Arseneau R
Department of Medicine, University of British Columbia, Vancouver, Canada.
Acad Med. 1995 Aug;70(8):684-7. doi: 10.1097/00001888-199508000-00009.
This paper questions the long-held assumption that "experience is the best teacher". Reflection, it is argued, is the element that turns experience into learning. Unfortunately, reflection is the experiential learning skill in which student are most deficient. Further, clinical teachers may not appreciate the reciprocal and synergistic relationship of experience and reflection, and therefore they may not exploit its full potential. This paper argues for the formal and explicit use of reflection to clinical teaching. In addition to providing a theoretical rationale for the use of reflection is learning, one example of a reflection exercise--exit rounds--is described. Exit rounds focus on recently discharged patients and provide students with an opportunity to reflect on what they have learned from working with these patients. In addition to being a learning exercise, exit rounds provide attending physicians with an opportunity to address emotional issues, to evaluate students' learning and performances, to deal with "housekeeping" details, and to provide closure.
本文对“经验是最好的老师”这一长期以来的假设提出质疑。有人认为，反思是将经验转化为学习的要素。不幸的是，反思是学生最缺乏的经验学习技能。此外，临床教师可能没有认识到经验与反思之间相互促进、协同增效的关系，因此可能无法充分发挥其潜力。本文主张在临床教学中正式且明确地运用反思。除了为反思在学习中的应用提供理论依据外，还描述了一种反思练习的实例——出科小结。出科小结聚焦于近期出院的患者，为学生提供一个反思从与这些患者共事中学到了什么的机会。出科小结除了是一种学习练习外，还为主治医师提供了一个处理情感问题、评估学生学习情况和表现、处理“内务”细节以及画上句号的机会。
