Process Of Reflection Research Articles

Reflect to interact – fostering medical students’ communication through reflection-focused e-learning

BackgroundPrevious research indicates that reflection can foster medical communication competence. However, best practices for embedding reflection in online medical education are missing. This study examined how reflection processes can be promoted and embedded in an e-learning course on physician–patient communication to foster learning.MethodsWe investigated three differently designed e-learning conditions featuring different proportions of reflection triggers and compared their effects on students’ reflections. We had 114 medical students in their first clinical year complete one of the variants: video modelling (VM, n = 39), video reflection (VR, n = 39), or a variant merging both approaches (VMR, n = 36). Each student wrote a total of nine reflections based on the same guiding questions at three time points embedded in the course. The students’ levels of reflection were measured using an adapted version of the REFLECT rubric (scale 0–18).ResultsStudents of all course variants achieved good levels of reflection beyond the descriptive level at all three time points, with no significant differences between the variants. The mean reflection scores at the end of the course were M = 14.22 for VM (SD = 2.23), M = 13.56 for VR (SD = 2.48), and M = 13.24 for VMR (SD = 2.21). Students who completed VM showed significantly improved levels of reflection over the course, whereas we found no statistically significant development for those in VR or VMR. The reflection scores correlated significantly positively with each other, as did the text lengths of the written reflections. Reflection scores also correlated significantly positively with text length.ConclusionsOur study offers a teaching strategy that can foster good levels of reflection, as demonstrated in the three e-learning variants. The developed reflection prompts can be easily embedded in various e-learning environments and enable reflections of good quality, even in settings with limited available teaching time.

"We are not being taught sustainable citizenship!"

Education on sustainability is a crucial goal that requires a transformative shift in teacher education to drive meaningful changes oriented to action. A cross-sectional study with an exploratory design investigated preservice science teachers' perceptions regarding teaching sustainable citizenship, specifically focusing on the climate crisis and earthquakes-tsunamis. The study was conducted in two Chilean universities with similar teacher preparation programs. The team designed a podcast series, which was used and evaluated by the 13 participants through action research. Three group discussions explored their perceptions of the resources, as well as the aims and challenges of teaching sustainable citizenship and the podcasts. We used Grounded Theory steps, including triangulation by the researchers to ensure reliability, to qualitatively analyse the data. The results reveal a constraint on teaching in areas where the participants lacked the necessary preparation and background knowledge as students and preservice teachers. The main challenges were related to interdisciplinarity, the social dimension of socio-scientific issues and context-responsive teaching methods. The perceived aims were the development of students' critical thinking, informed positioning, and encouraging active citizen participation. Preservice teachers found the podcast series to be a valuable new epistemic and pedagogical resource that can support their efforts to teach sustainable citizenship and implement pedagogical strategies. The autonomous usage of the device triggered reflection processes, particularly regarding the human rights perspective, which unveiled the socio-political dimensions inherent in science education. It promoted personal re-positioning as active citizens and educators and empowered them to seek out and pursue the changes needed to reshape future classrooms. We discuss these findings in the context of teacher preparation and the use of educational technology in teacher education.

Breastfeeding mother’s experiences with breastfeeding counselling: a qualitative study

BackgroundMothers are recommended to breastfeed their children but can find it challenging and experience breastfeeding problems. Qualified breastfeeding counselling from healthcare professionals can help mothers master breastfeeding, but there is a need to explore mothers’ lived experiences with receiving breastfeeding counselling. We aimed to reveal breastfeeding mothers’ experiences with receiving breastfeeding counselling from midwives and public health nurses (PHNs) to provide a deeper insight into the phenomenon of breastfeeding counselling, which may improve breastfeeding counselling in practice.MethodsA qualitative design with a hermeneutic phenomenological approach was used. Individual interviews of 11 breastfeeding mothers from Norway were conducted from September 2021 to 2022. Van Manen’s guided existential inquiry guided the reflective process to provide deeper insights into the phenomenon of breastfeeding counselling.ResultsThe study captured the meaning of breastfeeding mothers’ lived experiences with breastfeeding counselling. Three themes and eight sub-themes were found. Breastfeeding was at stake for the mothers because breastfeeding could be reduced or stopped, and qualified breastfeeding counselling from midwives and PHNs was essential for them to establish and continue breastfeeding. They needed to be perceived as both breastfeeding mothers and as women with their own needs to master everyday life during the breastfeeding period.ConclusionsThis study offers insights to midwives, PHNs and others offering breastfeeding counselling by facilitating an understanding of being a breastfeeding mother receiving breastfeeding counselling. Qualified breastfeeding counselling and a trusting relationship with midwives and PHNs are essential for mothers to establish and continue breastfeeding, while deficient counselling may cause breastfeeding difficulties. Mothers need to be treated as whole and competent persons to avoid objectification and fathers/partners need to be included in breastfeeding counselling. The ‘Baby-Friendly Hospital Initiative’ should be continued, and guidelines should align with the mothers’ need to incorporate breastfeeding into their daily lives during the breastfeeding period.

