NHCPR First to Introduce the Reflective Practice Program to its Providers

Photo By Marcus Henry | It's a peaceful moment as the sun rises on the Patuxent River. This is the view from Capt. Karin Warner, Naval Health Clinic Patuxent River's Executive Officer's quarters during the Reflective Practice morning sessions for NHCPR's providers.  

PATUXENT RIVER, MD, UNITED STATES

04.19.2018

Story by Marcus Henry 

Naval Health Clinic Patuxent River, Maryland

PATUXENT RIVER, Maryland (NAS) – The setting is the living room of the Executive Officers quarters, a small 1970s era house sitting on the water at Patuxent River Naval Air Station – with a clear view of the bright morning sun rising on the water. A peaceful and tranquil setting perfect for this small group of nine of the clinics providers including doctors, nurse practitioners and physicians assistants to begin their first Reflective Practice session.

After a few minutes of socializing, the group is asked to silence their mobile devices, take their seats and are reminded of the reason they are there. “For the next hour and a half, we are creating a safe space for self-reflection and sharing,” begins Naval Health Clinic Patuxent River’s Executive Officer, Capt. Karin Warner. She invites the practitioners to participate in a guided centering exercise. After a five minute mindfulness session, the providers open their eyes, appearing focused and relaxed. The dialogue then begins with thoughts about today’s topic. “Mistakes.”

So what is “Reflective Practice?” Reflective Practice (www.reflectivepractice.net) is a learned skill that facilitates exploration of our personal context to identify our assumptions, biases, and perhaps most importantly, the way we think. It helps us understand the lens through which we individually view the world. The goal of the program is to help providers develop the skill of self-reflection to improve the quality of care they deliver to their patients. Providers are taught to identify, recognize, and consider their reactions, and think about how their reactions can impact the care they provide to their patients as well as the interactions they have with each other, the health care team, and family or friends.

The Reflective Practice program was introduced to NHCPR Warner, who is also an adjunct assistant professor at the Uniform Services University, Graduate School of Nursing. “One of the tenants of a highly reliable organization (HRO) is that people that work in HRO’s are mindful of the work they do, mindful of their reactions in any situation, and have the capacity to honestly reflect on those reactions and talk about them. It is a skill we have to practice and work on – and it is actually very healing and helpful for individuals – and has already shown impressive results with our staff that have participated here at Pax River. When I started this last fall of 2017, I thought we would do it quarterly, but it was so well received the medical staff asked that we add it to our training calendar for the providers every month, and we have done so. We have more attending each time, such that I have trained more facilitators in the med staff so we can break into smaller groups and keep the original intent of the program. It is a beautiful thing,” said Warner. NHCPR is the first non-academic Navy Medical facility in the U.S. to implement Reflective Practice as part of its provider training.

Warner was introduced to the program while teaching at USU, where Cmdr. Adam Saperstein, a family medicine doctor, was teaching the program. Saperstein’s words still resonate with Warner. "Personal Context is the interwoven fabric of one’s unique and diverse life experiences, and that shapes the lens through which we see the world. If I can really understand that, to begin with, it really opens up the conversation and increases my ability to engage effectively with others,” said Saperstein. Warner, who saw the value in providers dealing with their own personal view of the world decided it would be a useful tool for NHCPR. She worked closely with Saperstein to ensure what was started at NHCPR replicated the intent and structure of the courses taught at USU.

During a Reflective Practice session, providers discuss topics such as racism, ageism, obesity, and death in a way that helps them understand that often the lens through which they see the world, is shaped by their experiences over a lifetime. This perspective can be very different from their colleagues and patients. If our providers acknowledge that and bring it to their consciousness, they have a chance of helping themselves get back to center and stay focused on the care of the individual patient.

"Not only is Reflective Practice kind of cathartic for the providers, but it also allows us to learn from other peers that we may not otherwise have a chance to interact with on a daily basis," said Lt. Cmdr. Vincent Ackerman, the Medical Executive Committee chair. "Having the opportunity to share our experiences helps not only to replenish us but also allows us to learn from other providers. Participating in the program helps us avoid burnout, which is a major concern in primary care," Ackerman added.

Reflective Practice here at NHCPR has played an essential role in helping our providers gain insight as to how they react in certain situations. The NHCPR philosophy is that integrity is the foundation of our conduct; respect for others is fundamental to our character. If our providers understand how they think and the sources of their way of thinking, it allows them to be more mindful of the way they communicate with others and make decisions.

There is a definite link between the health and well-being of our medical providers and the mission and vision of our clinic. "Knowing that there are others that are going through the same experiences, gives us a sense of support. Overwhelmingly, the response to the program has been very positive." Ackerman said

Currently, the NHCPR Reflective Practice program is available for the providers in Medical Homeport and Military Medicine. However, we are opening the program to other departments soon. Doing so bridges professions and allows for providers from different backgrounds to share their experiences. The act of listening to others share gives the listener a chance to learn and understand that they are not alone.

• Date Taken: 04.19.2018
• Date Posted: 04.19.2018 18:45
• Story ID: 273772
• Location: PATUXENT RIVER, MD, US