Reflective practice

This thought came out of a recent exchange in a discussion group on rational use of medicines where we were discussing the role of publishing in academic life.
A friend, Dr Ranabir Pal wrote (I have quoted it)
“… Moreover, in our undergraduate/postgraduate teaching-learning programmes also we never educate and enthuse our students to enjoy publication as part of academic life. ”

I partly agree with this. I think one would not necessarily bracket publication with “academic” life but make it clear that publication is part of life. Record what you see. You can use a camcorder, a camera, pencil/paper/drawing boards, computer, the choice is yours. In the context of health professionals, there is a step beyond recording and that is “reflection”. The reflection should precede published research.

I think there is a need to sensitize students in the undergraduate levels to reflecting on their practice. An argument against reading research for undergraduate students is that, students need to know the background materials first, and then can frame questions to learn foreground stuff which happen to be in journals and advanced publications. Besides where is the time to read all the journal stuff because there is so much to cover in the textbooks and cram for examinations? Of course we have journal clubs, seminars and presentations, but there is a need to matured publications from those seminars and journal clubs as well.

I think if we want more publications out of our colleagues, we need to focus on reflective practice and respect questions. There is a case for inquiry guided learning in Medicine/medical Sciences at least in the context of India. An inquiry guided learning would contextualize problems to solve if nothing else and force some sort of reflective practice. I think we also need to emphasize that publications in the form of kernel ideas need not necessarily be only in the pages of journals but need to be pushed out for peer consumption and feedback in the form of any other media. The point and the principles need to remain the same: stick to evidence, write only what’s needed and no more, iteratively fit your data and the model or message. Whether it be a discussion group like this, or a more mature publication, these principles cannot be compromised.

The same message can even be packaged through different channels. One of the other ways to get published is to write letters to the editor, and op ed pages. There is a certain process of vetting and review even at that stage.

In his 1997 classic essay, “The Cathedral and the Bazaar”, Eric Raymond promoted the philosophy of “release early release often and listen to your customer”. This was then meant to apply for free software development and that model has worked very well since then. In the context of medical and health care related publishing, one may spin a similar mantra, “Write early, write often, and care for your readers”. For software it is their product to serve a specific purpose, for health professionals it’s our observations and ideas. Writing early in this situation would mean writing the messages as soon as the idea strikes and thinking about it, and writing often is about putting them any time there is an opportunity.


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