7. Reflects on his/her reasoning process and strategizes to improve it (PLI). This scale is based on both the frequency of one aspect of the behavior and the acquisition of a new, second skill for the behavior. It is intended to focus on the student’s comments or reflections on his/her reasoning process and not comments on case content or the student’s medical knowledge.
Pre-Emergent	Emerging (1 point)	Acquiring (2 points)	Mastering (3 points)
Has not achieved the Emerging level.	Sometimes comments on strengths/weaknesses of his/her reasoning or approach to case.	Usually comments on strengths/weaknesses of his/her reasoning or approach to case. Sometimes outlines a specific strategy for improving his/her reasoning process and evaluates its effectiveness.	Almost always comments on strengths/weaknesses of his/her reasoning or approach to case. Often outlines a specific strategy for improving his/her reasoning process and evaluates its effectiveness.

CLERKSHIP LEVEL (for reference; not expected of pre-clerkship students): Routinely performs self-directed reflection on academic and clinical performance. Identifies strengths and weaknesses and develops strategy to improve performance. Implements strategy in future situations and reflects on effectiveness of this strategy.