By Michael P. McCarthy
The New Year offers a clean slate, a welcome opportunity to try something new. Given the title of the blog, Reflective MedEd, I would like to offer a way of refocusing and reorienting oneself through reflecting on the experiences of the day. As Hedy Wald described in her blog post, reflection enhances a variety of skills that are essential for continuing professional identity formation for medical students, educators, and practitioners alike. The process of the examen serves as a way to reflect by reviewing hour-by-hour the events, circumstances, and experiences of the day…
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By David Leach
On March 1st my aortic valve was replaced. I received extraordinary care, was discharged on the third postoperative day, and am doing very well. When I arrived from the operating room to the intensive care unit I had an endotracheal tube, two chest tubes, an arterial line, a jugular vein Swan-Ganz catheter, two 14 gauge intravenous lines, a urinary catheter, various chest leads monitoring my heart rhythm, a pulse oxygen monitor and I have rarely felt better. In fact I was filled with joy. The Society of Thoracic Surgeons rates the 1300 plus cardiovascular surgery programs in the U.S. and I was happy to discover that my local thoracic surgery program was highly rated. I was grateful to have a disease that was fixable and a surgeon who knew how to fix it. I was also terrified at what I would have to go through to get it fixed. I did not anticipate joy…
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By Karen Spear-Ellinwood
I began professional life as a lawyer, representing people accused of violent crimes, most having failed to graduate high school, if they made it there at all. I realized that while a lack of education accounted for a great deal of crime, the more dangerous affliction was a failure to reflect before acting.
After 13 years, I became an educator. I started in middle school. I constructed debates on history, legal and social issues, on weighing the potential harm of perceived ills and their perceived remedies. The sorts of subjects that forced reflection and self-awareness.
I told my eighth graders that lawyers never make decisions without reflecting on what’s likely to happen and what might happen. Lawyers had to know the law and they had to figure out how to apply it, sometimes while encountering unanticipated circumstances. I assigned these eighth graders to argue the side of the debate with which they vehemently disagreed. They had to stretch their perspective, I told them. See this issue from someone else’s perspective to reconsider their own position. They might not change their mind but they would understand the issue and themselves better…
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By Hedy Wald
Reb Zusha* used to say: “When I die and come before the heavenly court, if they ask me, ‘Zusha, why were you not Abraham?’ I’ll say that I didn’t have Abraham’s intellectual abilities. If they say, ‘Why were you not Moses?’ I’ll say I didn’t have Moses’ leadership abilities. For every such question, I’ll have an answer. But if they say, ‘Zusha, why were you not Zusha?’ for that, I’ll have no answer.”
*Rabbi Meshulam Zusha of Hanipol (Anipoli), pious great Hassidic Rabbi (1718-1800)
What is our answer when faced with the challenge of helping our “Zushas,” our learners and educators, be all the “Zushas” they can be?
Developing a “reflective culture” within medical schools and teaching hospitals can encourage and guide learners, educators, and practitioners to recognize and take steps toward realizing untapped potential in self and in health care teams. Within a longitudinal, developmental reflective process starting in year one of medical school, extending into residency and beyond,1 reflection-fostered awareness of self, other, and situation facilitates purposeful, self-directed learning, more effective use of feedback, and development of new habits of mind, heart, and practice.2 Meaning is created from experience and newly illuminated capabilities may be actualized…
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By David C. Leach
William Butler Yeats said: “We make out of the quarrel with others, rhetoric, but of the quarrel with ourselves poetry.” During the course of normal human development most people at some point have had their hearts broken, cherished beliefs challenged, paradoxes entertained or have been lonely or felt abandoned. Sometimes these moments can offer powerful prompts to turn inward and to enhance one’s reflective capacities, one’s poetic repertoire, and this in turn can enable learners and faculty to be more compassionate and reflective practitioners. The alternative responses, hardening the heart, embracing idols, not honoring the paradox or becoming ever more isolated can have devastating effects on both the learner and their patients. Moving from rhetoric to poetry is an important skill for learners to develop…
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