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Reflective and Reflexive Practitioners

Although the coverage of this issue was illuminating, the Taking Issue editorial (1) makes reference to Schön's "reflexive practitioner," which I found confusing. Benner's "reflexive practitioner" (2) and Schön's "reflective practitioner" (3) are related concepts but are not exactly the same (4). The reflexive practitioner gains experience and, through active observation and reflection, is able to utilize "on-the-spot" experimentation to fulfill the role of "helping expert." This is to be contrasted with the "knee-jerk" reflex approach to health care, which, when dominant, contributes to a one-size-fits-no-one approach (5).

I believe that coexistence of these methodologies and broader awareness of them will be a critical factor in leveraging the enormous technological advances in modern health care so that all patients benefit from them.

Laurence P. Karper, M.D.

Dr. Karper is vice-chair in the Department of Psychiatry, Lehigh Valley Hospital, Bethlehem, Pennsylvania.

References

TOP References

 

1. Hopper K: Qualitative and quantitative research: two cultures. Psychiatric Services 59:711,2008[Free Full Text]
2. Benner P: From Novice to Expert. Menlo Park, Calif, Addison-Wesley, 1984
3. Schön DA: The Reflective Practitioner. London, Temple Smith, 1983
4. Rolf G: Beyond expertise: theory, practice and the reflexive practitioner. Journal of Clinical Nursing 6:93–97,1997[CrossRef][Medline]
5. McEvoy V: Identical care is not best for all patients. Boston Globe, July 14, 2008

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