Open-ended Reflection Research Articles

Reflections on Limiting Social Media Use and Mental Health

The relationship between social media use and mental health has been well documented. A study by Bradley et al. (2023) examined whether reducing social media use to 30 minutes per day would improve mental health, but found no significant improvements, partly due to participants’ lack of adherence to study instructions. The current study examines qualitative responses to an open-ended reflection question from participants of this previous study. Most participants struggled to limit their social media use, largely because of benefits social media use provided and perceived consequences of not using social media. Many participants wanted to limit their social media use, despite most failing to do so during the study. Participants who did limit their social media use experienced improved mental health when limiting. Additionally, many participants had negative opinions about social media use, such as increasing social comparison, though positive and mixed opinions were also reported. This study suggests social media use limiting interventions may not be viable, and that different types of social media use must also be considered. Additionally, research viewing social media use as only having negative impacts is inaccurate; this study demonstrates that there is a continuum of effects it may have.

The power of storytelling: Impact of an interprofessional substance use disorder symposium on stigma and bias in health professions students

With nearly 92,000 drug-involved overdose deaths in the United States in 2020, it is critical to enhance health care professions students’ curricula to prepare future clinicians to meet the complex needs of patients with substance use disorders (SUD). This curricular resource describes a half-day, in-person interprofessional SUD symposium using storytelling as a pedagogical approach. Two learning objectives guided the symposium: a) examine biases against people with SUDs through storytelling, reflection, and role-play and b) create solutions to mitigate stigma that people with SUDs face in the healthcare system. Pre-post analysis included comfort level with interacting with persons with SUDs, Medical Condition Regard Scale, Jefferson Scale of Empathy for Health Professions Students, and word-frequency analysis. Open-ended reflection prompts were completed throughout the symposium and at its conclusion. After participating in the symposium, students reported higher levels of comfort in interacting with persons with SUDs and higher levels of regard for patients with SUDs. Qualitative analysis revealed that students gained knowledge, insight, and skills that will inform their future clinical practice. Overall, the symposium content and format was well received by students. Incorporating interprofessional learning using storytelling, multi-perspective discussion, and role-playing may be an effective way to mitigate stigma and bias regarding SUDs in health professions students. Information required to implement the activity is available under required materials, tables, and figures.

Strategies for assessment of student learning outcomes via the final project in a general education acoustics course

Learning outcomes of the final project in an undergraduate general education acoustics course were assessed via three short essay questions on an open book final exam. For the project, students construct a simple sound-making device or musical instrument that produces at least four different sounds using ordinary household objects, recyclables, etc. They are required to develop a hypothesis about how changes in the device will change the properties of the sounds. They then test their hypotheses using spectrograms, FFT measurements, and/or sound level measurements. The written responses of 60 students were downloaded and stripped of identifiers. The first two essay questions were designed to assess whether students could connect the steps of their project with the scientific method and explain therationale for their choice of measurement methods based on their hypothesis. These results were assessed via rubrics. The third question was an open-ended reflection on what they learned about acoustics by completing the project, and how they learned it. These responses were assessed via qualitative data analysis. Results, key findings, and implications for the design of the assignment and future assessments will be discussed.

Utilizing Bloom's taxonomy and authentic learning principles to promote preservice teachers' pedagogical content knowledge

The global reading crisis has been widely reported. One of the reasons attributed to the reading crisis is teachers' inadequate pedagogical content knowledge (PCK) regarding the teaching of reading. In South Africa, a multilingual country, the reading dilemma and the need for improved PCK have been debated extensively. This study, therefore, explores how utilizing Bloom's taxonomy and authentic learning principles within teacher education can promote the development of PCK in teaching reading. Using an interpretivist paradigm and an exploratory qualitative research design, data were collected from 20 second-year preservice teachers. The data collection consisted of a qualitative open-ended reflection questionnaire and document reviews. Inductive and thematic analysis was used for data analysis. The findings highlight the importance of authentic learning and PCK in teacher education and training. Furthermore, the findings indicate how Bloom's taxonomy can serve as a possible metacognitive framework to promote preservice teachers' PCK development. The benefits and challenges of PCK within teacher education are also elaborated on. Recommendations are made for teacher education programs to explore the value of Bloom's taxonomy as a metacognitive learning framework instead of a hierarchical assessment framework to create authentic learning opportunities to better prepare preservice teachers for practice.

