Instructions and Template for Assignments on Sub-Domains
1. Write some basic statements regarding your assigned sub-domain. These statements do not need to be worded
as competency statements.
2. Define key terms in your statements
3. Provide references for your definitions
Please complete the following for each of your assigned sub-domains:
Sub-domain:
 “Habits of Mind”
Statements related to sub-domain:
Outcome Statements:
1. Demonstrate self-awareness through reflection of one’s culture and beliefs, conscious and unconscious
assumptions, needs, emotions, expectations, practice skills, and the impact of daily distractions and
exploration of how these factors affect one’s care of patients. (this could be considered a sub-domain of #2;
but, many articles focus on developing both “self-awareness” and “mindfulness”)
2. Perform self-monitoring that promotes mindfulness and a mindful practice.
3. Demonstrate a willingness to acknowledge and correct errors.
4. ??Do we need an outcome about “critical curiosity??”
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Definition of “Habits of Mind”:
1. Those dispositions that are skillfully and mindfully employed, by characteristically successful
people, when confronted with problems, the solutions to which are not immediately apparent.1
2. A disposition toward behaving intelligently when confronted with problems, the answers to which
are not immediately known.2
Habits of Mind identified as relevant to medical education (these were supported by the 2011-12 Argus
Commission):
o a) Observations of one’s own thinking, emotions, and techniques, b) attentiveness, social curiosity,
c) cognition of and response to cognitive and emotional biases, d) willingness to acknowledge and
correct errors.3
o Specifically, a practitioner needs to be “attentive, curious, self-aware, and willing to recognize
and correct errors. (from Epstein and Hundert, 2002 and Epstein, 1999)4
Habits of Mind that are emphasized in K-12 Education (should we consider some of these pre-requisite;
assume they are also developed in pre-pharmacy as discussed by the 2011-12 Argus commission? )
o Persisting
o Managing Impulsivity
o Listening to others – with understanding and empathy
o Thinking flexibly*
o Thinking about our thinking (metacognition)*
o Striving for accuracy and precision*
o Questioning and posing problems*
o Applying past knowledge to new situations*
o Thinking and communicating with clarity and precision
o Gathering data through all senses
o Creating, imagining and innovating
o Responding with wonderment and awe
o Taking responsible risks
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o
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Finding humor
Thinking interdependently
Learning continuously*
* These areas align with recommendations of Epstein and Hundert (2002) and therefore, should
continue to be developed during professional education
Cecilia - - let me know your thoughts.. I think the following items except internal motivation are covered in other
domains.
 Reflective education
o Pharmacy education should encompass reflective learning to promote awareness of a person’s self,
knowledge, and work output.
 Reflective education could help inform student’s when there are deficits in knowledge.
Through self-awareness, students should then be self-motivated enough to choose an
alternative learning strategy to improve this gap in knowledge.
 Self-directed learner
o Self awareness leads to a self-directed learning style, which is promoted in many pharmacy schools
and the primary means of finding solutions for patients who present with problems is to look up
information on one’s own volition in order to garner an answer to a given problem.
 Internal Motivation
o Being motivated internally will promote the desire to learn educational content more fully and
promote the will to seek out information that is not achieved. Internal curiosity and inquisitiveness
are associated with internal motivation and help with the development of learning study
techniques that are self-directed and effective.
 Professional Identity
o Professional socialization into the pharmacy profession can support the formation of respect for the
pharmacy career, and it can enhance the initiative to become a more fully-informed individual in
regards to pharmacy knowledge and curriculum. Professional identity may garner a student to feel
responsibility for being attentive, present, and aware during lectures in order to maintain
professionalism and encourage motivation for self-directed study skills.
Key terms and definitions:
Habits of Mind: Those dispositions that are skillfully and mindfully employed, by characteristically successful
people, when confronted with problems, the solutions to which are not immediately apparent (reference 1)
Mindful Practice: Qualities that are seen in exemplary clinicians and include clinical specialty and clinical
experience. Mindful practice includes – attentive observation, critical curiosity, a beginner’s mind (informed
flexibility) and presence.
Mindfulness: The ability to pay attention to experiences without having to react to them; the ability to notice and
observe sensations, thoughts and feelings that may be unpleasant; acting with awareness and intention (ie, not
being on automatic pilot); and paying attention to emotions. Mindfulness includes the following qualities:
attentiveness, interest in the clinical problem, clinical judgment, compassion, and presence. Mindfulness is
characterized by four habits that can be taught: 1) attentive observation of oneself, the patient, and the problem, 2)
critical curiosity, 3) a beginner’s mind (the ability to see a situation freshly), and 4) presence (undistracted
attention on the task and the person, and compassion based on insight rather than sympathy).
