Self-Reflection And Insight Scale Research Articles

Predictors Affecting the Attitude Towards Homosexuality Among Health Sciences University Students in East Coast Malaysia

Introduction As a minority group homosexuality poses the risk of various mental illnesses and medical comorbidities. In Malaysia, homosexuality is prohibited according to culture, law, and religion. Thus, this group is reluctant to seek help due to the negative attitude of certain healthcare professionals. Healthcare professionals’ negative attitudes towards this group may negatively impact patient care quality. This study aimed to identify predictors of health sciences students’ attitudes toward homosexuality. Materials and methods An online cross-sectional study was conducted among 307 undergraduate clinical students at a university on the east coast of Malaysia from December 2020 to February 2021. The instruments consisted of the Homosexual Attitude Scale Malay Version (HASMV), Self-Reflection and Insight Scale (SRIS), and Duke University Religion Index (DUREL). Results The mean (SD) age of participants was 22.91 (0.78) years old. The majority are female, Malay, and Muslim. Mean (SD) scores of attitudes towards homosexuality among health sciences students were 61.53 (17.06). Non-Muslims, final-year students, and those with higher self-reflection scores in central and southern Peninsular Malaysia displayed a more positive attitude towards homosexuality, as did students with a history of contact with homosexuals. Students with higher intrinsic religiosity scores were shown to be more negative towards homosexuality. Conclusion The attitude towards homosexuality of Malaysian future health practitioners leaned mostly towards the positive attitude towards homosexuality. These findings shall aid the relevant authorities in revising the curriculum to raise awareness about homosexual health, as well as arranging training programs. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1120-1128

Mental Pain Correlates with Mind Wandering, Self-Reflection, and Insight in Individuals with Psychotic Disorders: A Cross-Sectional Study.

Understanding the cognitive processes that contribute to mental pain in individuals with psychotic disorders is important for refining therapeutic strategies and improving patient outcomes. This study investigated the potential relationship between mental pain, mind wandering, and self-reflection and insight in individuals diagnosed with psychotic disorders. We included individuals diagnosed with a 'schizophrenia spectrum disorder' according to DSM-5 criteria. Patients in the study were between 18 and 65 years old, clinically stable, and able to provide informed consent. A total of 34 participants, comprising 25 males and 9 females with an average age of 41.5 years (SD 11.5) were evaluated. The Psychache Scale (PAS), the Mind Wandering Deliberate and Spontaneous Scale (MWDS), and the Self-Reflection and Insight Scale (SRIS) were administered. Statistical analyses involved Spearman's rho correlations, controlled for potential confounders with partial correlations, and mediation and moderation analyses to understand the indirect effects of MWDS and SRIS on PAS and their potential interplay. Key findings revealed direct correlations between PAS and MWDS and inverse correlations between PAS and SRIS. The mediation effects on the relationship between the predictors and PAS ranged from 9.22% to 49.8%. The largest statistically significant mediation effect was observed with the SRIS-I subscale, suggesting that the self-reflection and insight component may play a role in the impact of mind wandering on mental pain. No evidence was found to suggest that any of the variables could function as relationship moderators for PAS. The results underscore the likely benefits of interventions aimed at reducing mind wandering and enhancing self-reflection in psychotic patients (e.g., metacognitive therapy, mindfulness). Further research will be essential to elucidate the underlying mechanisms.

What is metacognitive reflection? The moderating role of metacognition on emotional regulation and reflection

IntroductionThis paper explores the trilateral relationship among metacognition, emotional regulation, and reflection under the integrative framework of metacognitive reflection.MethodsData were gathered from undergraduate participants at a large state university on the East Coast (N= 493). The quantitative data were derived from: the Metacognitive Awareness Inventory (MAI), the Self-Reflection and Insight Scale (SR-IS), and the Cognitive Reappraisal Scale (ERQ). Data analysis consisted of structural equation modeling (SEM) in which the associations between latent constructs were tested. Emotional regulation and metacognition were found to be positively and significantly related to the latent construct of reflection.ResultsSEM results indicated that emotional regulation (which emerged as the strongest predictor) together with metacognition predicted 52% of the variance in reflection. Moreover, the latent moderation model showed that metacognition significantly moderated the relationship between emotional regulation and reflection such that emotional regulation was a strong and positive predictor of reflection when students simultaneously showed high levels of metacognition. In contrast, emotional regulation did not significantly predict reflection for students with low levels of metacognition. The alternative model showed that emotional regulation also moderated the relationship between metacognition and reflection such that metacognition contributed to reflection the most when participants simultaneously showed high levels of emotional regulation.DiscussionThese findings suggest the interaction between metacognition and emotional regulation is critical in the gamut of reflection.

