![]() The Accreditation Council for Graduate Medical Education (ACGME) of the U.S. In parallel process, we suggest, critical reflection on our use of RW to foster RC in medical education appears timely.Ĭompetency-based medical education is the golden standard for both undergraduate and graduate medical education with RC now highlighted as integral core component. Referencing the student’s actual text that represents this experience, medical educators facilitate development of RC with supportive challenging of assumptions, exploring emotional responses (of patient and student), and encouraging consideration of new perspectives as relevant. Through interactive RW-reading and responding to students’ reflective narratives-we teach our students to “slow down” 5 and become more aware in the clinical encounter as they elicit a patient’s story and embark on diagnostic reasoning. ![]() Such pedagogy is no longer the renegade new kid on the block-these theoretical underpinnings have served as a foundation for proliferation of narrative medicine curricula initiatives within medical education. ![]() ![]() 4 Clinicians, after all, fundamentally teach, communicate, and reason through cases with stories 3. 3Ĭharon, an internationally regarded authority on narrative medicine – medicine practiced with the competence to recognize, absorb, interpret, and be moved by stories of illness- taught us about enhancing patient-centered medical practice through the use of literature and RW to build “narrative competence” (contained in and almost synonymous with the definition of narrative medicine). Indeed, clinical reasoning has been described as a narrative, interpretive, and experiential activity. What have we here? A key realization about reflective writing (RW) and other narrative medicine initiatives within medical education has emerged – these exercises resonate with the core of clinical practice. The transformative act of reflection-the implicit becomes explicit and new habits of mind develop. Capturing the lived experience of the patient–physician encounter in the description and subsequent reflection. Grappling with chaos and complexity, sometimes achieving clarity, sometimes not, as the colorful tapestry of patient interactions often contains shades of grey. Both the writer and reader use the medium of the written word for meaning making within the often ambiguous, sometimes arduous journey of becoming a physician. The writer is a medical student the reader a medical educator charged with providing quality feedback to a student’s reflective narrative in order to promote reflective capacity (RC). “Writing that affects the reader is art” 2 Writing improves clinicians’ stores of empathy, reflection, and courage” 1 Within this article, we consider opportunities and challenges associated with implementation of reflective writing curricula for promotion of reflective capacity within medical education. Such initiatives, however, raise fundamental questions of reflection definition, program design, efficacy of methods, and outcomes assessment. At Alpert Med, “interactive” reflective writing with guided individualized feedback from interdisciplinary faculty to students’ reflective writing has been implemented in a Doctoring course and Family Medicine clerkship as an educational method to achieve these aims. There has been a proliferation of reflective writing pedagogy within medical education to foster development of reflective capacity, extend empathy with deepened understanding of patients’ experience of illness, and promote practitioner well-being. Reflection has been recently linked to promoting effective use of feedback in medical education and associated with improved diagnostic accuracy, suggesting promising outcomes. Reflective capacity has been described as an essential characteristic of professionally competent clinical practice, core to ACGME competencies.
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