Curiosity: The urge to investigate, to seek after knowledge, to gratify the mind with new information or objects of
interest.5,6
Self-Monitoring: The ability to attend moment to moment, to our own actions; curiosity to examine the effects of
those actions; and willingness to use those observations to improve behavior and patterns of thinking in the
future.7
Motivation: Internal emotional, cognitive, or social force that activates and directs behaviors. Specifically,
motivation to achieve educational goals and conduct self-directed learning.
Self-awareness: the process whereby the practitioner self-calibrates to produce the desired effect (eg, effective
communications, prevent errors, accurate dosing recommendations, accurate identification of medication-related
problems. Self-awareness requires both cognitive and emotional processes.8
Cecilia – I think these fit into other domains
 Reflective education – thoughtful deliberation on one’s own experiences with emphasis on how a person can be
better through action.
 Self-directed education – personal initiative to learn and self-identification of study skills needed to achieve an
educational outcome.
 Professional Socialization – process of inculcating a profession’s attitudes, values, and behaviors in a
professional with the goal of developing professionalism.
o From AACP/ APhA White Paper on Pharmacy Student Professionalism
Abstracts of Relevant Articles:
 Speedie MK, Baldwin JN, Carter RA, Raehl CL, Yanchick VA, Maine LL. Cultivating 'habits of mind' in the
scholarly pharmacy clinician: report of the 2011-12 Argus Commission. Am J Pharm Educ [Internet]. 2012
Aug 10 [cited 2012 Nov 12];76(6):S3. doi: 10.5688/ajpe766S3. Available from:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3425935/
o Summary:
 This was an Argus Commission report with recommendations for strategies to improve
pharmacy education. The Commission wants to ensure that future pharmacists and
colleagues across the spectrum of the health professions are inquisitive learners and
problem solvers comfortable in applying both the scientific method and evidence-based
content to the identification and resolution of clinical issues/problems at the individual
patient and population levels. This begins far down the pipeline in pre-collegiate education
and continues throughout the period of pre-professional and professional education with an
ultimate goal of creating a scientific thinker with the requisite abilities to apply that
knowledge in practice
 The Argus Commission believes that the integrated curriculum encourages students to
make linkages between pieces of information from various disciplines and encourages
learning of content as it is needed. It is one factor in creating an inquisitive and scholarly
thinking pharmacist. Secondly, we believe it is essential that students be immersed in a
culture of scholarship as exemplified by faculty engaging in scholarly activity and delivering
evidence-based education.
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Dyche L, Epstein RM. Curiosity and medical education. Med Educ. 2011 Jul [cited 2012 Nov 12];45(7):6638. Available from:
http://web.ebscohost.com.ezproxy2.library.umc.edu/ehost/pdfviewer/pdfviewer?sid=1a75f3b7-7dea4ea6-9117-97d592ac200c%40sessionmgr4&vid=2&hid=12
o Summary:
 It is thought to be true for medical doctors that curiosity is fundamental to understanding
each patient’s unique experience of illness, building respectful relationships with patients,
deepening self-awareness, supporting clinical reasoning, avoiding premature closure and
encouraging lifelong learning.
 This study is aimed at identifying common barriers to and facilitators of curiosity and
related habits of mind in the education of doctors by conducting a theory-driven conceptual
exploration and qualitative review of the literature.
 RESULTS : Curiosity is related to inquisitiveness, reflection and mindfulness. Instructional
practices can suppress curiosity by confusing haste with efficiency, neglecting negative
emotions, promoting overconfidence and using teaching approaches that encourage passive

learning. Curiosity tends to flourish in educational environments that promote the student’s
responsibility for his or her own learning, multiple perspectives and mindful reflection on
both the subject and the learning process. Specific educational strategies that can support
curiosity in classroom and clinical settings include the mindful pacing of teaching, modeling
effective management of emotions, confronting uncertainty and overconfidence, using
inquiry-based learning, helping students see familiar situations as novel, simultaneously
considering multiple perspectives, and maximizing the value of small-group discussions.
Instructor attributes that contribute to the development of student curiosity include
patience, a habit of inquiry, emotional candor, intellectual humility, transparency and
recognition of the benefits to be gained in learning from peers.