The Effect of Holistic Nursing Competence on Work Engagement, Self-Reflection and Insight in Nurses.

This study aimed to examine the effects of holistic nursing competence on work engagement, self-reflection and insight in nurses. This descriptive and cross-sectional study was conducted with 309 nurses working in Turkey. Data were collected using the "Descriptive Information Form", "Holistic Nursing Competence Scale (HNCS)", "Utrecht Work Engagement Scale (UWES)", and "Self-Reflection and Insight Scale (SRIS)". Pearson correlation analysis and multiple linear regression analysis were used to analyze the data. We found that the HNCS had a moderate positive relationship (r = 0.411, p < 0.05) with the UWES, and a weak positive relationship (r = 0.324, p < 0.05) with the SRIS. In the model established by multiple regression analysis, the effect of the HNCS, age, marital status, position, and performing the profession willingly on work engagement explained 33.7% of the variance. In another established model, the effect of the HNCS, gender, and having children on self-reflection and insight explained 11.5% of the variance. Our findings revealed the effect of holistic competence on nurses' positive attitudes about their work engagement and self-reflection in practice. We recommended developing awareness-based programs for nurses to increase their holistic nursing competence.

Exploration of Grit, Self-Reflection and Insight, and Anxiety: A Multisite Study of Doctor of Physical Therapy Students

Introduction. Physical therapist education is rigorous and challenging and reports of mental health concerns in college-aged students continue to rise. Review of Literature. Although the association between student mental health and behavioral characteristics has garnered interest, few researchers have examined the relationship across educational programs and years of study. This study aimed to investigate grit, self-reflection, and anxiety in Doctor of Physical Therapy (DPT) students. Methods. In this cross-sectional study, 535 DPT students (years 1, 2, 3) enrolled in 3 programs were invited to complete a demographic survey, Grit scale (Grit-S), State portion of the State-Trait Anxiety Inventory (STAI-S), and Self-Reflection and Insight Scale (SRIS). Data analysis summarized demographic variables and survey scores and explored differences and associations among schools, years of study, and demographic variables. Results. Two hundred fifty-four students (72.7% female; 76.8% Caucasian; 70.9% aged 20–25 years) participated; response rate of 47.5%. Mean survey scores for Grit-S (3.73; ± .52), SRIS composite (92.01; ± 12.54), and STAI-S (41.94; ± 11.66) showed no meaningful differences among schools. Grit scale scores were lowest in the second year and highest in year 3. Female participants scored higher than male participants on the SRIS engagement subscale. Higher Grit-S scores were associated with lower anxiety scores and higher composite SRIS scores. Higher SRIS composite scores were associated with less anxious students. Anxiety scores were inversely related to insight scores. Discussion. Doctor of Physical Therapy student grit scores were generally consistent with published means for health professional students. Self-Reflection and Insight Scale scores for DPT students were higher than nursing and medical students. Students exhibited higher state anxiety scores compared with the general population. Grit Scale changes over time may reflect curricular experiences and growing sense of competence. Relationships among grit, self-reflection, and anxiety may represent an important finding with potential to prompt proactive interventions or support. Further research is needed to understand the impact of demographic factors.

