In my last blog post I argued that stories can be a springboard for individual reflection. As testament to the great champions of reflective learning, my experiences of practicing, teaching and learning medicine always seem to come back to module 1 of the SHCR: Change starts with me. It taught me to examine my motivations and challenge my assumptions before committing to the change. It isn’t easy and it certainly isn’t always comfortable.
In Change Starts with Me Helen Bevan told her story of life getting in the way of youthful aspirations, reminding us of the importance of finding and reigniting our inner fire. I cried as I listened to Helen’s story because I recognised, for the first time, so much of myself and my teenage desire to change the world one patient at time. A desire that had seeped away so slowly with each medical exam and long shift that I hadn’t even noticed. A fine example of the emotions elicited by storytelling precipitating a change in mindset.
Boud argues that we cannot truly transfer learning between contexts without reflection. The problem comes when we underestimate how complex and challenging reflection is. You have to access deeper levels of meaning than may be superficially evident, tapping into our beliefs, motivations, values and expectations. Sometimes it’s difficult to accept that the experiences don’t “fit” with our internal map of the world.
Gibbs acknowledges that feelings influence the way be translate our experiences into practice. A experience which evokes unpleasant emotions may lead to avoidance or the determination (just think of footballers in penalty shoot outs). Our different values, beliefs, motivations, experiences, societal expectations and cultural norms have made us unique and often gloriously irrational.
But Gibbs doesn’t ask us to really question what makes us tick. In trying to make sense of the world, we draw conclusions, refining them as more information is gathered (Schon, 1983). Unfortunately, humans aren’t always critical consumers of information. Atkins and Murphy (1993) designed a model of reflective learning that requires the learner to articulate an awareness of the situation and evaluate the relevance of knowledge and feelings. In other words, are your assumptions valid? Are they helping or hindering? It is within these cognitive or emotional “gaps” that we learn and grow.
Storytelling is like a short-cut to our feelings. Sometimes we cannot put our emotions into words, such is the power of the story. Sometimes it is preferable to acknowledge the emotion and address the logic later. This can take time – two years in my case. Inspired by Helen’s story, I pledged to reconnect with the optimism of my youth and revisited those early motivations with 20 years of life experience behind me. I realised that I wanted to be a teacher, which is where you find me now. Stories helped me get here and keep me inspired, not as passive entertainment or knowledge transfer but as an active part of my own life narrative.
Atkins, S. and Murphy, K. (1993) ‘Reflection: a review of the literature’, Journal of Advanced Nursing, vol. 18, pp. 1188–1192.
Schon, D. (1983) The reflective practitioner: How professionals think in action, London, TempleSmith.Schon, D. (1983) The reflective practitioner: How professionals think in action, London, TempleSmith.