Reflection as a
Lifelong Learning Tool
Guiding Principles
Alice Fornari, EdD
Barbara Hirsch, MD
compassion community innovation humanism reflection
professionalism communication empathy
Reflection as a SOM Value
“We are committed to embedding in all our learning
experiences the time and skills necessary to
consciously examine, interpret and understand the
thoughts and feelings that emanate from intense
patient encounters. Through this process of
mentored self-reflection and assessment, we
ensure the development of a true learning and
professional community capable of nurturing the
transformation from student to physician.”
Objectives
1.
Explore Narrative Practices as integral to
humanistic and patient centered care.
2.
Actively experience reflective practice tools using
a prompt and poem/story to engage in reflective
practice.
3.
Identify the use of Narrative Practice as a
teaching and learning tool across medical
education (CME, GME, UGME)
Relevant
Lifecentered/Real
Stories
Selfdiscovery
*ANDROGOGY
*Teaching
Adults
Past
experiences
Selfdirected
learning
NARRATIVE
PRACTICE
Narrative
Competence
MINDFULNESS
REFLECTION
Goal: A Community of
Reflective Discourse
Reflective Practitioner
ReflectionON-Action
(requires
planning in
“off time”
ReflectionIN-Action
(occurs daily in
“real time”)
Let us Begin to Experience
Reflection…
PROMPT as a Tool: Facilitator Begins
with General Guidelines
1.
2.
3.
Write freely, everything said in this
session is confidential
Write within the allotted time (7 min.)
Don’t worry about “getting the prompt
right”
Reflective Process #1:
PROMPT

Write about a time where you felt a loss
of control.
Prompts in Narrative
Medicine





A simple invitation to write : “tell the story of your
name”
Prompts should be open ended to allow writing
at any level
Timing should be limited for written response
Sharing of writing in small groups facilitates the
reflective process
Journals can be encouraged
PROMPT as a Tool:
General Guidelines
1.
Reading – no preamble, no explanations, no adlibbing;
just read as written.
2.
Feedback/Questions –
1.
2.
3.
3.
Base on the text only, do not assume the writer is the narrator
Use neutral, passive language
Start with positives follow with questions
Writer’s Response – You do NOT have to
answer any questions
Storytelling is universal across
cultures: Why read stories/poems?
close
attention to
detail as we
construct
meaning
highlight the
subtlety &
ambiguity of
words &
language
embody
themes
encountered
by clinicians
stretch our
worldview &
allow us to
experience/
imagine the
unfamiliar
Reflective process #2:
POEM as a Tool
Fleeing Alzheimer’s
Authored by Sandra Miller

Read the story/poem from start to finish
twice : savour the experience
Read & Reflect
How to Approach a Story or Poem
①
Note feelings, thoughts and points of curiosity
②
Which character(s) stand(s) out for you?
What is the context/setting/worldview of the
story?
④ Add a Prompt:
Write about a time you forgot something?
③
Are these tools realistic in
Clinical Education/Practice?
Music
Media
Stories
Poetry
Art
Stimuli for reflective practice leading to
humanistic patient-centered care
4 Domains Supported by
Reflective Practice
Relationships
Behaviors
Provider-Society
Professionalism
ProviderColleagues
Listening
Provider-Self
Trust
Provider-Patient
Empathy
Narrative Rounds: Promoting
Humanism in Healthcare
Ephraim Rubenstein, MFA
 Tuesday, January 15th, 2013
 Art and Medicine
 Professor at Columbia University’s
Department of Narrative Medicine
Narrateur: Reflections on Healthcare
The Hofstra North Shore-LIJ School of
Medicine Literary Journal
 http://www.narrateur.org
 Open to all in the SOM and Health System
 Second submission due date
December 1, 2012, with March publication