Self-reflection, insight, and mood disorder symptoms: Evaluating the short form of the self-reflection and insight scale with clinical interviews and self-reports

The 20-item Self-reflection and Insight Scale (SRIS) is a widely used measure of individual differences in self-focused attention and private self-consciousness. In the present research, we examined the validity of a 12-item short form of the SRIS, which was recently developed based on item response theory models. Measures related to mental health and well-being were used as criteria for evaluating the relative effect sizes for the long and short SRIS. In Study 1 (n = 278 adults), the short and long SRIS scores had highly similar correlations with dimensional measures of depression, anxiety, and stress symptoms as well as with neuroticism. In Study 2 (n = 78 adults), participants were classified into major depression and healthy control groups based on structured clinical interviews. The short and long SRIS had similar profiles of differences between the two groups. Taken together, the studies suggest that the short forms effectively recover the effect sizes of the long forms, so the briefer SRIS would be a good option when time and survey space are tight.

Building a foundation in self-awareness: Genetic counseling students' experiences with self-care, reflection, and mindfulness.

Stress and anxiety are significant concerns for practicing genetic counselors as well as genetic counseling students and can have downstream effects on patient care. Prior research suggests graduate-level training in self-awareness practices such as self-care, reflection, and mindfulness could have lasting effects for genetic counselors, their patients, and the profession as a whole. This mixed-methods study assessed self-awareness among 154 genetic counseling graduate students using the Self-Reflection and Insight Scale (SRIS), the Mindfulness Attention Awareness Scale (MAAS), and self-described experiences with self-awareness practice. Genetic counseling students had significantly lower mean scores on the MAAS and the Insight subscale of the SRIS compared with other health professionals, indicating that genetic counseling students have lower levels of mindfulness and may lack insight into their thoughts and feelings. After starting genetic counseling graduate programs, students were more likely to reduce participation in active self-awareness practices such as physical activity and mental health counseling. Most students reported having structured practice in self-care (n=97, 63%), reflection (n=125, 81.2%), and mindfulness (n=77, 50%) as a part of their training programs. Second-year genetic counseling students reporting mindfulness practices had significantly higher scores on the Insight subscale of the SRIS than those who did not, indicating that students engaged in mindfulness practice are better able to understand their thoughts, feelings, and behavior. The majority of students reported benefitting from structured practice in self-care (n=63, 64.9%), reflection (n=101, 80%), and mindfulness (n=54, 70.1%). Open-ended responses regarding students' perceived benefits and limitations of structured practice were analyzed for recurrent themes. Students reported improved self-awareness which enhanced their counseling relationships during clinical rotations. However, they also perceived that implementation of self-awareness practices may have been inconsistent. Findings from this study have implications for integrating self-awareness practices into genetic counseling graduate curriculum.

Measures of empathy and the capacity for self-reflection in dental and medical students

BackgroundEmpathy and self-reflection have been studied among medical students, but fewer studies have examined the presence of these attributes among dental students and investigated the correlation between empathy and self-reflection.MethodsFirst-year dental and medical students (n = 198) beginning their studies at the University of Oulu, Finland in August 2017 participated in this study, which was conducted via an internet-based questionnaire. Data were collected on personal characteristics and scores on Davis’s Interpersonal Reactivity Index (IRI) and Roberts’s Self Reflection and Insight Scale (SRIS).ResultsDifferences in IRI scores between dental and medical students were significant only in male students and in two IRI domains. Mean (SD) scores for male dental and medical students were personal distress, 8.2 (4.0) and 10.7 (3.1) (p = 0.022); empathic concern, 15.0 (4.0) and 16.9 (3.5) (p = 0.054). Mean SRIS scores did not differ between sexes or training programs. Positive correlations (r = − 0.3–0.65) were observed between some empathy and self-reflection subscales.ConclusionsA lower degree of empathy was observed among male dental students than in male medical students. A positive correlation between empathy and self-reflection was demonstrated in both study groups and sexes. However, more research in this field is warranted.

The self-reflection and insight scale: applying item response theory to craft an efficient short form

The human ability for self-consciousness—the capacity to reflect on oneself and to think about one’s thoughts, experiences, and actions—is central to understanding personality and motivation. The present research examined the psychometric properties of the Self-reflection and Insight Scale (SRIS), a prominent self-report scale for measuring individual differences in private self-consciousness. Using tools from Rasch and item response theory models, the SRIS was evaluated using responses from a large sample of young adults (n = 1192). The SRIS had many strengths, including essentially zero gender-based differential item functioning (DIF), but a cluster of poor performing items was identified based on item misfit, high local dependence, and low item difficulty and discrimination. Based on the IRT analyses, a concise 12-item scale, evenly balanced between self-reflection and insight, was crafted. The short SRIS showed strong dimensionality, reliability, item fit, and local independence as well as essentially no gender DIF. Taken together, the many psychometric strengths of the SRIS support its popularity, and the short form will be useful for research and applied contexts where an efficient, concise version is needed.

