At UCSF, we are newcomers to reflective practice and self constructed learning plans. Here's what we are doing so far:

1. We are having PGY-2s and PGY-3s evaluate themselves with the same form with which attendings evaluate resident performance. I am including their self assessment in their annual evaluation. It is interesting to see how a resident's self assessment compares to attending assessments. The residents generally evaluate themselves lower than their attendings. It is no surprise that the most difficult residents tend to do the opposite -- their self assessment is significantly higher than their attendings.

2. For pharmacotherapy clinic for PGY-3s: I am having them self assess at beginning, mid point and end point their skill in the areas that we have defined as essential and to identify areas for growth. I give them their prior responses at each subsequent point.

3. For rising PGY-4s: we began last year having them in January meet with an assigned advisor and with informal mentors to develop a learning plan for fourth year identifying how they want to grow in the areas of leadership, teaching, clinical, and expertise/focus. This then informed their construction of an actual rotation plan. I had them enter their individualized self constructed learning goals via the web. It went very well and I think introduced for the first time in a real way reflective practice as something that informs actual learning plans.
 
We are planning on incorporating these principles and practices throughout the program and are hoping that the portfolio software that our GME is purchasing will be helpful in this regard.