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Reflection: A powerful health literacy skill

Some literacy scholars argue that reflection is so essential to making meaning from information and applying it in context that it should be classified as a basic literacy  skill, the fourth R: Reading, ‘Riting, ‘Rithmatic, and Reflection.  If we follow this line of thinking, reflection is a basic health literacy skill needed to personalize and act on health or medical information that has been processed and understood through reading or listening.  Reflecting on what I just heard or read, I ask myself, “What does this mean for me, in my circumstance, with my family and my resources? How can I use this information to cope, recover, or improve my health?”  Without this step, it is easy to understand information and then disregard it.

In the Beginnings Guides Life Skills Development Training,  we say reflection is a repeating process of Think, Link & Respond. Think about what is happening; Link to feelings and facts (information); and formulate a purposeful response.  So it is reflection that makes information useful in context; that translates information to action. 

Reflection is especially important and especially challenging in a clinical setting where real and perceived threats abound: illness, injury, unfamiliar people, language, machines; unexpected smells, sounds, emotions, roles and expectations. All these produce anxiety, which triggers our survival mechanism, stops thinking, and makes us react automatically – we can only fight, flee or freeze. In this state of mind, even good clear information cannot be useful.  Not reading or listening to information, being confused by it, or disregarding it are forms of fleeing and freezing.  To make good information effective for patients and caregivers, we need to facilitate their reflective process. 

More soon. Stay tuned. ss

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