Examining the Moderator Role of Gender in the Association Between Self-Reflection and Spirituality

Spirituality and religiosity are increasingly becoming a necessity for each individual in supporting the quality and well-being of life. Student involvement in self-reflection affects their spirituality / religiosity. This study aims to determine the relationship between self-reflection and spirituality/religiousness (S/R), which is moderated by gender. This research uses a quantitative approach with a correlational design. The study sample consisted of 124 students with a mean age of 19.4 years. The total sample was obtained from 98 women and 26 men. Sample selected from students majoring in Elementary School Teachers (PGSD) in various semesters with a purposive sampling method. Measuring instruments used are the Ironson-Wood Spirituality/religiousness Index (IWSRI) and The Self-Reflection and Insight Scale (SRIS). Data analysis using Process Macros. The results showed that there was a significant effect of self-reflection on spirituality/religiousness (B=0.669; p=0.000) and gender could not moderate the effect of self-reflection on spirituality/religiousness on students of Elementary School Teachers (PGSD) (B=-0.317; p=0.369). Based on research conducted, it can be concluded that self-reflection significantly influences spirituality/religiousness, and gender is not able to strengthen or weaken the effect of self-reflection on spirituality/religiousness; thus, gender cannot become a moderator between self-reflection and spirituality/religiousness.

Experiential Learning Program to Strengthen Self-Reflection and Critical Thinking in Freshmen Nursing Students during COVID-19: A Quasi-Experimental Study.

This article focuses on the unique needs and concerns of nursing educators and nursing students in the face of the COVID-19 pandemic. During social distancing, interacting with other human beings has been restricted. This would undermine the experiential learning of nursing students. Hence, it is important to develop and evaluate an experiential learning program (ELP) for nursing education. A pre-test and post-test design were used. The study was conducted in a university in Central Taiwan. A total of 103 nursing students participated in the study from February to June 2019. The study intervention was the experiential learning program (ELP), including bodily experiences and nursing activities with babies, pregnant women, and the elderly. After the intervention, the students completed the self-reflection and insight scale (SRIS) and Taiwan Critical Thinking Disposition Inventory (TCTDI) as outcome measures. An independent t-test showed that there was a significant difference between pre-test and post-test in both SRIS and TCTDI (p < 0.01). The Pearson product–moment correlation analysis showed that SRIS and TCTDI were significantly positively correlated (p < 0.01). ELP has a significant impact on the self-reflection and critical thinking of first-year nursing students, which can be used as a reference for the education of nursing students. During these turbulent times, it is especially vital for faculties to provide experiential learning instead of the traditional teaching concept.

A Constructive Blended Approach to Ethical Reasoning: The Impact on Medical Students’ Reflection and Learning

Background: Teaching medical ethics is currently one of the most essential parts of medical education. Objectives: The present study aimed to design a blended learning program based on a constructive approach to ethical reasoning and determine its effect on the students’ reflection and learning. Methods: This quasi-experimental, single-group, pretest-posttest study was conducted on 35 students who took the medical ethics course in a university of medical sciences. Case studies were presented to the students in a discussion forum, and the main concepts in question were then addressed through interactive lectures and group discussions. Data were collected using the Self-Reflection and Insight scale (SRIS) developed by Grant et al. to assess reflection, with 20 items in three domains. The students’ ethical reasoning was assessed using multiple-choice and open-ended questions and the Objective Structured Clinical examination (OSCE). The relationships between the tests were assessed by calculating the correlation between them. The results of the multiple-choice questions were compared with those of students in the previous year (with the same teacher and content), using the independent t-test. Results: Assessing the mean scores before and after the intervention showed a significant increase in the students’ reflection in all three domains, including the need for self-reflection, encouraging reflection, and insight after the intervention. The findings also showed a significant relationship between the students’ final scores and their virtual round and OSCE scores (P &lt; 0.05). In the final theoretical test, the students’ mean scores were significantly higher than those of students in the previous year (P &lt; 0.001). Conclusions: The proper use of technology with a blended learning approach can help improve the students’ quality of learning and reasoning.