The benefits of rotating through palliative care: A qualitative study

Purpose This is a qualitative study of written reflection projects by medical learners who completed a clinical rotation in Palliative Care (PC) at an academic tertiary care center. Methods Upon completing their rotation in PC, medical learners were asked to complete an open-ended reflection project that captured their overall impressions of this training and experience. Fourteen reflections were coded and analyzed. Results Upon analyzing the reflections, 5 main themes emerged. The first theme is that this rotation helped the learners become more empathetic and compassionate towards patients and their families. Second, the learners were able to recognize the humanity in their patients, regardless of their medical condition. Third, each of the learners in this study had meaningful interactions with numerous patients and really felt that they played a supportive and important role in the death of patients with whom they were working. Fourth, this experience challenged the learners to think and act in ways that they have not been taught in medical school. Lastly, the learners experienced a sense of transformation and a new-found appreciation for all of the emotions involved with working with dying patients. Conclusions Rotating through PC and reflecting upon that experience can be very meaningful for medical learners who have not worked much with dying patients and their families.

Implementing Ungrading in Undergraduate Exercise Physiology

Natural science faculty are increasingly experimenting with alternate modes to assess student learning. Ungrading, popularized by Susan Blum’s edited anthology of the same name, gives instructors freedom to move beyond traditional grades for a more complete understanding of student learning. Ungrading is a student‐centered approach to assessment of learning which focuses on student self‐reflection and metacognition, and limiting instructor bias. Ungrading can be useful in physiology education by incentivizing intrinsic motivation and attention to understanding instead of memorization. Reducing grade anxiety allows students in exercise physiology to focus on understanding and applying course content.In spring 2020, ungrading was implemented in an upper division undergraduate exercise physiology course taught over 4 weeks (N=19). In previous sections, students often commented that their grade did not reflect how much they learned. The purpose of ungrading was to more closely align grades with student learning. The lecture portion of the course occurred as a flipped classroom with small group meetings. In class, students asked and answered questions, discussed primary research, and interpreted physiological data to better understand and apply course material. Students were given details about ungrading at the beginning of the course, read selected essays about ungrading, and discussed their impressions of the new system with the instructor. One student had previous experience with ungrading.Students completed two guided self‐evaluations to describe their learning and reflect on their challenges and successes. Twice during the course students met individually with the instructor to receive feedback about their self‐evaluations and overall performance. During the mid‐term meeting, students set specific goals to work towards for the remainder of the course.Student self‐reflections (n=19) and student opinion surveys (n=15) were used to evaluate the ungrading practice. 89.4% (n=17) of the students indicated they agreed or strongly agreed that their learning was enhanced by ungrading. 100% of students agreed or strongly agreed that they valued their learning during the course. 87% (n=13 of 15) indicated the amount they learned in the course was excellent or good. 93% (n=14 of 15) rated the evaluative techniques and grading as excellent or good. Qualitative analysis of open‐ended reflection questions revealed students felt they were more easily able to apply knowledge with less grade based anxiety. Students reported increased curiosity and a deeper understanding of content when revising mistakes or misconceptions in their work. The instructor found ungrading very effective in improving student engagement with and understanding of course content. Overall, ungrading was effective for encouraging a deeper understanding of course content and aligning course grades with student learning.

