Reflective Journals
Click here and consider this done.
Instructions:
-These are REFLECTIVE journals for a medical student
-The rotation in which the journals are written in is mental health (psychiatry), therefore the overall theme of each post pertains to mental health.
-The diary entries should not solely focus on clinical knowledge and skills, even though these will be a component of the journal. The focus of each journal is to address and reflect on issues which are inherent to the concept of Medical Professionalism. (details below)
-6 journals 350-450 words each (which occurred over a 6 week period)
–PLUS 2 additional detailed analyses (see template) of significant events, and learning goals you developed in each journal. (do this after the 6 journals have been completed). And an explanation of how you worked towards/achieved these goals. (550-650 words each)
-Each journal should reference 1 to 2 scholarly articles which has helped reflect on the experiences. (List of articles provided below)
Issues inherent to the concept of Medical Professionalism
Demonstrate ethical practice and complies with legal responsibilities
-Aware of and complies with legal responsibilities and requirements and guidelines of regulatory bodies
-Applies ethical principles in professional practice
-Displays and reflects on, appropriate professional attitudes and values
-Values patient autonomy, privacy and confidentiality
-Maximises patient safety, ensures quality care and manages risk and adverse medical outcomes
Teamwork
-Works effectively and cooperatively as a member of a multidisciplinary team and as a member of the health care system
Learning & Teaching
-Engages in self and peer evaluation, lifelong learning and teaching.
Personal needs
-Recognizes own personal, physical and emotional needs and is aware of the pathways available for assistance
Medical humanities
-Engages in scholarship of the arts and humanities to interpret the diverse human experience of health, illness and medical care
Scholarly articles:
- You are encouraged to undertake your own search for other current relevant articles.
Reflective practice
http://www.lc.unsw.edu.au/onlib/reflect.html (basic introduction to reflective writing by the UNSW Learning Centre).
Ballon, B. C. and W. Skinner (2008). “”Attitude is a Little Thing That Makes a Big Difference”: Reflection Techniques for Addiction Psychiatry Training.” Acad Psychiatry 32(3): 218-224.
Boud, D. (2001). “Using Journal Writing to Enhance Reflective Practice.” New Directions for Adult and Continuing Education 90.
Hays R, Jolly B, Caldon Lea. Is Insight Important? Measuring capacity to change performance. Medical Education. 2002;36:965-971
Plack MM, Greenberg L. The reflective practitioner: reaching for excellence in practice. Pediatrics. 2005;116:1546
Papadimos TJ. Reflective thinking and medical students: some thoughtful distillations regarding John Dewey and Hannah Arendt. Philosophy, Ethics, and Humanities in Medicine. 2009;4:5
Stark P, Roberts C, Newble D, Bax N. Discovering Professionalism through guided reflection. Medical Teacher. 2006;28:25-31
Professionalism
Boon K, Turner J. Ethical and professional conduct of medical students: review of current assessment measures and controversies. British Medical Journal. 2004;30:221
Cohen JJ. Professionalism in medical education, an American perspective: from evidence to accountability. Medical Education. 2006;40:607
Irvine D. The performance of doctors: professionalism and self regulation in a changing world. BMJ. 1997;314:1540-
Cohen JJ, Cruess S, Davidson C. Alliance between society and medicine: the public’s stake in medical professionalism. JAMA. 2007;298:670
Cruess SR, Cruess RL. Professionalism must be taught. BMJ. 1997;315:1674-1677
Frohna A. Medical Students’ Professionalism. Medical Teacher. 2006;28:1-2
Hafferty F. Professionalism- The Next Wave. New England Journal of Medicine. 2006;355:2151-2152
Pellegrino ED. Professionalism, profession and the virtues of the good physician. Mt Sinai J Med. 2002;69:378-384
Project MotMP. Medical Professionalism in the New Millenium: A Physician Charter. Annals of Internal Medicine 2002;136:243-246
Feudtner, C. and D. A. Christakis (1994). “Making the Rounds The Ethical Development of Medical Students in the Context of Clinical Rotations.” The Hastings Center Report 24(1): 6-12.
Monrouxe, L. V. (2009). “Solicited audio diaries in longitudinal narrative research: a view from inside.” Qualitative Research 9(1): 81.
Medical student and Physician Health
Ball, S. and A. Bax (2002). “Self-care in medical education: effectiveness of health-habits interventions for first-year medical students.” Academic Medicine 77(9): 911.
Bergman, B., F. Ahmad, et al. (2003). “Physician health, stress and gender at a university hospital.” Journal of psychosomatic research 54(2): 171-178.
Brown, K. W. and R. M. Ryan (2003). “The benefits of being present: mindfulness and its role in psychological well-being.” Journal of personality and social psychology 84(4): 822.
