Reflecting on Reflection


To the Editor:

As a junior faculty member, and fellow in medical education, the article “The Use of Reflection in Emergency Medicine Education” in the August issue of AEM[1] greatly resonated with me. This image of the emergency physician, “able to focus, fully engaged with his or her patients, aware of his or her feeling at all times, constantly self-monitoring” is the kind of physician and teacher I would like to be. I want to note that I never received training in reflection during my medical education, and neither did most of my peers. In reading this article I realized how unfortunate this is and how much richer my learning experience might have been had reflection been part of the curriculum.

While research continues to support the use of reflection in medical education, we fail to incorporate such a curriculum with clear structure and intention.[2] At Maimonides Medical Center, we are now addressing this challenge and are in the midst of designing a reflective curriculum to be incorporated into our residents' morbidity and mortality conferences, patient follow-ups, and competency and milestone assessments. The goal of this curriculum is to graduate residents who can apply reflective skills successfully in their everyday practice and bridge gaps between the various expected competencies and milestones.[3] A key component in making this idea a reality is first to apply motivational theory techniques to ensure that both faculty and residents understand the importance of a reflective education for their practice. By implementing this curriculum, we hope to gain a deeper understanding of the challenges and benefits of creating a reflective learning model, so that we may continue to maximize the transmission of these skills. It is my vision that in the near future reflective education will be incorporated ubiquitously into emergency medicine curriculum.