An Interprofessional Team-Based Experiential Learning Experience in Public Libraries

The Stony Brook Medicine Healthy Libraries Program (HeLP) is an interprofessional team-based experiential learning opportunity for health professional students. University faculty members in the fields of nursing, public health, social work, and library science collaborated with four suburban public library directors to design, implement, and evaluate a team-based interprofessional service-learning experience, in which supervised students engaged in health monitoring and promotion in the library setting. Participating students were enrolled in either a semester-long population health course ( n = 16), a Master of Social Work fieldwork internship ( n = 2), a Master of Library Science internship ( n = 1), or a Master of Public Health practicum ( n = 2). HeLP faculty educated students on content, library culture, communication, professional roles/responsibilities, and documentation using standardized data collection tools. Concurrently, the interprofessional student teams delivered resources to patrons 1 day a week, with alternating locations, for a minimum of 2 hours per visit over the course of 6 weeks. HeLP provided students with an opportunity to apply core competencies based on the Interprofessional Education Collaborative. The team-based approach fostered interprofessional learning, as students worked together to assist library patrons on health and social needs. Throughout the program’s duration, students documented the type of resources provided, the types of encounters between team members, and the number of referrals. Student learning was assessed after program completion using three open-ended reflection questions.

Short-term Service-Learning: Implications for Preparing Health Science Students for Practice

Purpose: The purpose of this paper is to examine students’ self-reported learning outcomes following participation in collaborative interprofessional service-learning experiences through the qualitative analysis of participants’ written, guided critical reflections. Method: Participants responded to guided reflection questions pre and post trip. The four pre-trip open-ended reflection questions included: what the students expected or hoped to learn, how they expected to learn this, the importance of this learning for their career skill development and how this learning could be used in the future. Upon completion of the service-learning experience, students were asked the same questions with slight variation- What did they learn, how did they learn this, the importance of this learning for career skill development and how this learning could be used in their future practice. Open coding strategies were employed to guide the researchers’ analysis of the student participants’ written responses. Results: There were 145 participants in the study, including 86 students in a comparison group and 59 students who participated in service-learning trips during 2018 and 2019. Service-learning participants majored in nursing (47.4%, n=28) and occupational therapy (33.9%, n=20), with fewer participants in pharmacy (n=5), physical therapy (n=5) and social work (n=2). Comparing pre and post service-learning group responses, researchers noted that the post-trip reflections included more depth, breadth and insight compared to the pretest reflection responses for each theme. Post trip responses also included the additional theme of personal growth. Post-trip participants reported having a greater self-awareness of their own limitations and strengths, having a broadened perspective, experiencing spiritual growth, and developing attitudes of gratefulness, humility, flexibility, patience, and empathy after participating in the trip, reinforcing the idea that immersion created learning is exponential when it is experiential. Conclusions: Service learning coupled with guided critical reflection is an effective tool in enhancing interprofessional collaboration. Qualitative analysis of students’ self-reported learning through written reflections served as a valuable means for capturing learning outcomes related to interprofessional collaboration competencies.

Utilizing Home Visits to Assess Social Determinants of Health During Family Medicine Residency.

Home visits can improve quality of care and health outcomes and provide a unique opportunity to learn more about patients' social context and assess patients' various social determinants of health (SDH). The objectives of this study were to assess patient self-reported SDH, resident reflections on patient social status, the utility of a SDH survey during home visits, and resident comfort levels addressing patient SDH. This was a mixed-methods pilot study utilizing patient self-reported data and open-ended reflection questions. Participants included adult patients aged more than 18 years from an urban safety-net clinic and family medicine residents who provide their care. We received forty-two surveys from 42 home visits. Most patients were female (61.9%) and African-American (45.2%), aged from 25 to 88 years (mean=60.24). Top patient-reported SDH include transportation, paying bills, and food insecurity. Common themes of resident responses included positive utility of the survey for assessing patient SDH; variation in comfort level when inquiring about patient SDH with positive influence from prior experience, assistance from colleagues, or prior good relations with patients; and expressed intention to include SDH assessment in future practice. Residents recognized the value of assessing SDH during home visits and expressed intent to include it in future practice. Thorough assessment of patient SDH may help to craft a more robust and standardized system to prioritize patients who would most benefit from receiving home visits.