Creating an Assignment to Incorporate Antiracist Pedagogy Into an Undergraduate Introductory Nursing Course.

Antiracist pedagogy was incorporated into an undergraduate introductory nursing course using National League for Nursing diversity and inclusion initiatives and academic nurse educator competencies as a framework. This article describes the reflective process and steps taken to select Taylor's memoir, Reminiscences of My Life in Camp, as a required text for an introductory nursing course. By incorporating antiracism into an introductory nursing course, educators can assist novice nursing students from diverse groups to envision themselves as nurses, role model allyship for White students, and create a more inclusive teaching environment.

Explanatory videos in the context of learning processes: An interdisciplinary interpretative interaction analysis of production and reflection processes

Explanatory videos in the context of learning processes: An interdisciplinary interpretative interaction analysis of production and reflection processes

Challenges and tensions in the role of the LMS for medical education

In the context of discussions of a “next generation LMS” and other contemporary challenges in higher education, this case study looks at the iterative process a team of educational designers and Medical School academics at Australian National University used in a review of the ANU's Medical School LMS sites. Adopting the framework of the actor network theory, this reflective process discovered the tensions, dynamics and issues involved, and worked to gain and maintain key Medical School staff engagement and support for the review and for any changes that might be recommended. This paper reflects on emerging possible models for technology-enhanced learning beyond our current institutional LMS while acknowledging the institutional constraints on learning innovation within the global higher education context. Next generation LMS models may provide a more flexible future solution that could be applicable not just to medical education, but to higher education generally.

Creative righting: autoethnographic creative writing as a tool to prevent teacher burnout and attrition

ABSTRACT Teacher burnout is a key feature of the current international crisis of teacher shortages. Teachers are feeling isolated, marginalised and disempowered. Research on burnout in teachers has focused on attrition and how to avoid it. However, factors contributing to teacher burnout are multi-dimensional and complex. Consequently, any potential solution must be able to address such complexities in a personalised way. The literature tells us that personal reflection and discussing experiences, particularly negative or those that involve conflict, can result in improvements in teacher identity, positive teaching experience, positive mental health, and thus less burnout. In my own case of burnout, I used autoethnographic writing to re-imagine challenging episodes from my career. The creative and reflective processes reinvigorated my passion for teaching so that writing and sharing stories became an unexpected pathway away from burnout and into empowerment. The use of autoethnographic creative writing to tell and reflect upon the challenges of teaching offers a personalised and valuable way to address the complex variables of burnout affecting individuals. Importantly, one does not have to be an expert in creative writing to be effective. More research is needed to determine whether this approach has wider appeal and benefit for educators experiencing burnout.

A bridge between worlds: Embedding research in telepractice co‐design with disability community

