Exit rounds: a reflection exercise.

This paper questions the long-held assumption that "experience is the best teacher". Reflection, it is argued, is the element that turns experience into learning. Unfortunately, reflection is the experiential learning skill in which student are most deficient. Further, clinical teachers may not appreciate the reciprocal and synergistic relationship of experience and reflection, and therefore they may not exploit its full potential. This paper argues for the formal and explicit use of reflection to clinical teaching. In addition to providing a theoretical rationale for the use of reflection is learning, one example of a reflection exercise--exit rounds--is described. Exit rounds focus on recently discharged patients and provide students with an opportunity to reflect on what they have learned from working with these patients. In addition to being a learning exercise, exit rounds provide attending physicians with an opportunity to address emotional issues, to evaluate students' learning and performances, to deal with "housekeeping" details, and to provide closure.