Reflections on 'Thinking an Ethics of Gender Exploration: Against Delaying Transition for Transgender and Gender Variant Youth'.

In this short article are offered some brief reflections on the commissioned response to my article on ethical issues arising in the provision of medical interventions for gender diverse children. Ashley argues for the importance of 'an ethics of exploration' which prioritises making opportunities for fluid, open-ended reflection by gender diverse children and young people, operating through and alongside, rather than prior to, social and medical transition. While noting significant areas of shared outlook between Ashley and myself, I correct some assumptions that Ashley may be making about the range of young people seen at the UK Gender Identity Development Service (GIDS) and the way we work clinically within a developmental framework. I highlight my reasons for thinking that there are particular concerns arising in the care of the very young. Finally, I reiterate my view that professionals cannot so easily abandon altogether an 'ethic of prediction' and surrender their responsibilities and accountabilities in this area of clinical practice.

A Qualitative Study of Independent Home Visits by Hospice Fellows: Addressing Gaps in ACGME Milestones by Fostering Reflection and Self-Assessment.

With the rapid growth in the number of fellowship programs in Hospice and Palliative Medicine (HPM), many are in the process of developing ways to demonstrate that fellows are attaining educational milestones. Reflection and self-assessment are key components of 2 Accreditation Council for Graduate Medical Education (ACGME) competencies, practice-based learning and improvement, and systems-based practice, which have both been historically challenging to learn and assess. This article describes results of a content analysis of narrative data collected from HPM fellows' self-assessments as they performed hospice home visits independently in a new clinical rotation. This was a prospective qualitative study. Eight fellows completed 217 unsupervised hospice home visits from 2014 to 2016. Fellows completed weekly self-assessment forms, which captured both clinical visit information and practice data elicited from responses to open-ended reflection prompts. Analysis of 29 self-assessment forms generated 6 themes: patient- and family-centered care, self-efficacy, systems-based care, commitment to doing their best, catalyst for professional growth, and purpose and meaning in work. The fellows recognized numerous barriers distinct to providing care in homes. All fellows felt prepared to perform home visits throughout the rotation and after training. Narrative data collected during the independent home visit rotation provided evidence that HPM fellows detected gaps in their performance, planned for practice improvements in subsequent visits, and valued working within an interprofessional team. Built-in opportunities for fellows to reflect during training are critical in meeting ACGME milestones, and are integral to their professional development.

Integrating Syrian refugee teachers into Swedish educational labour market – reflections on a fast track design

ABSTRACTIn autumn 2016, Malmö University started two “fast track” trajectories for teachers with refugee backgrounds. The participants were offered an education of 26 weeks as an introduction to the Swedish school system, consisting of content courses, professional Swedish and workplace learning. The aim of this small explorative study was to get an impression of the participants’ views and understanding of the role of becoming a teacher in Swedish schools, realising the characteristics of pedagogy aimed for in the curriculum, specifically the interaction patterns and student participation in learning processes. Main research questions addressed participants’ expectations of differences and challenges in the Swedish school context as compared to their experiences in Syrian contexts. A combination was chosen of focus groups interviews with a small number of teachers and students on their views and experiences with pupils’ involvement in classroom communication as well as quantitative data gathering. The quantitative survey measured teachers’ acquisition and participation-oriented views on learning. Open-ended reflection on learning questions was also given to the students. Results showed significant development towards more participation-oriented beliefs on learning. Interview data and written statements reveal varied differences between the Swedish context and the participants’ experiences from schools in Syria.

