experimental mentoring program conducted in a major medical school in the
Northeast of the United States. In it, primary care physicians mentored medical
students in the course of conducting their daily practices. All involved were trained
in a special reflecting process that led them to focus on, and to discuss, concrete
events occurring during the day. We illustrate how, both in pairs and in larger
meetings, in discussing events within their practice together that they were 'struck
by', student-mentees not only came to a more practical grasp of the medical
knowledge of the classroom and textbook, but that all involved in the program
came to create between them a resourceful community. At work within this
program was a practice that functioned, not only to help the students, but the
whole ongoing practice: for within it, besides moments of teaching, where other
kinds of shared moments to do with the details of clinical practice, ethical issues,
administrative problems, and so on - with all involved helping each other with
what we have called, the appreciative evaluation and elaboration of their practices.

In the article above (Shotter and Katz, this issue), we have been concerned with those
kind of circumstances in which a group of people involved in the conduct and discussion
of a practice together, respond to each other's different activities within it, not in terms of
any pre-established meanings, and especially not in terms of a set of disciplinary of
professional meanings, but in terms of how they are each 'struck by' certain fleeting
moments from within the ongoing conduct of the practice. And furthermore, we have
been interested in how these moments 'gesture toward', 'express', or 'manifest'

something special within their shared lives together, and with how they suggest new
possible connections and relations between aspects of those shared lives previously
unnoticed. One of the most unusual features of such dialogical circumstances as these,
however, is that initially, the new relational-responsive meanings to which they give rise,
instead of occurring in people's heads, are 'out there' in the 'space' of activities occurring
between them. So, while such meanings may be codified by the group and internalized
later by individuals, it is within the ongoing activities of the group that they first come
into existence and have their currency. But once 'out there' in the 'space' between group
members, they can function as a resource of already established 'topics' or
'commonplaces' that those engaged 'in' the conversation can all draw upon and refer to in
what they say or do - even though they may be far from having any fully explicit
articulation or representation.

Below, then, we want to present some such moments that occurred in two video-taped
conversations, between primary care physician-mentors and their medical student
mentees, that we were a part of an experimental mentoring program designed and co-
directed by one of us (AMK)(1) in a major medical school in the Northeast of the United
States. But first, let us mention some of the details of the program, some of the
'instruments' and 'methods' used: Each time the mentors met their mentees, they were
asked to enter into a dialogue with them: 1) To first ask them, what do you want to focus
on today? 2) Next, to conduct the doing of it. And then 3) to have the student reflect with
their mentor on what had happened during the day. In this way, over time, what can be
called a reflecting practice emerged within the ongoing primary care practice. Or, in other
words, a way of doing mentoring emerged that was dialogical, iterative or elaborative,
and formative. It was iterative or elaborative in the sense that, as each new 'topic' of
discussion was created between them in the dialogue, it was added to those already
existing in the 'space' between them, thus to enrich it. And it was formative in the sense
that, in articulating the noticed features of their practice together, it rendering these
features visible, as it were, so that they could be explicitly made use of and referred to in
both their subsequent mentoring and in their clinical activities. Further 'tools' were used
throughout the year in the institution of the reflecting practice: Each time the mentors
gathered, they were asked to write of moments in the mentoring process that had struck
them, e.g., teachable moments, clinical moments, researchable moments, along with a
plan for how they might make use of such moments in practice - as mentors with their
mentees, or, as one of the mentors put it, with their mentee as "a dialog partner." Given
these 'tools', over time, the reflections encouraged at the different phases of the

program, became a general part of how to 'go on' for everyone involved in the program:
choose what to focus on, do it, and reflect upon what 'struck' you in it. In such a way, a
practice began to be was articulated from within the practice which led to the original
practice becoming self-elaborating, self-modifying, and also, as we shall see in turning to
events occurring within the larger gatherings, self-appraising and appreciative.

Before saying anything about these conversational gatherings in detail, overall we must
comment on the degree of engagement exhibited by all those involved in them. Not only
did they both overrun their allotted time, but, as is apparent from the video-tapes,
everyone displays an intense engagement in the conversation. Furthermore, all the
comments made were all listened to with rapt attention, and received as making sense
and as valued comments. Also, rather than critical comments of a negative kind, the
comments were all appreciative, in the sense of offering what they thought would be
useful to each other in 'going on' in practice, in the overall program. We must mention
too, the fact of our own rapt involvement - AMK's deep involvement in overseeing the
whole program, and JS's involvement in viewing the video-tapes. Like the other
participants, we also worked in terms of picking out things we were 'struck by'. In the
first of these gatherings, the participants(2), both mentors and mentees were asked to
discuss what they felt that they had got from the program; whilst in the second gathering
(a year later), after having watched a selected portion of the video-tape of the first
meeting, they were asked specifically for what they had been 'struck by' in their
experience of the program. We will begin with a quote from a student in the first group:

".. And we walked in and it was a boy who had run into a fence and cut his chin
and the gland was all swollen. And my mentor looked and he said, 'What is the
lymph node drainage superficial left side? And I answered. And he said, 'Where is
the swelling going to be if it's infected?' And all of a sudden, ...all of the hours you
put in and all of the associated facts that are supposed to be attached, all of a
sudden... it's a person, so it really matters; it means something. And you finally
understood why you're doing this, why it matters. And why it's important to know
these things. And it's an eye opener just as much as anything we do in medical
school in the traditional curriculum is an eye opener."

The comment illustrates how the 'relational landscape' upon which students can 'place'
their technical knowledge and orient themselves toward its application in patient's lives, is
beginning to open up for them. And the student is expressing some profound awareness