Nursing Student Interprofessional Simulation Increases Empathy and Improves Attitudes on Poverty

ABSTRACTPoverty is increasing and it has adverse effects on health. Nurses need to understand how to help patients in poverty meet health goals within interprofessional teams. Nursing students and Veteran’s Affairs employees, consisting of patient care and support staff, were recruited for an interprofessional poverty simulation. Prior to and directly following the simulation, participants were asked to complete the Attitudes about Poverty and Poor People (APPP) scale, the Toronto Empathy Questionnaire (TEQ), and the Self Reflection and Insight Scale (SRIS). Scores on the APPP and TEQ improved. The SRIS results had no significant changes. Interprofessional simulation positively impacts attitudes toward poverty and empathy in nursing students and health professionals.

Validating Self-Reflection and Insight Scale to Measure readiness for Self-Regulated Learning.

BACKGROUND:Professional behavior of physicians is under scrutiny by medical associations, media, and patients; therefore, medical students are expected to be self-directed learners rather than the passive ones. One of the useful strategies for professional development and life-long learning of students is self-regulated learning. Self-regulation concept and lifelong learning commitment are in the heart of medical practice. Therefore, this study aimed to evaluate the validity of Self-Reflection and Insight Scale (SRIS) to inspect the medical students’ readiness for self-regulation.MATERIALS AND METHODS:SRIS was translated according to the Sousa and Rojjanasrirat guideline. To examine the reliability and validity evidence of the scale, 136 medical students from Tehran University of Medical Sciences completed the questionnaire. Internal consistency and intraclass correlation were used to examine the reliability evidence, as well as qualitative content validity, and confirmatory factor analysis and exploratory factor analysis (EFA) were used to examine the construct validity of the scale.RESULTS:The content validity of the scale was verified. Cronbach's alpha and the Interclass Correlation Coefficient value for the four-factor model was 0.87 and 0.79, respectively. Goodness-of-fit indices displayed acceptable and poor values (P = 0.0001, χ2 = 373.51, df = 167, Root Mean Square Error Of Approximation = 0.096, standardized root mean square residual = 0.12). EFA was conducted; a well-structured model was achieved through the EFA. The new four-factor model was extracted as the best model by performing EFA.CONCLUSION:SRIS Persian version is saturated with four factors and has desirable content validity and constructs reliability.

Autorreflexão e insight como dimensões da autoconsciência privada: uma revisão da literatura

Investigações da autoconsciência têm envolvido o uso de escalas na aferição de suas dimensões e relação com cognição e comportamento, como a Escala de Autorreflexão e Insight (EAI), desenvolvida para mensurar a dimensão privada da autoconsciência. O instrumento parte do pressuposto de que autorreflexão e insight, componentes metacognitivos, estariam envolvidos no processo de refletir, avaliar e regular os próprios pensamentos, sentimentos e comportamentos. Esta revisão sistemática procurou entender a relação entre autorreflexão e insight na cognição e no comportamento por meio da análise de estudos empíricos que utilizaram a EAI, publicados entre 2002 e 2017, disponíveis no Portal de Periódicos CAPES, e recuperados a partir dos termos “autoconsciência”; “autorreflexão”; “EAI”, e seus equivalentes em inglês, incluindo também “insight ”. Resultados apontam para uma associação entre insight e reações saudáveis, porém divergem sobre os benefícios da autorreflexão. Essa relação e os aspectos que a influenciam são discutidos.