AbstractIntroductionCo‐production approaches are increasingly being advocated for as a way of addressing the research translatory gap while including patient and public involvement in development of services they access, and particularly in disability service provision. Embedded research (ER) is a method which integrates the researcher within the target organization to better facilitate both co‐production of research outputs and the reduction of the research translation gap. The aim of this reflection is to better understand the commonalities and differences between ER in a disability context to accounts published in academic literature.MethodA review of embedded researcher literature was completed in combination with a personal reflection of lived experience as an embedded researcher within a disability support service organization. The reflective process included review of research journal entries and other records of lived experience (photographs, audio recordings, drawings) maintained throughout the period in the role of embedded researcher. A reflexive thematic analysis process was used.ResultsI reflect throughout the article upon five themes which highlight both the commonalities between my experiences and those of other embedded researchers as well as instances where they differed. The five themes include (1) A knowledge bridge, (2) Considerations of positionality, (3) Ethical complexity, (4) Anticipating change, and (5) Existing in the in‐between together.ConclusionExperiences of ER appear to transcend the discipline in which the research is being embedded, and while the lived experience in a disability host organization was invaluable in facilitating a successful co‐produced research project, significant avenues for improvement exist in terms of ethical frameworks, methodological guidance, and communities of support.

Community-based participatory-research through co-design: supporting collaboration from all sides of disability

BackgroundAs co-design and community-based participatory research gain traction in health and disability, the challenges and benefits of collaboratively conducting research need to be considered. Current literature supports using co-design to improve service quality and create more satisfactory services. However, while the ‘why’ of using co-design is well understood, there is limited literature on ‘how’ to co-design. We aimed to describe the application of co-design from start to finish within a specific case study and to reflect on the challenges and benefits created by specific process design choices.MethodsA telepractice re-design project has been a case study example of co-design. The co-design was co-facilitated by an embedded researcher and a peer researcher with lived experience of disability. Embedded in a Western Australian disability organisation, the co-design process included five workshops and a reflection session with a team of 10 lived experience and staff participants (referred to as co-designers) to produce a prototype telepractice model for testing.ResultsThe findings are divided into two components. The first describes the process design choices made throughout the co-design implementation case study. This is followed by a reflection on the benefits and challenges resulting from specific process design choices. The reflective process describes the co-designers’ perspective and the researcher’s and organisational experiences. Reflections of the co-designers include balancing idealism and realism, the value of small groups, ensuring accessibility and choice, and learning new skills and gaining new insights. The organisational and research-focused reflections included challenges between time for building relationships and the schedules of academic and organisational decision-making, the messiness of co-design juxtaposed with the processes of ethics applications, and the need for inclusive dissemination of findings.ConclusionsThe authors advocate that co-design is a useful and outcome-generating methodology that proactively enables the inclusion of people with disability and service providers through community-based participatory research and action. Through our experiences, we recommend community-based participatory research, specifically co-design, to generate creative thinking and service design.

Cooperative Learning on Sports Confidence among Students of Baseball Elective

Cooperative learning emphasizes collaboration, shared problem-solving, and communal knowledge, positing that learning in groups enhances understanding and practical application. This study aimed to explore the correlation between cooperative learning in a baseball elective and the sports confidence of 208 surveyed students. The findings indicated strong agreements in domains of Positive Interdependence, Interpersonal Skills, and Reflective Group Processing, with slightly lower agreement in Individual Accountability. Holistic Development emerged as the highest indicator of sports confidence, while Performance Assurance was lower, yet all were within agreeable ranges. The study recommends the "Team Synergy: Enhancing Sports Confidence through Cooperative Learning" program, aiming to blend cooperative learning strategies into sports training, thereby bolstering sports confidence and fostering a holistic development of student-athletes.

Indication and Contraindication of Video-Based Psychotherapy: A Qualitative Delphi Survey to Capture Psychotherapists' Reflection and Deliberation Processes

The Corona pandemic forced many psychotherapists to make a rapid transition to video setting. Even after the acute phase of the pandemic, video-based treatments can be determined to a certain extent in practice. Thus, indication and contraindication recommendations are essential to ensure treatment quality. However, empirical studies are almost completely lacking in this regard. In the context of this work, the decision-making and consideration processes of psychotherapists regarding video-based treatments are to be recorded and those factors that can have an effect on the indication are to be identified. Two-stage, qualitative Delphi survey with psychodynamically oriented psychotherapists (n=9) and behavioural therapists (n=7) who can be assigned to the fields of research and practice. The quality of the therapeutic alliance guides the participants' choice of setting. An indication for video setting results from the feasibility of therapeutic interventions and the respective treatment goal. The therapists weighed the costs and benefits of video setting for various disorders. The changed feeling of control on both sides and the possibility of improving health care are decisive factors. Based on the results, a decision tree for psychotherapists was created, which includes the identified indication criteria.

