Abstract
Critical reflection supports enactment of the social roles of care, like collaboration and advocacy. We require evidence that links critical teaching approaches to future critically reflective practice. We thus asked: does a theory-informed approach to teaching critical reflection influence what learners talk about (i.e. topics of discussion) and how they talk (i.e. whether they talk in critically reflective ways) during subsequent learning experiences? Pre-clinical students (n = 75) were randomized into control and intervention conditions (8 groups each, of up to 5 interprofessional students). Participants completed an online Social Determinants of Health (SDoH) module, followed by either: a SDoH discussion (control) or critically reflective dialogue (intervention). Participants then experienced a common learning session (homecare curriculum and debrief) as outcome assessment, and another similar session one-week later. Blinded coders coded transcripts for what (topics) was said and how (critically reflective or not). We constructed Bayesian regression models for the probability of meaning units (unique utterances) being coded as particular what codes and as critically reflective or not (how). Groups exposed to the intervention were more likely, in a subsequent learning experience, to talk in a critically reflective manner (how) (0.096 [0.04, 0.15]) about similar content (no meaningful differences in what was said). This difference waned at one-week follow up. We showed experimentally that a particular critical pedagogical approach can make learners’ subsequent talk, ways of seeing, more critically reflective even when talking about similar topics. This study offers the field important new options for studying historically challenging-to-evaluate impacts and supports theoretical assertions about the potential of critical pedagogies.
Highlights
This paper analyzes the outcomes of one enactment of critical pedagogy, as an approach to teaching for critical reflection, which is a lens for critically reflective practice: a way of being and seeing in practice that orients the practitioner to question assumptions, power relations, and structures, and to change these when they are unhelpful (Ng et al, 2019a, b)
We conducted an experiment to address the questions: does teaching critical reflection influence what learners talk about and how they talk during a subsequent learning session and debrief? Acknowledging that the passage of time can impact performance, we explored whether any effects changed one week after initial training
We developed a single teaching and learning session based on theories of critical reflection, reflexivity, and critical pedagogy, and on the teaching materials and scholarship of the first author and colleagues (Kinsella et al, 2012; Ng, 2012; Ng et al, 2015a, b; Phelan & Ng, 2015; Halman et al, 2017; Baker et al, 2018, 2020; Ng et al, 2018, 2020)
Summary
This paper analyzes the outcomes of one enactment of critical pedagogy, as an approach to teaching for critical reflection, which is a lens for critically reflective practice: a way of being and seeing in practice that orients the practitioner to question assumptions, power relations, and structures, and to change these when they are unhelpful (Ng et al, 2019a, b). (Mykhalovskiy & Farrell, 2005; Verma et al, 2005; Kumagai, 2014; Ng et al, 2020) These roles include the health advocate, communicator, collaborator, professional, and systems-based practitioner; collectively, they have been variably referred to as humanistic, intrinsic, or social roles (Dyne et al, 2002; Frank & Danoff, 2007; Sherbino et al, 2011; Whitehead et al, 2014). Dominant approaches to prepare practitioners for these social roles include teaching social determinants of health (SDoH) and cultural competence, and using portfolios or similar ‘reflective’ documents. Each of these approaches have encountered considerable critique (Driessen et al, 2005; Kumagai & Lypson, 2009; Metzl & Hansen, 2014; Kuper et al, 2017; Ng et al, 2015a; Sharma et al, 2018)
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