This document provides an overview and introduction to a course on Reflective Practice for Teaching in Medicine. It discusses key concepts in reflective practice from theorists like Moon, Brookfield, Boud and Schön. It also outlines the Kolb learning cycle and Moon's model of reflection. The course will cover topics like mindfulness, self-motivation, critical reflection, appreciative inquiry and narrative medicine. Appreciative inquiry, an approach to organizational change focused on strengths, will be a framework for class discussions. Facilitators will be selected for sessions and concept mapping will be used to synthesize learning. The goals are to get acquainted, review readings and schedule, and prepare for engaged reflective discussions.

1. Welcome to our course in
Reflective Practice For
Teaching in Medicine
September 7, 2017
ADLT 677 – Teaching in Medical Education
(TiME)

2. Many perspectives on reflection in
learning
Reflective Practice is a method of assessing our
own thoughts and actions, for the purpose of
personal learning and development (J. Moon)

3. What do we mean by “reflective
practice?”
Stephen Brookfield’s
concept of critical
reflection
David Boud’s ideas
about reflective
learning through
writing
Donald Schön’s
concepts
• Knowing-in-action
• Reflection-on-action
• Reflection-in-action

4. Reflection in the Kolb
Experiential Learning Cycle

5. Through concrete experience,
people grow to have a greater
range of emotions

6. Through reflective observation,
people develop increased
awareness and capacity to “see”

7. Through abstract conceptualization, people
develop more sophisticated conceptualization
schemes

8. Through active experimentation, people develop an
expanded repertoire of behaviors

9. Jenny Moon’s conception of
reflection
Noticing
Making Sense
Making Meaning
Working with Meaning
Transformative Learning

10. Our Course in Reflective
Practice
Mindfulness Burnout and
Resilience
Self-Motivation
Critical Reflection
and critical self-
reflection
Appreciative Inquiry
Authenticity in teaching
Narrative Medicine

11. APPRECIATIVE
INQUIRY
Reflective Practice for Teaching in Medicine –
2017
An organizational development approach
to change
Belief that positively-oriented questions
can frame how we think about issues
University of Virginia created a Center for
Appreciative Practice about 10 years ago
The book we are using contains
questions they have developed for use in
their work.

12. Appreciative Inquiry
Foundational beliefs:
• People have unique gifts, skills to contribute
• Organizations are human social systems and have unlimited
relational capacity
• Images of future are socially created and when articulated,
guide individual and collective actions
• In communication, people can shift from problem analysis to
productive possibilities
Appreciation + Inquiry
• Appreciate: affirm, recognize, value
• Inquire: discover, ask, study, learn

13. Fully Affirmative
• Focus on organization at its best – past, present & future
• Focus on possibilities not problems
Inquiry-Based
• The “art of the question”: craft unconditionally positive
questions about organizational relevance and vitality
Improvisational
• No singular methodology although based on principles and
follows 4-D framework
Paradoxical
• It does not aim to change. It aims to identify existing
strengths and hopes in order to amplify the positive
What’s Different about AI?

14. From change focused on deficits
to change focused on the
positive
Deficit-Based Change Positive Change
Identified problem Affirmative Topics
Selective inclusion of people Whole system
Problem diagnosis and root cause
analysis
Discovery of positive core,
organization’s narratives
Brainstormed list of alternatives Dreams of a better world and
organization
Best solution to resolve the problem Design to realize dreams and
human aspirations
Capacity to implement and measure
the plan
Destiny of ongoing positive
change

15. How Our Course is Designed
 Eight sessions to provide reading time
 Each session has two facilitators
 Lead the discussion
 Use the AI questions selected, or choose others
 Can add questions to pose to the group to encourage
discussion
 Plan to be flexible and “go with the flow”
 Facilitators write the blog forum topic afterwards; other
class members respond with comments (replies)
before next week
 End of course reflective paper on learning

16. Goals for Tonight
Get to know each other
Review the readings and schedule for suitability
with your own goals and purposes for learning
Selection of facilitators for each session
Use of concept mapping through Cmap – whole
class exercise at the end of in-class discussions

17. Websites worth noting
 The University of Virginia’s Center for
Appreciative Practice:
 https://med.virginia.edu/appreciative-
practice/
 The Maslach Burnout Inventory – for health
professionals (be sure to take the Report about
Me version as a self-report for $15 if interested
 http://www.mindgarden.com/mbi-human-
services-survey-medical-personnel/699-
mbihssmp-report-about-me.html

18. Selection of Facilitators
 Attending: Medicine, Mindfulness, and Humanity
(Epstein)
 Sept 14 and 28 (two separate facilitations)
 Why We do What We Do: Self-Motivation (Deci)
Oct 12
 Narrative Medicine
October 26
 Authenticity in Teaching
Nov 2
 Becoming Critically Reflective
Nov 16
 Interest in Balint Group facilitation to build reflective

19. A Balint group is a group of clinicians who meet
regularly to present clinical cases in order to improve and
to better understand the clinician-patient relationship.
Balind, M. (1964/1986) . The doctor, his patient, and the
illness. London, UK: Pitman Medical, 2nd ed.
We have Balint Group facilitators at VCU, including Dr.
Steve Crossman and Mary Lee Magee
What is a Balint Group?

20. How We Can Use Concept
Mapping
 Whole class exercise at the end of facilitated
discussions – last 45 minutes of class time
 End of course final session to examine where
we’ve been and what you’ve learned
 Use of CMap, online app for creating robust
concept maps
 Read about CMap tools:
https://cmap.ihmc.us/cmaptools/

21. Today’s tasks
 Hopes and goals you have for the course
 Proposing of ground rules for conversations
 Overview of course/establishing Rampage blog
accounts / use of Blackboard
 Selection of facilitators – names / week / topics
 Facilitators review the AI questions for relevance
 Small group dialogue based on questions posed for
tonight
 Use of Concept Mapping with CMap

22. Questions for the start of the
class
 What do you find most meaningful about your work
as a physician? (Charon)
 What was the highlight of your medical
education/training? (Appreciative Inquiry p. 89)
 What qualities do the people you admire possess?
Without being humble, in what ways do you exhibit
these same qualities? (AI, p. 91)
 From where do you draw the strength of your
character? (AI, p. 91