Effect of international rehabilitation visiting student program on students’ professional development

One of the important and enduring strategies that developing countries take in advancing education and training of rehabilitation students and professionals is fostering international partnerships, improving the quality of international education provision, and encouraging partnerships with foreign education institutions. The purpose of this presentation is to describe and examine the effect of an international visiting student program in a university of USA on students’ professional development. A total of seventy students in rehabilitation from China participated in the three-month summer visiting student program that included a combination of didactic coursework, clinical observation, and cultural immersion in the past three summers. The outcomes of the program were evaluated annually through a mixed methods approach incorporating a single group pre/posttest analysis and focus group discussions. The quantitative portion of the study incorporated the use of two instruments: the Team Skills Scale (TSS) (Hepburn, Tsukuda, & Fasser, 2002), and one subscale of the Cultural Competence Health Practitioner Assessment (CCHPA) (National Center for Cultural Competency, 2014). Qualitative data collection included videotaped interviews with participants at the end of the CRISP prior to the participants returning to China. The participants were asked open-ended reflection questions by a CRISP staff moderator. The results of quantitative data analyses revealed significant differences between pre and post tests suggesting the summer program had significant impact on students’ team work skills and cultural competence. The results of qualitative data analysis echoed the findings of the quantitative data. Findings of the program evaluation revealed that international immersion programs is one of the effective stepping stones to help prepare and develop rehabilitation professionals for countries in which rehabilitation is less developed. The willingness of educational institutions to commit to working with partners in another country is vital to initiate the collaboration.

“A Personal Touch of Advocacy to My Profession”: Counter-Narratives of Immigrant Latina Teachers in English as a Second Language Education

Guided by Critical Raced-Gendered epistemologies and methodologies, this study investigated life experiences of six Latina teachers who were former English Language Learners (ELL) and are currently becoming English as a Second Language (ESL) teachers in an urban community. Multiple data sources such as interviews, open-ended autobiographical surveys, anecdotal notes, reflection journals, online discussions, and field observation notes were collected over two years and analyzed through inductive analysis in conjunction with Grounded theory. The findings present counter-narratives to dominant yet deficit narratives of minority teacher education. Salient themes included teachers9 support versus institutional racism; strength of motherhood and female family support versus traditional gender roles; agency and advocacy versus marginalized socio-cultural environments. In their journeys from ELLs to ESL teachers, constant negotiation between the conflicting life experiences and critical self-positioning turned out to be crucial.

Examining the perceived impact of an ethics workshop on interprofessional values and teamwork

ABSTRACTInterprofessional education (IPE) is a vital component of healthcare education yet challenges to implementation persist. This study aimed to evaluate the perceived impact of an ethics-based IPE workshop designed for professional phase healthcare students enrolled in athletic training, health management systems, occupational therapy, physical therapy, physician assistant studies, and speech-language pathology programmes at one university. A pre/post-test cohort study was conducted to evaluate the impact of the workshop on interprofessional values and teamwork. Findings from the 61 students who completed both pre- and post-programme evaluation surveys suggest that the ethics-based workshop was successful in improving perceived confidence as related to the workshop objectives and strengthened positive perceptions of IPE as evaluated by the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R). Analysis of responses to open-ended reflection questions after the workshop suggest that student participants perceived changes in understanding related to multiple areas of IPE. These results suggest that an ethics-based workshop using case-based collaborative pedagogy may be an effective mechanism for delivery of IPE-oriented information resulting in greater student confidence and understanding of IPE competencies.

Preparation of a Carbon Doped Tissue-Mimicking Material with High Dielectric Properties for Microwave Imaging Application.

