Engaging intentionally in self-reflection can help lead to awareness of the values and attitudes one holds, as well as how they impact thinking and behavior. Given these effects, clinicians may nudge and influence consciously or nonconsciously the clinical decisions of parents. There is a well-constituted literature that highlights the influence of message framing on the medical decision-making process ( Wilkinson et al., 2014), including on intents to resuscitate in the neonatal context (e.g., the impact of framing options as survival with lack of disability rates versus framing as death and disability probabilities) ( Haward et al., 2008 ). Nonreflective engagement in neurologic prognosis has clear pitfalls. Individuals are typically not aware of the biasing effects of their values, as these are often the result of unconscious implicit processes. As outlined earlier in this chapter, there is significant evidence demonstrating that one's deeply held values and attitudes can influence perceptions of and responses to clinical situations and create biases in decision making.
The principle of (self-)reflection refers to an ability to look critically at oneself, especially one's attitudes and behaviors, through self-examination and discussion with others. Eric Racine, in Handbook of Clinical Neurology, 2019 Application of the practice principle of reflection They ask themselves, going forward, what should they stop doing (e.g., stop assuming I understand the assignment, when I actually have questions), keep doing (e.g., keep tracking my progress on an assignment calendar), and start doing (e.g., set a self-imposed deadline at least a day in advance of the actual deadline).ĭearbhail Bracken-Roche. In this process, students reflect on what worked and what didn’t as they progressed through the process of completing their assignment. This handout guides students on self-reflection, using the SKS process. Although it appears as the fourth step in the PROS process, over time and with practice students should treat self-reflection as a recursive process to inform their ongoing planning and decision-making (see Student Handout 4: Self-Reflection: Stop–Keep–Start, Appendix D). We recommend the stop–keep doing–start (SKS) process as a way not only to reflect, but to do so in a focused way.
Self-reflection allows for ongoing monitoring of the extent of learning and the relative effectiveness of particular strategies. Ramsay, in Unplugging the Classroom, 2017 4.5.4 Step 4: Self-reflect