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Preceptors' Use of Reflection to Teach in Ambulatory Settings: An Exploratory Study

Blase, Jo PhD; Hekelman, Francine P. PhD; Rowe, Marla MD

Academic Medicine:
Educating Physicians: Research Reports

Purpose: Reflection on one's teaching behavior is a means to question teaching events to bring teaching actions to a conscious level, to interpret the consequences of those actions, and to conceptualize alternative teaching actions. Ambulatory teaching settings are variable, unpredictable, and discontinuous, often resulting in lessfocused teaching. The authors sought to measure the level of reflection on teaching used by preceptors to plan teaching in these settings.

Method: Three preceptors who had participated in the Case Western Reserve University's peer-coaching program each answered four questions about how they planned to respond to two teaching case studies. The questions were posed by a medical educator who, for three of the four questions, also prompted the preceptors to stimulate their reflection. The audiotaped responses were assessed using Sparks-Langer and Colton's framework for reflective thinking.

Results: The levels of reflective thinking increased after prompting, but they did not exceed the rather low technical and practical levels, particularly for the more complex of the two cases.

Conclusion: This exploratory intervention suggests that faculty rely more on external and non-reflective levels of thought when planning to teach in the ambulatory setting. The authors recommend further research to foster discussions about the cognitive processes involved in planning for teaching in this setting.

Author Information

Dr. Blase is professor, Department of Educational Leadership, University of Georgia, Athens. Dr. Hekelman is associate professor, Department of Family Medicine, University Hospitals of Cleveland, Cleveland, Ohio. Dr. Rowe is a physician, Henry Ford Health Systems, Detroit, Michigan.

Correspondence and requests for reprints should be addressed to Dr. Hekelman, Department of Family Medicine, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4950.

The authors gratefully acknowledge the contributions of Ileen Harris, PhD, University of Minnesota; David Irby, PhD, USCF; Deborah Simpson, PhD, University of Wisconsin; LuAnn Wilkerson, PhD, UCLA College of Medicine, and Beth Bierer, MA, Metro Health Medical Center, Cleveland, Ohio.

© 2000 Association of American Medical Colleges