The Karnieli-Miller Communication and Professionalism Lab
Faculty of Medicine and Health Sciences,
Tel Aviv University, Israel
The Department of Medical Education
Professionalism and Reflective Practice
In recent years physicians' professionalism (the values, attitudes, and behaviors required of the physician, such as responsibility, respect, and continued learning) has increased in importance, to ensure that they are worthy of their patients' and society's trust. One process important within it is reflective practice (reflection).
Reflection is a metacognitive process meant to enhance one’s understanding of the self, the other, and the situation. Reflection focuses on improving self-awareness by encouraging learners to be constructively critical of their learning and their developing practice as professionals.
Through this metacognitive activity, learners are expected to become aware of what they know, what they don’t know, and the importance of things that they need to know. The reflective process is also an opportunity to enhance understanding of the other— a patient, a caregiver, or a colleague. Our lab studies the development of reflective ability in medicine as an essential competency for learning from experience and a foundation for career-long professional growth in medicine. This is done through various studies focused on the implications of exposure to unprofessional behavior in clinical practice, through identifying and discussing the hidden curriculum. Karnieli-Miller co-authored an international online module for coping with hidden curriculum in clinical practice.
In the field of reflective practice, she published various studies, including an article summarizing the importance of reflection at all stages of communication teaching, as well as an in-depth exploration, together with Dr. Rozental, of the way feedback is written for students' reflective journals. They identified five major components that were perceived as helpful and three as unhelpful. These enlighten educators in providing feedback that encourages students to read and learn.
To learn more about our studies:
Karnieli-Miller, O., Michael, K., Gothelf, A., Palombo, M. & Meitar, D. (2021). The association between reflective practice and communication skills. Patient Education and Counseling, 104, 92-98.
https://doi.org/10.1016/j.pec.2020.06.028
Rozental, L., Meitar, D., & Karnieli-Miller, O. (2021). Medical students'; experiences and needs from written reflective journal feedback. Medical Education, 55,505-517.
https://doi.org/10.1111/medu.14406
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Karnieli-Miller, O. (2020). Reflective practice in the teaching of communication skills. Patient Education and Counseling, 103(10), 2166-2172. (invited)
https://doi.org/10.1016/j.pec.2020.06.021
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Franco, R. S., Franco, C. A. G. S., Severo, M., Ferreira, M. A., Karnieli-Miller, O. (2022). Reflective writing in the teaching of communication skills for medical students—a systematic review. Patient Education and Counseling, 105(7), 1842-1851
https://doi.org/10.1016/j.pec.2022.01.003
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Franco, R. S., Franco, C. A. G. dos S., & Karnieli-Miller, O. (2021).
Deepening the teaching and learning of clinical communication: The importance of reflection and
feedback in health education. Scientia Medica, 31(1), e39795.
https://doi.org/10.15448/1980-6108.2021.1.39795
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Karnieli-Miller, O. (2022). Caring for the health and wellbeing of our learners in medicine as critical actions toward high quality care. Israel Journal of Health Policy Research. 11:10.
https://doi.org/10.1186/s13584-022-00517-w (invited)
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Monrouxe, L. V., Chandratilake, M., Chen J, Chhabra S., Zheng, L., Costa, P. S., Lee, Y. M., Karnieli-Miller, O., Nishigori, H., Ogden, K., Pawlikowska, T., Riquelme, A., Sethi, A., Soemantri, D., Wearn, A., Wolvaardt, L., Yusoff, M. S. B., & Yau, SY. (2022). Medical students’ and trainees’ country-by-gender profiles: Hofstede’s cultural dimensions across sixteen diverse countries. Frontiers in Medicine
https://www.frontiersin.org/articles/10.3389/fmed.2021.746288/full
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Frankel, R, M., Karnieli-Miller, O., Inui, T. (2018/20). Values at work: Comparing affirming and challenging narratives of nurses and physicians in a large health system. Communication & Medicine, 15(3), 268–281. https://doi.org/10.1558/cam.35227
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Karnieli-Miller O, Frankel RM, Inui TS. (2013). Cloak of compassion, or evidence of elitism? An empirical analysis of white coat ceremonies. Medical Education, 47(1):97-108.
https://doi.org/10.1111/j.1365-2923.2012.04324.x
Karnieli-Miller O, Vu R T, Frankel R M, Holtman M, Clyman S, Hui S L, Inui T.S. (2011). Which experiences in the hidden curriculum teach students about professionalism? Academic Medicine, 86(3), 369-377. DOI:10.1097/ACM.0b013e3182087d15
Karnieli-Miller, O., Taylor, A. C., Inui, T. S., Ivy, S. S., Frankel, R. M. (2011). Understanding values in a large health care organization through work-life narratives of high performing employees. Rambam Maimonides Medical Journal, 2(4), 1-14.
https://www.rmmj.org.il/issues/6/Articles/127
Karnieli-Miller O, Vu R.T. Holtman M C, Clyman S G, Inui T.S. (2010). Medical student's narratives and professionalism: a window on the informal and hidden curriculum. Academic Medicine, 85(1), 124-133.
DOI: 10.1097/ACM.0b013e3181c42896
Karnieli-Miller O, Taylor, A.C, Cottingham A. H, Inui T. S, Vu R.T, Frankel R.M. (2010). Exploring the meaning of respect in medical student education: an analysis of student narratives. Journal of General Internal Medicine, 25(12), 1309-1314.
https://link.springer.com/article/10.1007/s11606-010-1471-1