Reflection is the mechanism by which we contemplate and try to understand relatively complex and sometimes troubling ideas for which there is no obvious solution. Reflection allows us to transform current ideas and experiences into new knowledge and action. Personal experiences and organizational feedback can trigger reflection, whereas a lack of time, available colleagues, and social networks detract from the ability professionals have to reflect. Educational programs can encourage reflection through the judicious use of case-based discussion, formal and informal needs assessments, and commitment to change exercises. Learning journals and personal learning projects are self-directed methods that facilitate reflection. In the workplace, critical incident techniques and debriefing of cases provide opportunities for thoughtful inquiry. Additional study is needed to understand how and why reflection works to transform surface learning into deep learning and change in practice; how reflection enhances the integration of reading, collegial interchange, and classroom discussion into practice; and how technology can enhance reflection.
A study was undertaken to determine the feasibility of using a computer program to mark examinee write-in responses. It compared the performance of a computer against that of physician markers. A new examination designed to assess clinical decision-making was administered to eighteen residents. The write-in responses on twenty-three questions were marked both by physicians and a microcomputer. The study found the computer to be more consistent in marking, equally as cost effective, and as valid as physician markers. Since the computer provided question statistics (i.e., means, frequencies of examinees' responses) it was evaluated to be better and more helpful than physician markers by providing data useful for improving examination questions and learning experiences.Use of human markers to mark examinee responses on write-in (WI) questions has many disadvantages. It is time-consuming, unrewarding labor that is shunned by many educators and evaluators. It provides little, if any, summary data for question improvement. It is prone to errors, adding to the unreliability of examinee scores.In September of 1986, the Medical Council of Canada (MCC) approved a five-year research and development project aimed at developing a new examination booklet for the MCC Qualifying Examination. The Qualifying 'This project was commissioned and supported by the Medical Council of Canada (Ian Bowmer, Director; George Bordage and Gordon Page, Principal Investigators). The contributions of the 0 4 Test Committee in producing the testing materials for this project are gratefully acknowledged. 79 0 1993, Baywood Publishing Co., Inc.
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