• Let the Training Begin: My Secret to Becoming a Better Physician

    Reflective practice has been a integral part of my professional life, I’ve used it to develop and maintain competence as a clinician and surgeon. In my personal life, reflective practice also provides the structure I need to become a successful amateur dressage competitor.

    What Reflective Practice Is

    Because reflective practice is used in many different disciplines, it has been interpreted in a variety of ways. The general consensus is that reflective practice is a process in which critical analysis of an event can lead an individual to greater self-awareness.

    Reflective Practice and Ophthalmology

    Reflective practice can be used in almost every aspect of professional development, but it’s particularly helpful in improving surgical outcomes at any stage of an ophthalmologist’s career.

    The following is an example of how I incorporate reflective practice in our cataract surgical curriculum. In the first part of the learning process, I coach the young physician to safely complete portions of the surgery or the entire procedure. Afterwards, the resident and I independently reflect on the case and assess it by answering the same set of questions:

    • What was good about the procedure?
    • What steps need improvement?
    • Are there any barriers to improvement?
    • Is there anything else you feel is important about the case?

    Dr. Wayman (pictured bottom center) and residents from the Vanderbilt Eye Institute.
    Dr. Wayman (pictured bottom center) and residents from the Vanderbilt Eye Institute.

    What Is the Plan for Improvement?

    In the third phase of the exercise, the resident and I meet to review our assessments and the video of the case. The fourth and final phase requires that the resident takes the information obtained and develops, with my guidance, a plan for improvement.

    Key Components of the Exercise

    • First, it is important that in the early years of training, the resident obtains input from an experienced educator (attending surgeon). The resident’s inexperience can lead to unreasonable expectations or the wrong improvement plan.
    • Second, it is critical that the resident recognizes the positive features of the case and avoids focusing solely on the areas of weakness, or those that need improvement.
    • Third, it’s important to find a process that works for both the learner and mentor.
    • Fourth, all parties should keep the process simple.
    • Fifth, residents should follow through and complete the action items on their improvement plan.

    A Key to Lifelong Growth

    Reflective practice is a valuable skill for any phase of one’s career and very important in the development of self-awareness. It helps acquire and retain new knowledge by encouraging active learning. It promotes self-motivation and identifies strengths and areas that need improvement. It stimulates change that can lead to better outcomes. And finally, the process of working with a coach encourages the exchange of ideas between surgeon and mentor, which, in turn, can lead to growth.

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    Laura L. Wayman, MDAbout the author: Laura L. Wayman, MD, is vice chair of education, director of resident education and associate professor of ophthalmology at the Vanderbilt Eye Institute, Vanderbilt University Medical Center. She is also the 2016 president of the Program Directors Council of the Association of University Professors of Ophthalmology.