Encouraging Reflection and Change in Clinical Practice: Evolution of a Tool.

This article describes the systematic development and gradual transformation of a tool to guide participants in a continuing medical education program to reflect on their current practices and to make commitments to change. The continuous improvement of this tool was influenced by evolving needs of the program, reviews of relevant educational literature, feedback from periodic program surveys, interviews with group facilitators, and results from educational research studies. As an integral component of the educational process used in the Practice Based Small Group Learning Program, the current tool is designed to help family physicians think about what has been learned during each educational session and examine issues related to the implementation of evidence-based changes into their clinical practice. Lessons learned will be highlighted. Both the developmental processes employed and the practice reflection tool itself have applicability to other educational environments that focus on continuing professional development.