Abstract
BackgroundSelf-reflection and reflective practice are increasingly considered as essential attributes of competent professionals functioning in complex and ever-changing healthcare systems of the 21st century. The aim of this study was to determine the extent of students' awareness and understanding of the reflective process and the meaning of 'self-reflection' within the contextual framework of their learning environment in the first-year of their medical/dental education. We endorse that the introduction of such explicit educational tasks at this early stage enhances and promotes students' awareness, understanding, and proficiency of this skill in their continuing life-long health professional learning.MethodsOver two years, students registered in first-year pathology at the University of Saskatchewan were introduced to a self-reflection assignment which comprised in the submission of a one-page reflective document to a template of reflective questions provided in the given context of their learning environment. This was a mandatory but ungraded component at the midterm and final examinations. These documents were individually analyzed and thematically categorized to a "5 levels-of-reflection-awareness" scale using a specially-designed rubric based on the accepted major theories of reflection that included students' identification of: 1) personal abilities, 2) personal learning styles 3) relationships between course material and student history 4) emotional responses and 5) future applications.Results410 self-reflection documents were analyzed. The student self-awareness on personal learning style (72.7% level 3+) and course content (55.2% level 3+) were well-reflected. Reflections at a level 1 awareness included identification of a) specific teaching strategies utilized to enhance learning (58.4%), b) personal strengths/weaknesses (53%), and c) emotional responses, values, and beliefs (71.5%). Students' abilities to connect information to life experiences and to future events with understanding were more evenly distributed across all 5 levels of reflection-awareness.ConclusionsExposure to self-reflection assignments in the early years of undergraduate medical education increases student awareness and promotes the creation of personal meaning of one's reactions, values, and premises in the context of student learning environments. Early introduction with repetition to such cognitive processes as practice tools increases engagement in reflection that may facilitate proficiency in mastering this competency leading to the creation of future reflective health professionals.
Highlights
Self-reflection and reflective practice are increasingly considered as essential attributes of competent professionals functioning in complex and ever-changing healthcare systems of the 21st century
Despite what is often a daily ritual of recording and discussing, in an academic context, students often struggle with the reflective process
The majority of the students included some detailed mention of the course content
Summary
Self-reflection and reflective practice are increasingly considered as essential attributes of competent professionals functioning in complex and ever-changing healthcare systems of the 21st century. In contrast to “social reflection”, accurate definition of “academic reflection” is recently articulated as twelve tips for teaching reflection at all levels of medical education by Aronson These twelve tips are: “1) define reflection 2) decide on learning goals for the reflective exercise, 3) choose an appropriate instructional method for the reflection, 4) decide whether you will use a structured or unstructured approach and create a prompt, 5) make a plan for dealing with ethical or emotional concerns, 6) create a mechanism to follow-up on learners’ plans, 7) create a conducive learning environment, 8) teach learners about reflection before asking them to do it 9) provide feedback and follow-up, 10) assesses the reflection, 11) make this exercise part of the larger curriculum to encourage reflection, and 12) reflect on the process of teaching reflection” [6]. The awareness of these skills in first-year medical/dental students will facilitate and guide the development of self-reflective exercises that can be specially tailored to suit students’ needs to create a firm foundation towards this final objective
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