In this paper, the oil-in-gelatin based tissue-mimicking materials (TMMs) doped with carbon based materials including carbon nanotube, graphene ink or lignin were prepared. The volume percent for gelatin based mixtures and oil based mixtures were both around 50%, and the doping amounts were 2 wt %, 4 wt %, and 6 wt %. The effect of doping material and amount on the microwave dielectric properties including dielectric constant and conductivity were investigated over an ultra-wide frequency range from 2 GHz to 20 GHz. The coaxial open-ended reflection technology was used to evaluate the microwave dielectric properties. Six measured values in different locations of each sample were averaged and the standard deviations of all the measured dielectric properties, including dielectric constant and conductivity, were less than one, indicating a good uniformity of the prepared samples. Without doping, the dielectric constant was equal to 23 ± 2 approximately. Results showed with doping of carbon based materials that the dielectric constant and conductivity both increased about 5% to 20%, and the increment was dependent on the doping amount. By proper selection of doping amount of the carbon based materials, the prepared material could map the required dielectric properties of special tissues. The proposed materials were suitable for the phantom used in the microwave medical imaging system.

Providing context for a medical school basic science curriculum: The importance of the humanities

Introduction: To increase students’ understanding of what it means to be a physician and engage in the everyday practice of medicine, a humanities program was implemented into the preclinical curriculum of the medical school curriculum. The purpose of our study was to determine how medical students’ views of being a doctor evolved after participating in a required humanities course.Methods: Medical students completing a 16-clock hour humanities course from 10 courses were asked to respond to an open-ended reflection question regarding changes, if any, of their views of being a doctor. The constant comparative method was used for coding; triangulation and a variety of techniques were used to provide evidence of validity of the analysis.Results: A majority of first- and second-year medical students (rr = 70%) replied, resulting in 100 pages of text. A meta-theme of Contextualizing the Purpose of Medicine and three subthemes: the importance of Treating Patients Rather than a Disease, Understanding Observation Skills are Important, and Recognizing that Doctors are Fallible emerged from the data.Conclusions: Results suggest that requiring humanities as part of the required preclinical curriculum can have a positive influence on medical students and act as a bridge to contextualize the purpose of medicine.

A Comparison and Analysis of Preservice Teachers’ Oral and Written Reflections

Teacher reflection continues to be a key component of many preservice teaching programs across the United States. In Agricultural Education, reflection begins in the early field experience and continues throughout the teacher education program as an important opportunity to assess students’ proficiency of teaching concepts, thought process, and growth over time. The purpose of this study was to examine the topics of preservice teachers’ reflections and compare the effectiveness of written and reflective interviews. We examined the written and reflective interviews of four preservice teachers over three reflection cycles, comparing themes, levels of reflection, and completeness to determine the benefit of multiple methods of reflection. Applying the theory of preservice teacher concerns, we found participants tended to report more task reflection than self-concerns or impact concerns when given open-ended reflection prompts. Moreover, written reflections tended to be more summative in nature, while reflective interviews provided more support and detail. The findings indicate reflection across multiple methods may provide a more complete assessment of student proficiency. Teacher education programs could benefit from these findings by analyzing their means of facilitating preservice teacher reflection.

Social interaction and reflection for behaviour change

This article introduces the theme issue on social interaction and reflection for behaviour change. A large body of research exists on systems designed to help users in changing their behaviours, for instance, to exercise more regularly or to reduce energy consumption. Increasingly, these systems focus on multiple users, often to encourage open-ended reflection rather than prescribing a particular course of action. As background for this theme issue, this article presents a literature review on behaviour change support systems that focus on social interaction and reflection. The review highlights five key approaches amongst these systems: social traces, social support, collective use, reflection-in-action, and reflection-on-action. Each approach offers unique benefits, but also challenges for the design of behaviour change support systems. We highlight how the articles in this theme issue contribute to our current understanding of these five approaches, and beyond that, set out some broad directions for future work.

Learning and Developing Followership

Followership has been recognized as an essential component of leadership studies as evidenced by growth of research within this area. To keep pace with the growth of this research, it is time to bring followership into the leadership classroom. This paper proposes a case-based exercise with two main learning objectives: (1) to help students broaden their perceptions about followership, and (2) to promote followership behaviors that actively contribute to organizations. This exercise includes large group discussion, peer coaching, and individual work to facilitate these endeavors. The paper concludes with suggested methods for assessment that include both self- and peerratings, as well as open-ended reflection.