learning cycle.  Our Department of Pediatrics is working to promote a culture of reflection, now including pediatric clerkship students. 

Objective:  Incorporate reflection-on-action into pediatric-specific history and physical exam curriculum within the third year pediatric clerkship.

Methods:  At the clerkship orientation students are instructed to write a reflection piece about an experience they have during the clerkship with pediatric physical exam, history taking, or communication, and then be prepared to read and discuss it on the last day of the clerkship.  Students have the option to write a 55-word story, free-form narration, or a different creative piece.  On the last day, students are divided into groups, each with a faculty facilitator.  To start, students read aloud a poem we provide, then discuss the poem and relate it to their pediatric experiences.  After this warm-up, students read their reflections to the group.  Discussion follows.  Evaluation includes tabulation of types of reflective products and qualitative analysis of students’ written reflections and field notes from faculty facilitators.  Evaluation will continue for a full academic year (8 blocks, 160 students).

Results:  To date, 69 students (4 blocks) have participated in the reflective exercise, yielding 83 pieces.  This includes 34 55-word stories, 41 free form narratives, 3 poems, 5 haikus.  26 addressed physical exam, 37 communication, and 29 history taking.  Preliminary qualitative analysis has identified the following themes within the reflections:  patients with difficult social circumstances, building rapport and interacting with pediatric patients, resilience of children, career decisions, and lessons learned.  Faculty facilitators commented on (1) willingness of students to share their reflections, (2) the depth of discussion in small groups, and (3) the insight and humanism displayed by students.   

Discussion:  We successfully implemented a new reflection-on-action exercise for the pediatric clerkship.  Students took advantage of a flexible format, with nearly half using the suggested 55-word structure and the others using free form or another structure.  Discussion reflects students’ thoughtfulness, insight, and humanism.  Both writing and discussion demonstrate tenets of professionalism.