A transparent mechanism of Formative assessment (only) that documents and validates/restructures a medical-student's reflective practice (more here: http://pediatrics.aappublicati
ons.org/content/131/2/204) is a definitive starting point, beginning with day 1 of entry,
so that all students (future-practitioners) are accountable to their patients from day 1.
Given current information technology it is not difficult (or cost-cumbersome) to set up a mechanism for this using freely available online-tools. The modules of 'Attitude and communication' development are also subsumed in this approach.
Currently there is no exit for a student/practitioner till s/he retires or resigns from the profession. Hope to discuss more about it in this upcoming panel discussion here: https://meducon2016.com/
The above proposed approach would in effect regularly assess both students and teachers alike from the same online-platform and all our daily work (teaching-learning-patient-car
e) would be laid bare for public scrutiny. More like regularly playing for an audience in an accountable manner. Perhaps it will force all of us to play to survive (harsh) and not allow us to wallow in the luxury and security of work-related-anonymity and non-accountability?
There is no need for summative assessments in this this scheme of things although summative-success as a measure of achievement is built into the fabric of our society globally and this is what makes it all the more challenging (if not impossible) to digest?
Some resource links on reflective practice to build the right ATCOM (attitude and communication) in medical students and practitioners:
Here's something from Harry Potter and i re-quote, "Harry stared at the stone basin. The contents had returned to their original silvery white state, swirling and rippling beneath his gaze. “What is it?” Harry asked shakily.
“This? It is called pensieve,” said Dumbledore. "...One simply siphons the excess thoughts from one’s mind, pours them into the basin, and examines them at one’s leisure. It becomes easier to spot patterns and links, you understand, when they are in this form.” Rowling, The Goblet of Fire (2000, pp.518-519).
"Strategies to Promote Learning in Each Domain of Reflective Practice
|Sample Strategies for Reflection in Action||Sample Strategies for Reflection on Action|
|Doctor as a person|
Preceptor role modeling of self-awareness and vulnerability.
Priming learners to focus on emotions and nonverbal cues in patient interactions.
|Skill-building exercises focused on improving “mindfulness,” cultivating “engaged curiosity,” and improving observation of events such as perspective-taking and role-playing workshops.19||Reflections on critical incident reports, formative events, and multisource feedback.20|
|Role modeling of reflection|
|Doctor as an expert||Diagnostic “pauses,” with focus on justifying the differential diagnosis based on discriminating features of illnesses..." |
Quoted from: http://pediatrics.
The use of reflection in medical education: AMEE Guide no 44: http://www.medicalteacher.
org/medteach_wip/supp%20files/ Guide%2044/Sandars%20Appendix% 201%20Guide%2044%20Reflection. pdf