Validity and Reliability of the Self-Reflection and Insight Scale for Korean Nursing Students

Purpose The purpose of this study was to translate the Self-Reflection and Insight Scale (SRIS) into Korean and test its validity and reliability. Methods Participants were 340 nursing students who were recruited from 5 nursing colleges in Korea. Data were collected from November 21 to December 20, 2016 and analyzed using the IBM Statistics SPSS 22.0 and AMOS 23.0 programs. Exploratory factor analysis, Confirmatory factor analysis, and concurrent validity analysis were performed. Results For the Korean-SRIS (K-SRIS) 4 items were deleted from the original SRIS. The final scale consisted of 16 items which were sorted into- the 2 factors: self-reflection (11 items), insight (5 items). The cumulative percent of variance was 50.91%. The statistically significant correlation between K-SRIS scores and the Reflection in Learning Scale (RLS) support the concurrent validity of the K-SRIS. The reliability of the scale, Cronbach's α was .83. Conclusion The finding indicate that the K-SRIS has validity and reliability. Therefore it can be used for measuring and developing reflection ability in nursing students. 주요어: 성찰, í†µì°°ë ¥, 간호학생, 타당도, ì‹ ë¢°ë„ Key words: Reflection, Insight, Nursing students, Validity, Reliability

An integrated model for the effects of self-reflection and clinical experiential learning on clinical nursing performance in nursing students: A longitudinal study

BackgroundThe use of clinical simulation in undergraduate nursing programs in Taiwan has gradually increased over the past 5years. Previous research has shown that students' experience of anxiety during simulated laboratory sessions influences their self-reflection and learning effectiveness. Thus, further study that tracks what influences students' clinical performance in actual clinical sites is vital. ObjectiveThe aim of the study is to develop an integrated model that considers the associations among anxiety, self-reflection, and learning effectiveness and to understand how this model applies to student nurses' clinical performance while on clinical placement. DesignThis study used a correlational and longitudinal study design. MethodsThe 80 nursing students, who ranged in age from 19 to 21 (mean=20.38, SD=0.56), were recruited from a nursing school in southern Taiwan. Data were collected during three phases of implementation using four questionnaires. During the first phase, the State-Trait Anxiety Inventory (STAI), Simulation Learning Effectiveness Scale (SLES), and Self-Reflection and Insight Scale (SRIS) were used after students completed the simulation course in the school simulation laboratory. Nursing students also completed the Holistic Nursing Competence Scale at 2months (Phase 2) and 4months (Phase 3) after clinical practice experience. In Phase 3, students again completed the STAI and SRIS. Partial least squares (PLS), a structural equation modeling (SEM) procedure, was used to test the research model. ResultsThe findings showed that: (1) at the start of the simulation laboratory, anxiety had a significant negative effect on students' simulation learning effectiveness (SLE; β=−0.14, p<0.05) and on self-reflection with insight (SRI; β=−0.52, p<0.01). Self-reflection also had a significant positive effect on simulation learning effectiveness (β=0.37, p<0.01). Anxiety had a significant negative effect on students' nursing competence during the first 2months of practice in a clinical nursing site (β=−0.20, p<0.01). Simulation learning effectiveness and self-reflection and insight also had a significant positive effect on nursing competence during the first 2months of practice in a clinical site (β=0.13; β=0.16, p<0.05), respectively; and (2) when students practice in a clinical setting, their previous experience of nursing competence during the first 2months of clinical care and their self-reflection and insight have a significant positive effect on their 4-month nursing competence (β=0.58; β=0.27, p<0.01). Anxiety, however, had a negative effect on 4-month nursing competence but not significantly. Overall, 41% of the variance in clinical nursing performance was accounted for by the variables in the integrated model. ConclusionThis study highlights that self-reflection with insight and clinical experience may help students to deflect anxiety that may influence the development of clinical competence. Of note is that real-life clinical experience has a stronger effect on enhancing clinical performance than does a simulation experience.