Chew‐Graham, C. A., A. Rogers, et al. (2003). “‘I wouldn’t want it on my CV or their records’: medical students’ experiences of help‐seeking for mental health problems.” Medical education 37(10): 873- 880.
Gruzelier, J. (2002). “A review of the impact of hypnosis, relaxation, guided imagery and individual differences on aspects of immunity and health.” Stress: The International Journal on the Biology of Stress 5(2): 147-163.
Linzer, M., et al. (2001). “Predicting and preventing physician burnout: results from the United States and the Netherlands.” The American journal of medicine 111(2): 170-175.
Miller, M. N. and K. R. McGOWEN (2000). “The painful truth: physicians are not invincible.” Southern Medical Journal 93(10): 966-973.
Hidden Curriculum
Ara T. Must the hidden curriculum be the ‘black box’ for unspoken truth? Medical Education. 2009;43:822-823
Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Academic Medicine. 1994;69:861-871
Jaye C, Egan T, Parker S. Do as I say, not as I do’: Medical Education and Foucault’s Normalizing Technologies of Self. Anthropology & Medicine. 2006;13:141-155
Ozolins I, Hall H, Peterson R. The student voice: recognising the hidden and informal curriculum in medicine. Medical Teacher. 2008;30:606-611
Reisman A. Outing the Hidden Curriculum. Hastings Center Report. 2006;July-August:9
Wear D, Skillicorn J. Hidden in Plain Sight: The Formal, Informal, and Hidden Curricula of a Psychiatry Clerkship. Academic Medicine. 2009;84:451
Wolpaw JED. Hidden humanity. Medical Teacher. 2009;31:945-946
Anderson, R. M. and M. M. Funnell (2005). “Patient empowerment: reflections on the challenge of fostering the adoption of a new paradigm.” Patient education and counseling 57(2): 153-157.
Patient Doctor Relationship
Brody, H. (2011). “” My Story Is Broken; Can You Help Me Fix It?”: Medical Ethics and the Joint Construction of Narrative.” Literature and Medicine 13(1): 79-92.
Crossley, M. L. (2003). “Let me explain’: narrative emplotment and one patient’s experience of oral cancer.” Social science & medicine 56(3): 439-448.
Anspach, R. R. (1988). “Notes on the sociology of medical discourse: the language of case presentation.” Journal of Health and Social Behavior: 357-375.
Gender, Ethnicity, Culture.
Boutin-Foster, C., J. C. Foster, et al. (2008). “Viewpoint: physician, know thyself: the professional culture of medicine as a framework for teaching cultural competence.” Academic Medicine 83(1): 106.
Brogan, D. J., E. Frank, et al. (1999). “Harassment of Lesbians as Medical Students and Physicians.” JAMA 282(13): 1290-1292.
Crampton, P., A. Dowell, et al. (2003). “Combating effects of racism through a cultural immersion medical education program.” Academic Medicine 78(6): 595.
Rees, C. E. and L. V. Monrouxe (2010). ““I should be lucky ha ha ha ha”: The construction of power, identity and gender through laughter within medical workplace learning encounters.” Journal of Pragmatics 42(12): 3384-3399.
Ridley, C. R., D. W. Chih, et al. (2000). “Training in cultural schemas: An antidote to unintentional racism in clinical practice.” American journal of orthopsychiatry 70(1): 65-72.
Rowland, P. (1999). “Gay Men and Lesbians in Medicine: Has Discrimination Left the Room?” Jama 282(13).
Seabrook, M. (2004). “Clinical Students Initial reports of the educational climate in a single medical school.” Med Educ 38 659-669.
Tervalon, M. and J. Murray-Garcia (2010). “Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education.” Journal of Health Care for the Poor and Underserved 9(2): 117-125.
Woolf, K., J. Cave, et al. (2008). “Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study.” British Medical Journal 337(aug18 1): a1220.
Weekly journal template.
This is a suggested format, to help you get started. As
you progress, you may find that a different presentation format suits your style better. Whichever format you choose, try to cover the suggested themes, each can provide important insights into your experiences. There is no need to address each point in every entry; select for relevance to your experiences.
Events (content) and analysis
The thing/s that stood out the most this week was/were:
What did I learn from this experience?
- i) About myself
- ii) From and about the people I work with
iii) About the health care and educational system
- iv) What else do I need to find out to better understand this experience?
- v) Are there other ways of viewing this experience?
- vi) Are there alternative actions that may have resulted in a better outcome?
Emotional reactions
I felt..
My beliefs and values were challenged by an incident in the following ways…
Strengths and weaknesses
My strong points
My weak points
My blind spots
Feedback from others and/or self analysis
Personal learning objectives and plans
Learning objectives in relation to professionalism and clinical development
Learning plans to address objectives (e.g. read literature on professional values in medicine, seek feedback from patients, practice communication skills with peer/tutor observation and feedback …)
