The understanding and experience of students, tutors and educators regarding reflection in medical education: a qualitative study

Fiona Muir

doi:10.5116/ijme.4c65.0a0a

Abstract

Objectives: This exploratory study was designed to investigate the understanding and experience of students, tutors and medical educators with respect to reflection in medical education during the MBChB medical degree programme. Methods: A qualitative approach was employed using semistructure interviews. Seven medical students, eleven tutors and eight medical educators participated in the study. An inductive thematic analysis was used to accomplish the aim of this study. Results: The results indicate that students, tutors and educators have an incomplete understanding of reflection. The cause exists at several points, not only at curriculum level but also at the level of the educator, tutor and the student. Whilst the study presents information regarding curriculum deficits and individual needs it also signifies that policy documents are not clearly understood. Assumptions were made by participants regarding the teaching, learning and assessment of reflection indicating a need for a review of student and tutor preparation. Conclusions: The importance of reflection is frequently noted in the literature as an essential characteristic for professional competence. This research has highlighted the need for a much greater emphasis on reflection in or through teaching, learning and assessment. Suggestions to overcome these are offered.

Highlights

Modern day changes in medical education have identified standards which students must achieve before they become qualified practitioners
Tutor and educator understand by the terms ‘reflection’, ‘critical reflection’ and ‘reflective practice’?
Comparison with existing literature from health and teaching professions indicates that many of the terms ‘reflection’ are comparable to those identified within the literature, whereby they have been used loosely and interchangeably, and numerous definitions and common characteristics exist.[12, 33]

Summary

Introduction

Modern day changes in medical education have identified standards which students must achieve before they become qualified practitioners. The General Medical Council policy documents 1,2 highlight the need for the professional to be reflective. These standards are significant as they clearly define the qualities and abilities essential for a competent and reflective doctor and for the continuing professional development of medical graduates. Key definitions of reflection and critical reflection derive from the early work of educationalists such as Dewey 3 and Schön.[4] In the last two decades of the twentieth century these two terms have increasingly appeared in the educational literature to support practice and practice development, education and research. Many writers 5-11 have contributed definitions of reflection and critical reflection. Reflection is described using numerous terms: memory, thinking, thought, indication, mirror image. Wide ranging and difficult to define completely, Hancock 12 reviews the number of definitions that exist and concludes the following common characteristics:

Objectives

Methods

Results

Conclusion