CONCLUSIONS Curiosity, inquisitiveness and related habits of mind can be supported in
medical education through specific, evidence-based instructional approaches. Medical
educators should balance the teaching of facts, techniques and protocols with approaches
that help students cultivate and sustain curiosity and wonder in the context-rich, often
ambiguous world of clinical medicine.
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Deyo ZM, Huynh D, Rochester C, Sturpe DA, Kiser K. Readiness for self-directed learning and academic
performance in an abilities laboratory course. Am J Pharm Educ[Internet]. 2011 Mar 10 [cited 2012 Nov
12];75(2):25. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073099/pdf/ajpe25.pdf
o Summary:
 The Self-directed Learning Readiness Scale (SDLRS) was administered to first-year (P1)
doctor of pharmacy (PharmD) candidates at the University of Maryland. It was used to
assess the relationship between readiness for self-directed learning, academic performance
on self-directed learning activities, and resources used to prepare for an abilities laboratory
course.
 The Fisher SDLRS is valid for predicting an association between readiness for self-directed
learning and self-directed learning habits, but the tool may not be useful for predicting the
association between readiness and academic performance. Whether the lack of association
is due to our course methodology, the tool itself, or both is unknown. The study
demonstrates that pharmacy students are capable of self-learning foundational knowledge
regardless of their level of readiness for self-directed learning when given specific
instructions on what material to learn. Whether high readiness for self-directed learning is
necessary for more complex learning or for self-identification of learning needs is unknown;
however, self-directed learning activities likely can be integrated into courses, curriculum,
and self-directed adult education activities without all learners having a high readiness for
self-directed learning.
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Smith L, Krass I, Sainsbury E, Rose G. Pharmacy students' approaches to learning in undergraduate and
graduate entry programs. Am J Pharm Educ [Internet]. 2010 Aug 10 [cited 2012 Nov 12];74(6):106.
Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933015/pdf/ajpe106.pdf
o Summary:
 Comparison of longitudinal data with previous cross-sectional data regarding Australian
undergraduate pharmacy students' approaches to learning, and explore the differences in
approaches to learning between undergraduate and postgraduate cohorts. In this survey
analysis, undergraduate students' preferences for meaning-directed, undirected, and
reproduction-directed approaches to learning displayed the same pattern across the 2
studies; however, application-directed scores increased significantly in the second half of
the undergraduate degree program. Commencing postgraduate students' approaches to
learning were similar to finishing undergraduate students, and this group was significantly
more oriented towards meaning-directed learning compared to undergraduate students.
 CONCLUSIONS: Pharmacy students' maturation in approach to their learning was evident
and this bodes well for pharmacists' engaging in life-long learning and capacity to work in
increasingly complex health settings
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Bouldin AS, Holmes ER, Fortenberry ML."Blogging" about course concepts: using technology for reflective
journaling in a communications class. Am J Pharm Educ [Internet]. 2006 Aug 15 [cited 2012 Nov
12];70(4):84. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1636988/pdf/ajpe84.pdf
o Summary:
 Web log technology was applied to a reflective journaling exercise in a communication
course during the second-professional year at the University of Mississippi School of
Pharmacy, to encourage students to reflect on course concepts and apply them to the
environment outside the classroom, and to assess their communication performance. The
assignment contributed to student learning and increased awareness level for
approximately 40% of the class. Students had few complaints about the logistics of the
assignment. Specific attitudinal objectives included increasing empathy and sensitivity in
interactions; blog entries made it evident that such development was effected for some
students. The Web log technology was a useful tool for reflective journaling in this
communications course. Future versions of the assignment will benefit from student
feedback from this initial experience
References:
1
Habits of Mind Organization. Defining Habits of Mind – a Closer Look. http://www.habitsofmind.org/content/defining-habits-mindclose-look
2
Costa AL, Kallick B. Describing 16 Habits of Mind. Source: www.instituteforhabitsofmind.com/resources/pdf/16HOM.pdf
Accessed: October 15, 2012.
3
Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA 2002;287:226-235.
4
Epstein RM. Mindful practice. JAMA. 1999;282:833-839.
5
Websters Seventh International Dictionary. Springfield, MA: G&C Merriam Publishers 1998.
6
Dyche L, Epstein RM. Curiosity and medical education. Medical Education 2011: 45:663-668.
7
Epstein, RM, Siegel DJ, Silberman J. Self-monitoring in clinical practice: A challenge for medical educators. Journal of Continuing
Education in the Health Professions; 2008;28:5-13.
8
Borrel-Carrio F., Epstein RM. Preventing errors in clinical practice: A call for self-awareness. Ann Fam med. 2004;2:310-16.