A framework to teach self-reflection for the remedial resident

Abstract

Background: Regardless of the area of deficiency, be it in knowledge, skills or attitudes, residents requiring remediation are rarely self-identified. This illustrates a diminished ability for self-reflection. Self-reflection is a cornerstone of adult education. During the remediation process, the remediation curriculum needs to emphasize self-reflection. Aims: How can one structure self-reflection in a remediation curriculum? Methods: This article describes how to adapt and apply environmental scanning for remedial residents. Results: Environmental scanning is a rigorous and well-developed business approach that can be adapted for personal continuous quality improvement to foster self-reflection in medical trainees. There are often already existing tools which can form the foundation for regular reflection in medical education using an environmental scanning structure. Conclusions: Environmental scanning can be thought of as a structured approach to internal and external reflections.

Reflection as a Learning Tool in Graduate Medical Education: A Systematic Review

“…[1][2][3][4] By reflecting on experiences, residents and fellows develop self-regulated learning skills that can lead to enhanced competence, humanism, and professionalism. 1,[5][6][7][8][9][10][11] Theory supports reflection as a means to advance knowledge, guide future learning, deepen understanding of complex concepts, and explore emotionally challenging situations. 1,[12][13][14] However, the impact of reflection on medical trainees and its most effective use in GME remain unclear.…”

Remediation programmes for practising doctors to restore patient safety: the RESTORE realist review

“…If they do not have insight going into remediation, then the remediation programme must work to help them develop insight. Insight is mentioned in a number of the returned papers, 7,40,[42][43][44][45][46][47][48][49][50] but two papers, 42,43 in particular, have been useful in conceptualising insight in the context of remediation. Hays et al 43 note that the term insight has been poorly defined in the setting of medical education, and that, in this setting, insight may be a combination of awareness of one's own and others' performance and the capacity to reflect.…”

“…if the remediating doctor lacks motivation, remediation will be more difficult). 40,45,53,110 Other papers discuss, even if only briefly, some of the strategies in remediation programmes that bring about motivation. 7,44,48,50,55,57,91,97,111 There is a basic distinction between intrinsic motivation (i.e.…”

Performance management versus bullying and harassment: An educator perspective

“…The doctor's perception of the credibility of their raters also impacts on the effectiveness of the feedback given and long‐term behavioural changes as a result of feedback are more common if there has been negative but constructive feedback, than if feedback was positive or where no changes were thought to be necessary . Successful performance management must seek to improve self‐reflection, assisting the doctor to become more self‐aware as an adult learner, and become more able to self‐assess in the future …”

“…21 Successful performance management must seek to improve self-reflection, assisting the doctor to become more self-aware as an adult learner, and become more able to self-assess in the future. 11,25…”