1. Using Critical Incident Reflection
Sessions to Promote Reflection in
Undergraduate Medical Learners:
Exploring Elements of the Hidden Curriculum
Siobhan Farrell
and
Dr. Marion Briggs
2. Faculty/Presenter Disclosure
• Faculty: Siobhan Farrell and Dr.
Marion Briggs
• No Relationships with
commercial interests:
– Employed by the Northern
Ontario School of Medicine
3. Objectives
• To understand the benefits and
challenges of small group critical
incident reflection (CIR) for
undergraduate medical learners
• To explore how themes from critical
incident reflection can reveal
opportunities for curricular
development.
4. “Critical reflection is the process of
analyzing, questioning, and
reframing an experience in order to
make an assessment of it for the
purposes of learning (reflective
learning) and/or to improve
practice (reflective practice).”
(Aronson 2010)
5. Why do CIR?
• “Safe space” for reflection about significant
experiences supports medical learners’
professional and personal development as
reflective practitioners
• CIR writing focuses on formative experiences to
highlight learners’ development as a person and
as a physician.
• Small group CIR demonstrates the power of
reflecting with peers and colleagues which
exposes learners to one way to reduce
professional and personal isolation in rural
practice.
6. Critical Incident
Reflection sessions
A critical incident is an incident that
is in some way significant to the
individual recounting it.
Learners record:
• What the situation was
• What they did in it
• What happened as a result of their actions
• A reflection on the situation or event & the
process by which it unfolded.
8. A reflection on reflection!
• What makes this a good story?
• What are the ingredients of a good story?
• What are the differences between a story
and a reflection?
• What is your role as a facilitator?
9. During a placement, we saw a patient who
had no family doctor. She was a older
lady, who had the beginnings of ___. The
physician said, “I think you have ___” and
then left the room, and the patient was left
with questions. [She] didn’t even know
what ___meant. I stayed and tried to
explain but was called to go. The patient
was left to figure out her newly diagnosed
condition, who to contact about follow-up
and treatment options all by herself……..
15. Reflection as a continuum
• Intro to reflection – theory and method
• Pre-clerkship
• Clerkship
• Specialty rotations
• Residency
• Continuing Education and Professional
Development
• Personal and Team Reflection (Intra and
inter-professional reflection)
16. Experience with Critical Incident
sessions has demonstrated
benefits of F2F discussion from
multiple perspectives, including:
– Learning and reflection
– Creating safe space
– Opportunities for peer feedback
– Learner satisfaction
17. Unintended outcomes ...
• Opportunities were identified for
curriculum development and for
faculty development
• Pressure for CIR beyond first and
second year
• The potential for CIR to contribute to
practitioner resilience
CIR role play-student talking about being with a young mental health patient whose needs are not being seriously addressed by physician, and the disappointment of student in the physician behavior. Second person in role play is other student or facilitator asking them questions about experience (can take 3-4 minutes).
