title: "Where Does the Circle End?": Representation as a Critical Aspect of Reflection in Teaching Social and Behavioral Sciences in Medicine.
abstract: OBJECTIVE
  This paper describes a reflective learning program within a larger curriculum on behavioral and social science that makes use of close reading, written representation of experience, discussion, and textual response. This response may in turn lead to further reflection, representation, and response in a circular pattern. A unique feature of this program is that it pays attention to the representation itself as the pivotal activity within reflective learning. Using the narrative methods that are the hallmark of this program, faculty writings were analyzed to characterize the essential benefits that derive from these practices.
  
  
  METHODS
  In the context of a faculty development seminar on the teaching of behavioral and social sciences in medical curricula, a group of 15 faculty members wrote brief narratives of reflective learning experiences in which they had made use of the methods described above. Their responses were submitted to iterative close reading and discussion, and potential themes were identified.
  
  
  RESULTS
  Four themes emerged: writing as attention to self, writing as attention to other, writing as reader/writer contract, and writing as discovery. In each instance, writing provides a new or deepened perspective, and in each case, the dividends for the writer are amplified by the narrative skills of those who read, listen, and respond.
  
  
  CONCLUSIONS
  The narrative pedagogy described and modeled herein provides a potentially promising approach to teaching the social, cultural, behavioral, and interpersonal aspects of medical education and practice. Future research will deepen our understanding of the benefits and limitations of this pedagogy and expand our appreciation of its applications.
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA. mjd5@columbia.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Devlin
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Boyd F
authors.initials: BF
authors.lastname: Richards
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Hetty
authors.initials: H
authors.lastname: Cunningham
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Urmi
authors.initials: U
authors.lastname: Desai
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Owen
authors.initials: O
authors.lastname: Lewis
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mutnick
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Mary Anne J
authors.initials: MA
authors.lastname: Nidiry
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Prantik
authors.initials: P
authors.lastname: Saha
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Charon
mesh_terms: D000328:Adult; D001525:Behavioral Sciences / Q000193:education*; D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D005180:Faculty, Medical; D006801:Humans; D063545:Personal Narratives as Topic; D012942:Social Sciences / Q000193:education*
keywords: Behavioral sciences; Medical students; Teaching methods