Reflections
Reflective learning and practice have been integral in my medical training, as well as my development as a teacher. Reflection is more than deepening understanding through one’s experiences; it is also about achieving greater self-awareness, as well as developing successful self-monitoring practices that will allow the physician to continually learn in response to change or to reaching the limitations of one’s competency (Mann, 2011). While an educator can provide significant feedback to help support the learner’s goals and can help monitor learner progress, ultimately, self-monitoring is required for an adult learner to sustain his or her self-efficacy following formal training (Mann, 2011). Gaining this confidence in skilled and autonomous decision-making can then be utilized in providing leadership and collaboration to the health care team.
While I have reflected on my clinical competencies regularly, I am likely guilty of not following suit in the self-evaluation of my educational practice and abilities. Fortunately, it is not surprising that in constructing this portfolio, which exemplifies both my development and capabilities over the past decade, that I have been combining evidence with self-reflection throughout (Epstein, 2007, p. 392). Specifically, I have included narrative reflections in different sections of this portfolio to demonstrate this development as both an educator and a learner, with links below directing you to some of my more deliberate reflections.
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All in all, my decision to create e-portfolio has created a bit more stress, as a result of the considerably greater time and effort needed to design the portfolio, and to select and post evidence of my responsibilities, contributions, and assessments (Keller, 2013). However, in challenging myself to achieve a higher level of artefact collection and reflection, I have gained pride and confidence in my own teaching, and the hope is that the e-portfolio will serve the multiple purposes of growth, evaluation and assessment, and marketing and employment (Oakley et al., 2013).
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Reflections on Teaching and Student Learning
Within the Student, Resident, Faculty and Peer Evaluation of Teaching sections of my portfolio, I have included some reflections on what I have learned from these evaluations. Additionally, while summarizing my teaching responsibilities, I included a teaching log of my activities in undergraduate medical education as a means of self-reflection, whilst also mentioning my reflections on clinical teaching in the undergraduate and postgraduate medical education sections.
I do believe that adult learners generally want to be engaged in relevant and meaningful activities, especially those that match their preferred learning styles. I also believe that the philosophical and theoretical assumptions that teachers and learners make often lead to differing perceptions of shared experiences. As an educator, it is important to remember this, in order to temper unrealistic expectations of being able to please every learner simultaneously.
In the clinical setting, I am more likely to achieve my goals as an educator, where a humanistic and progressive philosophy serves learners well. I try to provide residents and medical students progressively increased responsibility and both clinically and personally relevant material, while making specific inquiries, interactions, and challenges arising from patient care into teachable moments. By taking the time to get to know my learners as individuals, and helping them formulate and achieve their own goals with my guidance, most have been appreciative of this approach and of this strategy. Most have also really appreciated my owned, direct and regular feedback on their progress, with specific suggestions and resources to help them improve.
Where this strategy is less successful, however, is when the learner only considers traditional teaching methods as constituting education, and ignores the value of experiential learning. I also still have days where I struggle with delegation and balancing multiple roles, usually when days are extremely busy, and consequently, I stay at work later to ensure education and clinical work has been achieved. While students do not complain, it can adversely affect my enthusiasm because my life outside of medicine suffers, including time spent with family and extracurricular interests. Solutions likely lie in better delegation, accepting less time on some days for specific teaching topics in the interest of time, and encouraging learners more to seek out the appropriate supporting information on their own, particularly when the questions are non-urgent and related to their assigned responsibilities. I have been a strong believer in working and bedside rounds as a way of efficiently and simultaneously addressing clinical care while providing direct supervision and feedback to learners, and am trying to find ways to make that happen for the gastroenterology service. Finally, while I am a strong believer in self-reflection, I do not encourage this enough in the learner, and so I should make a point of asking the learner what weaknesses they would like me to observe for and provide guidance on for the duration of our time on service together.
I have also talked a fair bit about the challenges of providing thorough but concise presentations, but think I will be better served going forwards with implementation of a flipped classroom design. It fits best with my desire to create engaging lectures challenging higher-order cognitive skills. The corollary, however, is that less classroom time is spent on basic concepts that I have a tendency to present too thoroughly. The challenge is ensuring that within 10-15 minute podcasts, I can deliver the necessary background information, and that I still use classroom time to explain or elaborate on more difficult concepts that may provide a better foundation for practical knowledge application. This ability to simplify or organize key concepts is a skill of mine upon external and self-reflection, and is thus something I should be bringing to classroom sessions as an educator.
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Reflections on Scholarship
In medicine, scholarship is often synonymous with publications in journals, and fortunately, medical education need not be limited to this. Having now had an opportunity to reflect on my scholarship in medical education, I have come to realize that it has taken several different forms outside of these traditional bounds of medicine. Thus, scholarship is actually an area that I can take pride in for having demonstrated great initiative in relative to my stage in training.
That being said, I feel that I am just beginning this educational scholarship. Through the Masters in Education program, I am just starting to realize the variety of educational products that can be created, and the need to define objectives as a basis for evaluation. While I never thought that I had the capabilities to create anything that could be perceived as technologically innovative, I am challenging this notion through my course work, and in particular, through my research project. As I continue to develop the skills and insights needed to become what I deem to be an effective educator through this program, the opportunities to use such skills are always within arm’s reach as I can employ them through my approach to teaching and learning in paediatric gastroenterology. I can only hope to continue this trajectory with a commitment to producing scholarly projects to enhance medical education, and to continue to meet and collaborate with other like-minded colleagues so I can push myself in new directions and to new goals.
References
Epstein, R. (2007). Assessment in medical education. New England Journal of Medicine, 356: 387-396.
Keller, C. (2013). E-Portfolios for reflective practice, advocacy, and professional growth. School Library Monthly, 29, 8-10.
Mann, K. V. (2011). Theoretical perspectives in medical education: past experiences and future possibilities. Medical Education, 45, 60-68.