Reflection in clinical teaching: an analysis of reflection-on-action and its implications for staffing residents

In order to improve clinical teaching in the ambulatory care setting, clinical teachers need to know the range of instructional strategies available to them. One potentially useful strategy is that of reflection. In this paper, reflective practice will be described in the context of the professional training of physicians, with the purpose of improving clinical teaching. An example of reflective practice--a transcript of a video tape of an attending physician and a resident in a general internal medicine clinic--will be analyzed. In this transcript, reflective comments by both the attending physician and resident are integrated into the original dialogue.