Clinical Review

“Double loop” learning

BMJ 2004; 329 doi: (Published 26 August 2004) Cite this as: BMJ 2004;329:502
  1. Ed Peile, professor of medical education (
  1. 1 Division of Medical Education, Warwick Medical School, University of Warwick, Coventry CV4 7AL

    As well as sympathising with the patient, many respondents to this case commentary found themselves engaging in the difficulties faced by the general practitioner.1 Donald Schon, in Educating the Reflective Practitioner, described a “swampy lowland” wherein lie the problems of greatest human concern and where “messy, confusing problems defy technical solution.”2 Schon contrasts beautifully the technical and rational approaches of the theoretical high ground with the reflective approaches we often need in professional practice.

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