Reflection in practice
In our more functional moments many of us in the course of our day will consider carefully our actions, weigh up the pros and cons of any particular management plan and come to a decision. When we prescribe an antibiotic for an ear infection or for cellulitis in a wound, when we inject a shoulder or an elbow, when we consider whether or not to prescribe a steroid, or an anti-viral, or both for a case of Bell’s palsy, we are thinking about the consequences for the patient, and sometimes for society as a whole.
Occasionally we might wonder about the latest relevant evidence for what we are doing but more often the moment, and the opportunity pass us by as we return to the fray. The literature of medical education is full of examples of how we can capture such learning moments: Problem Case Analysis, the Educational Prescription, etc. but the mature self-directed professional finds his own way. Making the time for this can be a challenge. Some incorporate it into their working day (e.g. Richard Eve who books an appointment with himself to consider the events of the morning) and many of us are encouraged to make a record by way of a ‘Reflective Diary’ or a ‘Portfolio Entry’. Our opportunity to reflect, however, often comes later (perhaps out of necessity).
‘…every man of learning is ultimately his own teacher…’ - Thomas Payne