title: Learning to See Beneath the Surface: A Qualitative Analysis of Family Medicine Residents' Reflections About Communication.
abstract: Patients share straightforward statements with physicians such as describing their fears about their diagnosis. Physicians need to also understanding implicit, indirect, subtle communication cues that give broader context to patients' illness experiences. This project examines physicians' written reflections that offer insight into their interpretation of both the stated and the tacit aspects of their observations about communication, their resulting responses, and their intended actions. Tufts University Family Medicine residents (N = 33) of the Tufts Family Medicine Cambridge Health Alliance completed three reflective exercises each week over the course of 1 year (756 reflective entries). An interdisciplinary research team identified communication-related concepts within the reflections. Identified themes include (a) physicians recognizing and discovering mutual interplay of their communication with and patient disclosure, (b) physicians paying attention to subtleties of patient behavior as indicative of a fuller picture of patients' lives and their coping with illness, and (c) physician images of growth and awareness about communication indicative of their potential for growth and improvement. The project extends the literature in communication and medical education by examining explicit and tacit points of reflection about communication. The project (a) allows for unpacking the multifaceted aspects of reflection and (b) bridges reflective theory and medical education with communication foundations.
authors.affiliation: a Communication Department , Boston College , Chestnut Hill , Massachusetts , USA.
authors.forename: Ashley P
authors.initials: AP
authors.lastname: Duggan
authors.affiliation: b School of Theology and Ministry , Boston College , Chestnut Hill , Massachusetts , USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vicini
authors.affiliation: b School of Theology and Ministry , Boston College , Chestnut Hill , Massachusetts , USA.
authors.forename: Lucas
authors.initials: L
authors.lastname: Allen
authors.affiliation: c School of Medicine , Tufts University School of Medicine , Malden , Massachusetts , USA.|d Cambridge Health Alliance , Family Medicine , Malden , Massachusetts , USA.
authors.forename: Allen F
authors.initials: AF
authors.lastname: Shaughnessy
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D005194:Family Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D008404:Massachusetts; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012577:Schools, Medical