Purpose
Reflection related to teaching in health professions literature is frequently described as student assignments or assessment of those assignments. Failing to consider contexts beyond the classroom or to account for ways educators use reflection on, in, and before various teaching situations limits our understanding of educators’ use of reflection. We sought to determine how faculty understand and engage in reflection related to teaching in classroom, clinical, small/large group, and one-on-one settings.

Methods
This focus group study uses a constructivist paradigm and an interpretative phenomenological approach to explore the lived experience of faculty in a midwestern medical school. Purposive sampling was used to invite basic and clinical science educators who teach various subjects in various settings. Twenty educators have participated in three focus groups with additional groups planned to reach thematic saturation. Groups met via Zoom for one hour and were facilitated using a semi-structured focus group guide. Transcripts were analyzed for categories and themes; field notes supplemented transcripts, especially with respect to non-verbal communication. This study was determined by the IRB to qualify as quality improvement.

Results
When defining reflection, faculty tended to focus on analyzing past events. Examples of their use of reflection, however, incorporated reflection on past events (ex: why did I feel anxious in that discussion?), reflection in action (ex: examining students’ expressions to evaluate their comprehension of material), and planful reflection (ex: how can I set the stage for this uncomfortable conversation or learning experience?). Faculty emphasized the role of personal comfort, both emotionally and with content, in their ability to use reflection in action while teaching.

Conclusions
This study contributes to existing health professions literature by identifying an array of examples of how faculty routinely use reflection in their work as educators. Their discussion highlights gaps in faculty awareness of some aspects of reflection, such as critical reflection.