The use of action learning sets in developing a multiple lens view model with a charity’s leadership team. An account of practice

ABSTRACT This paper outlines the outcomes from three rounds of action learning sets with a charity that supports vulnerable adults and those with learning disabilities in supported living and residential care. The action learning sets focused on safeguarding cases and how they had been managed by 11 leaders at various levels of the charity (the team). The findings demonstrate that using a reflective process and the ‘fishbowl’ model of action learning sets in this context is effective in evaluating the actions taken by the team in the safeguarding case, but also the awareness of the perspectives – or lenses – the team had used when reflecting on the roles of the various stakeholders included. We outline the development and application of the Multiple Lens View Model (Table 1) which was designed during the research and which helps to analyse the perspectives the participants were taking when focusing on the issues in each case. We conclude with an exploration of how this charity can more critically engage in debate around assumptions made in safeguarding incidents. We discuss how The Multiple Lens View Model can be developed further as a conceptual framework for this charity and for critical action learning in other institutions.

The Hybrid Recharge Delayed Oscillator: A More Realistic El Niño Conceptual Model

Abstract El Niño–Southern Oscillation (ENSO) is the leading mode of climate interannual variability, with large socioeconomical and environmental impacts, potentially increasing with climate change. Improving its understanding may shed further light on its predictability. Here we revisit the two main conceptual models for explaining ENSO cyclic nature, namely, the recharge oscillator (RO) and the advective–reflective delayed oscillator (DO). Some previous studies have argued that these two models capture similar physical processes. Yet, we show here that they actually capture two distinct roles of ocean wave dynamics in ENSO’s temperature tendency equation, using observations, reanalyses, and Climate Model Intercomparison Project (CMIP) models. The slow recharge/discharge process mostly influences central-eastern Pacific by favoring warmer equatorial undercurrent and equatorial upwelling, while the 6-month delayed advective–reflective feedback process dominates in the western-central Pacific. We thus propose a hybrid recharge delayed oscillator (RDO) that combines these two distinct processes into one conceptual model, more realistic than the RO or DO alone. The RDO eigenvalues (frequency and growth rate) are highly sensitive to the relative strengths of the recharge/discharge and delayed negative feedbacks, which have distinct dependencies to mean state. Combining these two feedbacks explains most of ENSO frequency diversity among models. Thanks to the two different spatial patterns involved, the RDO can even capture ENSO spatiotemporal diversity and complexity. We also develop a fully nonlinear and seasonal RDO, even more robust and realistic, investigating each nonlinear term. The great RDO sensitivity may explain the observed and simulated richness in ENSO’s characteristics and predictability. Significance Statement El Niño and La Niña events, and the related Southern Oscillation, cause the largest year-to-year variations of Earth’s climate. Yet the theories behind them are still debated, with two main conceptual models being the recharge oscillator and the delayed oscillator. Our purpose here is to address this debate by developing a more realistic theory, a hybrid recharge delayed oscillator. We show how simple yet realistic it is, with equivalent contributions from the slow recharge process and from the faster delayed feedback. It even captures the observed El Niño and La Niña diversity in space and in frequency. Future studies could use the simple theoretical framework provided here to investigate El Niño–Southern Oscillation (ENSO) in observations, theories, climate models diagnostics and forecasts, and global warming projections.

THE REFLECTION OF DIDACTICAL DESIGN RESEARCH LEARNING AS AN EFFORT OF ELEMENTARY SCHOOL TEACHER EDUCATION (ESTE) LECTURERS’ PROFESSIONAL DEVELOPMENT

The determining factors for the success of the learning process are students and the teacher/lecturer as the person most responsible for implementing the learning process. This study aimed to describe the process of learning reflection as the professional development of Elementary School Teacher Education (ESTE) lecturers based on Didactical Design Research (DDR) in learning the Elementary Science Basic Concepts course. The method used in this research is qualitative. The research design used is phenomenology. This research was conducted at the ESTE Study Program, one of the tertiary institutions in Cimahi City. The participants in this study were an ESTE lecturer. Data collection techniques used in this study were participant observation, interviews, and focus group discussions. The data analysis technique used was Interpretative Phenomenological Analysis (IPA). The results showed that there were several learning obstacles in the form of epistemological obstacles, which occurred due to students' lack of knowledge related to the concepts they were learning and caused students to experience misconceptions. Then a hypothetical learning trajectory is compiled as a series of learning paths that students go through to achieve more meaningful learning goals. The limitation in this study is that the analysis of each step in the DDR process has not been fully described, so that for further research each step can be clearly described to see a more real impact from the lecturer professional development process that has been implemented.

