Significant Event Reflection Exercise at the University of Minnesota Medical School

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During the third or fourth year of medical school, University of Minnesota medical students complete a four-week Family Medicine Clerkship. Initially the Clerkship was comprised of clinical experience with a community preceptor and weekly didactic sessions. Based on feedback from students, faculty developed a facilitated reflective exercise. Now called “Significant Event Reflection” (SER), all students on the Clerkship participate in a single facilitated two-hour small group experience. Prior to meeting, students are asked to reflect on and write about an experience that moved them.

The goal of the SER is to provide a safe environment for the student to examine the impact and meaning of a significant event with six to eight peers. After brief introductions, the facilitator discusses ground rules: confidentiality, mutual respect, “no fixing” and “speak only for yourself.” Each student tells or reads his/her story with discussion between. Students often volunteer how the event changed or affected them. Other students or the facilitator may comment or ask questions.

Between May 2010 and April 2011 faculty recorded the themes of the students’ experiences and calculated frequencies. Recurring themes included: death, fetal demise, values conflicts, system failures and others. Evaluations show that students find this to be a valuable experience and rate it at 4-5/5 on all measures.

Conclusions The SER is a valuable exercise to identify and potentially relieve distress for medical students. Faculty facilitators model the sharing of significant events with peers and how to provide non-judgmental feedback. This helps students move to a deeper understanding of events and to breakdown the isolation they often feel. This process models future professional development for the students. In addition, understanding the recurrent themes may offer insights in curricular gaps in the professional development of students that might be effectively and intentionally addressed in the future.


This paper was presented at the International Conference on Communication in Healthcare. Presentation, Chicago IL, October 2011.