Preceptors' use of reflection to teach in ambulatory settings: An exploratory study

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 less focused teaching. The authors sought to measure the level of reflection on teaching used by preceptors to plan teaching in these settings.

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.

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.

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.