Developing paediatric skills and knowledge in pharmacy education: an exploration of a novel work-based learning experience

Abstract Introduction Pharmacy education in the United Kingdom must adapt to produce independent prescribing pharmacists ready to join an evolving healthcare system. Current placement practices exclude approximately 21% of the population due to a lack of specific recommendations surrounding paediatric experience and knowledge within the MPharm programme.[1] In turn, students’ current experiences may be limited by lack of interaction with unique learning outcomes offered by some healthcare settings, such as paediatric hospitals.[2] To promote student exposure in an overlooked speciality, novel approaches to work-based learning can be utilised. Aim This study aimed to explore pharmacy students’ experiences of work-based learning in a paediatric hospital setting. Methods In October 2022, fourth-year MPharm students at one school of pharmacy were invited to undertake work-based learning sessions across one academic year. The sessions aimed to develop students’ paediatric consultations skills and knowledge. Sessions consisted of a briefing, ward activities, scaffolded consultations with children and carers, and debriefs with a clinical supervisor. Debriefs included students reporting clinical information, required action and learning outcomes. All debriefs provided by students were transcribed by a clinical supervisor using a spreadsheet which recorded the date, ward visited, patient details, student handover, follow-up (if required) and learning outcomes. Data was initially cleaned, quality checked, and underwent content analysis to identify patterns and key themes to describe student experiences. Results Seventy-four students took part in sessions and delivered 233 consultations covering the medical history of the patient (76%, n=177), with varied levels of completeness. Students were exposed to acute conditions (41%, n=96) and chronic conditions (33%, n=76), with 13% (n=30) still awaiting diagnosis. Forty-eight percent (n=81) of learning points related to the pathology, diagnosis and symptoms of conditions, 24% (n=41) to medicines, 15% (n=25) to patient care, 11% (n=18) to non-clinical experiences and 2% (n=4) to other outcomes. In addition to carrying out ward activities, students underwent the processing of experiences during post-session debriefs: “It’s uncomfortable seeing a child struggle to breathe” [P131]. The process of active reflection was also evidenced in debriefs: “I felt very anxious, like a tightness in the chest, to hear that a child had a short life expectancy” [P145]; “I realised they had zero cultural competence after seeing a patient from the Middle East with jaundice” [P233]. Conclusion The study demonstrates a proof of concept that students can be exposed to complex care needs and challenging consultations under indirect supervision, demonstrating the paediatric setting to be a suitable work-based learning host. However, findings are limited to a single cohort of students at a single site, meaning transferability may be limited. Future studies could focus on longitudinal educational and emotional outcomes of students by measuring clinical knowledge, competence and confidence. Utilising post-session debriefs with peers and supervisors created a space to share both pharmaceutical and emotional learning points, aiding in managing the cognitive load of students. This experience not only highlights the requirement of paediatric exposure in pharmacy education programmes to aid the students’ future practice, but the importance of supervised reflective activities following work-based learning experiences.

Mathematical Problem Solving Through Mobile Learning Development Based on Assemblr Edu

Assemblr EDU based on mobile learning as a learning resource can be accessed anytime and anywhere. However, the utilization of these learning resources has not been optimal, so it has an impact on the quality of mathematical problem–solving abilities that need to be improved. The purpose of this research is the development of teaching materials through mobile learning based on EDU Assemblr. The method used is the development of the ADDIE model. Collecting data through observation techniques, interviews, studies from linguists, media design experts, content experts, tests, and questionnaires. The implementation phase of the trial has been carried out on students of class XI MIPA 7 State Senior High School in Bandung, Indonesia. In data analysis, the problem–solving ability test was analyzed quantitatively, and the questionnaire was analyzed qualitatively. The development of mobile learning based on Assemblr EDU received proper criteria from experts. The level of effectiveness and practicality of teaching material products is categorized as sufficient, so that it gets a good attitude from teachers and students. The development of mobile learning based on EDU assemblr as a learning resource facilitates the process of concept construction, interaction, and reflection so that there is an increase in students’ mathematical problem-solving abilities. Keywords: mathematical, problem solving, mobile learning, assemblr edu

When Should Popular Views be Included in a Reflective Equilibrium?

