Keeping Reflection Fresh by Peterkin Allan;Brett-MacLean Pamela; & Pamela Brett-MacLean

Author:Peterkin, Allan;Brett-MacLean, Pamela; & Pamela Brett-MacLean
Language: eng
Format: epub
Publisher: The Kent State University Press

Both time capsules were to be housed in the portfolio—a binder that was provided to each student by the faculty. The expectation was that students would open their “Secret Personal Message” one month before graduation. They were not required to discuss it in the context of the Physician Apprenticeship unless they wished to do so. The “Dear Me” letter, however, was to be reviewed in a one-on-one meeting, between the student and his or her Osler Fellow, three to four months into the clerkship. We know, based on privileged feedback from several Osler Fellows, that the “Dear Me” letters were reviewed occasionally, especially when students were struggling, and that they contributed to meaningful and supportive dialogues. We believe they have the potential to be of assistance by providing an entry for recognizing unmet needs, unrealized aspirations, and gaps between expectations and reality. (Additional research is required to substantiate this claim.)

In a subsequent year, the faculty attempted to reap additional benefits from the notion of time-activated reflections. Again it asked all students at the beginning of the clerkship year to compose a “Dear Me” letter. In this iteration, however, it instructed students to anonymize a copy of their letter and to deposit it in a cardboard box, similar to a ballot box, positioned at the front of the class. Confidentiality was guaranteed. This was conducted on the last day of the Introduction to Clerkship course. We have now embarked on this exercise annually for five years. Although we do not monitor who complies and who does not, the response rate has been consistently over 98 percent. None of the letters contain names, student numbers, or other markers that might result in identification. In a sense, the sealed box acts like a collective time capsule for an entire class.

We have analyzed the student reflections documented in the “Dear Me” letters collected in this manner and have found them useful. We have generally done so at the three-month mark into the clerkship year. In 2008, three main themes emerged. Most prominent were anxieties concerning clinical work (for example, making mistakes or wrong decisions and fear of unclear expectations or being left alone). The second was a perceived need to balance the professional and personal sides of life (being afraid of being submerged by medicine, not wanting to lose one’s personality, and preserving time for sleep and pleasures). Lastly, there were issues relating to performance assessments (constant evaluations, concerns about looking stupid, coping with competitive environments, and needing to impress tutors) and the impact of all these on career planning. All in all, despite the salience of anxieties, the tone of the letters was generally positive and the concluding remarks often optimistic. These letters revealed a cohort of students who were intent on trusting their basic personalities and secure in the notion that their core humanity would constitute an unfailing lifeline during clerkships. These findings were then shared with the Osler Fellows at one of their regular faculty development workshops. It was suggested that they might wish to explore some of these issues with the students in their apprenticeship groups.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.