Determinants of nursing competence of nursing students in Taiwan: The role of self-reflection and insight

A nursing practicum course is critical to strengthening the nursing competence of nursing students. Research has found that practice stress and coping behaviors can have either a negative or positive influence on the learning and practice performance of nursing students. Nevertheless, there are few evidence-based studies related to the relationship between self-reflection and insight and nursing competence in Taiwanese nursing students. To test the determinants and the effect of self-reflection and insight on nursing competence in nursing students during the first 2 months of their practice experience. Cross-sectional and correlational research designs were employed. From September to November 2013, a total of 312 nursing students at a junior college in southern Taiwan served as participants in this study. Four questionnaires were used to collect data: Self-reflection and Insight Scale (SRIS), Perceived Stress Scale (PSS), Coping Behavior Inventory (CBI), and Holistic Nursing Competence Scale (HNCS). The research model was evaluated through structural equation modeling (SEM), with the use of the partial least squares (PLS) method. Results indicated that self-reflection and insight, practice stress, and practice coping behavior were statistically significantly associated with nursing competence. In addition, self-reflection and insight were significantly and positively associated with practice coping behavior and negatively associated with practice stress. Students' coping behavior partially mediates the effect of self-reflection and stress on nursing competence. Overall, these variables explained 39.4% of the variance in these students' nursing competence. Self-reflection and insight affected nursing competence during the practice period. These variables have not only had a direct influence on nursing competence but also an indirect effect through the mediating effect of coping behavior and stress.

An innovative peer assessment approach to enhance guideline adherence in physical therapy: single-masked, cluster-randomized controlled trial.

Clinical practice guidelines (CPGs) are not readily implemented in clinical practice. One of the impeding factors is that physical therapists do not hold realistic perceptions of their adherence to CPGs. Peer assessment (PA) is an implementation strategy that aims at improving guideline adherence by enhancing reflective practice, awareness of professional performance, and attainment of personal goals. The purpose of this study was to compare the effectiveness of PA with the usual case discussion (CD) strategy on adherence to CPGs for physical therapist management of upper extremity complaints. A single-masked, cluster-randomized controlled trial with pretest-posttest design was conducted. Twenty communities of practice (n=149 physical therapists) were randomly assigned to groups receiving PA or CD, with both interventions consisting of 4 sessions over 6 months. Both PA and CD groups worked on identical clinical cases relevant to the guidelines. Peer assessment focused on individual performance observed and evaluated by peers; CD focused on discussion. Guideline adherence was measured with clinical vignettes, reflective practice was measured with the Self-Reflection and Insight Scale (SRIS), awareness of performance was measured via the correlation between perceived and assessed improvement, and attainment of personal goals was measured with written commitments to change. The PA groups improved more on guideline adherence compared with the CD groups (effect=22.52; 95% confidence interval [95% CI]=2.38, 42.66; P=.03). The SRIS scores did not differ between PA and CD groups. Awareness of performance was greater for the PA groups (r=.36) than for the CD groups (r=.08) (effect=14.73; 95% CI=2.78, 26.68; P=.01). The PA strategy was more effective than the CD strategy in attaining personal goals (effect=0.50; 95% CI=0.04, 0.96; P=.03). Limited validity of clinical vignettes as a proxy measure of clinical practice was a limitation of the study. Peer assessment was more effective than CD in improving adherence to CPGs. Personal feedback may have contributed to its effectiveness. Future research should address the role of the group coach.

Does self reflection and insight correlate with academic performance in medical students?

BackgroundMedical students in academic difficulty are often described as lacking insight. The Self Reflection and Insight Scale (SRIS) is a tool for measuring insight which has been validated in medical students. We investigated whether self reflection and insight scores correlate with academic performance in Year 4 medical students from a six year undergraduate medical degree, and whether self reflection and insight changes after one year of clinical training.MethodsSelf reflection and insight scores were measured in 162 students at the start of Year 4 at the University of Western Australia. Performance in end of year written and clinical exams was monitored and correlated with SRIS. Seventy of the students were surveyed again at the start of Year 5 to see if scores changed or were stable after one year of full time clinical training.ResultsWe found no correlation between self reflection or insight and academic performance in written and clinical exams. There was a significant increase in recognition of the need for self reflection in Year 5 compared with Year 4.ConclusionsWhile no correlation was found between this measure of self reflection and insight with academic performance, there was an increase in students’ recognition of the need for reflection after one year of clinical studies. This study is a valuable first step towards a potentially exciting research domain and warrants further longitudinal evaluation with larger cohorts of students using additional measures of achievement.