Identify two or three ways that this experience has affected how you anticipate approaching pediatric care in your practice.
- – The ability to ask searching questions
- – The ability to answer searching questions and being aware of the frames of reference in use
- Reflective Outcome
- – The ability to draw conclusions
- – The ability to describe concrete learning goals and plans for future action
| <6.5 (Habitual, non- reflective) | 7.5 (Thoughtful action or introspection)
|
8.5 (Reflective)
|
10 (Critical reflection) | |
| Writing spectrum | Superficial descriptive writing approach (fact reporting, vague impressions) without reflection or introspection | Elaborated descriptive writing approach and impressions without reflection | Movement beyond reporting or descriptive writing to reflecting (i.e., attempting to understand, question, or analyze the event) | Exploration and critique of assumptions, values, beliefs, and/or biases, and the consequences of action (present and future) |
| Presence | Sense of writer being partially present | Sense of writer being partially present | Sense of writer being largely or fully present | Sense of writer being fully present |
| Description of conflict or disorienting dilemma | No description of the disorienting dilemma, conflict, challenge, or issue of concern | Absent or weak description of the disorienting dilemma, conflict, challenge, or issue of concern | Description of the disorienting dilemma, conflict, challenge, or issue of concern | Full description of the disorienting dilemma, conflict, challenge, or issue of concern that includes multiple perspectives, exploring alternative explanations, and challenging assumptions |
| Attending to emotions | Little or no recognition or attention to emotions | Recognition but no exploration or attention to emotions | Recognition, exploration, and attention to emotions | Recognition, exploration, attention to emotions, and gain of emotional insight |
| Analysis and meaning making | No analysis or meaning making | Little or unclear analysis or meaning making | Some analysis and meaning making | Comprehensive analysis and meaning making |
| Attention to assignment | Poorly addresses the assignment question and does not provide a compelling rationale for choosing an alternative | Partial or unclear addressing of assignment question; does not provide a compelling rationale for choosing an alternative | Clearly answers the assignment question or, if relevant, provides a compelling rationale for choosing an alternative | Clearly answers the assignment question or, if relevant provides a compelling rationale for choosing an alternative |
Wald et al. Fostering and Evaluating Reflective Capacity in Medical Education: Developing the REFLECT Rubric for Assessing Reflective Writing. Academic Medicine,2012. 87(1).
Requirements:
Reflections of practical exam lab:
- a) Relevant identifying information (age, gender, ethnicity, size, dress, etc.). Please do not include the child’s real name or any identifying features.
- b) What could you assess about the child through observation alone?
- c) What made the process difficult or easy; what are some strategies that you or others employed to facilitate the exam?
- d) Findings and interpretation – list five findings on physical exam in appropriate charting terms (ie. “heart rate 96bpm”, not “heart rate was normal”) and interpret them (eg. “normal for child of this age,” “consistent with patent foramen ovale”); ideally, these would be findings that were of interest to you, or relevant to any concerns of the patient/caregiver
Reflections of clinical observation:
- a) Presenting concerns, and relevant identifying information (age, gender, ethnicity, size, dress, etc.). Please do not include the child’s name or identifying features.
- b) What about the child’s or parent’s behaviour made the process difficult or easy? Comment on how the practitioner (tone of voice, spontaneity, distractions, etc.) and/or the set-up of the clinic space (furniture placement, distractions, noise, length of visit, presence/absence of toys, etc.) affected the dynamics of the visit.
- c) Management – please explain your rationale and reference, as appropriate:
- i) Summarize key pertinent questions that helped to clarify the case.
- ii) In what way were physical exams or labs/investigations helpful to the case?
- iii) Did you identify any red flags in the history, behaviour or physical exam?
- iv) Generate a problem list arising from the encounter – the patient’s/parent’s concerns as well as the concerns of the practitioner and yourself.
- v) What is your assessment of this case? Consider differential diagnoses, working diagnoses and clinical impression. Consider symptoms and causes.
- vi) Outline your treatment goals for this case, both short term and long term.
- vii) Design a specific, realistic and rationalized treatment plan for this case.
Consider the family unit in your planning. Feel free to include elements of the plan initiated by the practitioner, but these must also be defended. For example:
- – any further questions, physical exams, or lab investigations (including cost)
- – instructions for diet/lifestyle interventions
- – nutritional/herbal/homeopathic prescriptions including product, dosage, duration and cost for treatment
- – any physical treatment that you will do, or that you will instruct the patient or parent to do at home, including frequency
- – any coordination of care, including consultations or referrals
- – intended follow-up plan (timing and plan for next and subsequent visits)
- viii) Critically evaluate the practitioner’s management of this visit, including an application of naturopathic principles (whether or not the practitioner is an ND).
Reflections of Self (with respect to practical lab and observation component):
- a) What did you notice about your own comfort level?
- b) Identify two or three ways that this experience has affected how you anticipate approaching pediatric care in your practice.
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