AbstractIt has become increasingly common to conduct research on popular views on ethical questions. In this paper, we discuss when and to what extent popular views should be included in a reflective equilibrium process, thereby influencing normative theory. We argue that popular views are suitable for inclusion in a reflective equilibrium if they approximate considered judgments and examine some factors that plausibly contribute to the consideredness of popular views. We conclude that deliberation and familiarity contribute to the consideredness of popular views, whereas prevalence does not. Furthermore, we raise the “fair trial” objection: that expert deliberation on popular views might fail to respect the consideredness of these views. Eliciting views approximating considered judgments directly from participants is therefore preferable to refining popular views or treating them as “bare” intuitions in the reflective process. These conclusions have important implications for which research methods will likely elicit popular views suitable for a reflective equilibrium process. Research focusing on the prevalence of views is unlikely to yield popular views suitable for a reflective equilibrium, whereas deliberative and in-depth work is more promising.

The impact of incorporating a simulation program into the undergraduate nursing curricula: A cross-sectional descriptive study

AimTo determine the degree of satisfaction for each academic year and according to the type of simulation performed (simulated patient actor/advanced simulator) among nursing students after the use of clinical simulation. IntroductionClinical simulation is currently being incorporated in a cross-cutting manner throughout undergraduate nursing education. Its implementation requires a novel curricular design and educational changes throughout the academic subjects. DesignA cross-sectional descriptive study was performed. MethodsDuring the academic years 2018–2019 and 2019–2020, 425 students completed the High-Fidelity Simulation Satisfaction Reduced Scale for Students based on 25 questions and six factors, with a total score between 0 and 125. In total, 91 simulation sessions were performed among students who had different degrees of clinical and previous experience with simulation as well as standardized patient versus advanced simulator. A bivariate analysis was performed, comparing the total scores and the different subscales by sex, previous experience, academic year, and simulation methodology. Linear regression was used for both bivariate and multivariate analysis. ResultsThe mean scale score was 116.8 (SD=7.44). The factor with the highest score was "F2: feedback or subsequent reflection", with a mean score of 14.71 (SD=0.73) out of 15. Fourth year students scored the highest (mean=119.17; SD=5.28). Students who underwent simulation training with a simulated patient actor presented a higher level of overall satisfaction (p<0.05) (Mean=120.31; SD=4.91), compared to students who used an advanced simulator (Mean=118.11; SD=5.75). ConclusionsSatisfaction with the simulation program was higher in fourth-year students compared to first-year students and was also higher when a simulated patient actor was used compared to an advanced simulator. The most highly valued aspect was the subsequent debriefing or reflective process.

Teaching an Internship Course with an Emphasis on Vocation and Calling

Teaching an Internship Course with an Emphasis on Vocation and Calling

Story-Sharing Facilitation Guide: An Educational Strategy to Develop Strengths-Based Nursing and Healthcare Leaders.

A reflective praxis process has been developed to facilitate story-sharing, an educational strategy grounded in narrative pedagogy. This article describes this strategy, the Story-Sharing Facilitation Guide (SSFG). The guide allows educators to facilitate the telling of a story that often triggers a memory of similar or contrasting experiences. Sharing stories helps learners find personal and professional meaning, develop new insights, and revise actions. The SSFG is underpinned by Dreyfus and Taylor's Contact Theory of how human beings learn and come to know and understand their different life-worlds. The SSFG was developed and used by faculty in a leadership training program. Evaluation results of the program found this to be an effective educational method. The guide provides educators with an intentional process of reflection that deepens learning and allows for labeling the experience and linking it with the concepts being taught. [J Nurs Educ. 2024;63(10):703-708.].