Critical reflection in medical training and the biomedical world view

Wilson, Hamish

doi:10.1111/medu.14077

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…Practicing critical reflection on the composition of one's social network during early significant clinical experiences is one potential curricular intervention to assist students in actively employing diverse and purposeful network connections. 4,13 In this study, participants represented how social network ties can be a form of social support 27,30through discussion, reassurance, guiding, advice, and even listening. This insight signals the power of social relations in stimulating reflection.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7][8][9] In particular, reflection can occur after meaningful or significant experiences and stimulates medical students to understand 'why things are the way they are.' [10][11][12][13] Authentic reflection can be difficult to both capture and implement in a curriculum. [14][15][16][17][18][19] Despite this, medical curricula are creating initiatives to guide reflection.…”

Section: The Power Of Reflectionmentioning

confidence: 99%

“…14 Despite the call for initiatives that stimulate authentic meaningful reflection, 14 we lack empirical evidence that demonstrates the personal ways students may experience reflection as a social phenomenon. 13 The role of social networks While traditionally described as an individual cognitive process, there is growing appreciation for the contributions that social relationships can offer in how we understand reflection. 7,20,22 We know that meaning is often coconstructed and interpreted through communication with others.…”

Section: The Power Of Reflectionmentioning

confidence: 99%

“…38 We asked participants to recall a recent personally significant clinical experience that would incite this type of memory recollection. 13 During the interview, participants were shown an example sociogram (i.e. ego network) to guide the creation of their own sociogram (Appendix A).…”

Section: Data Generation: Social Network Sociogramsmentioning

confidence: 99%

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The ways social networks shape reflection on early significant clinical experiences in medical school

2022

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Background: Medical curricula are increasingly providing opportunities to guide reflection for medical students. However, educational approaches are often limited to formalized classroom initiatives where reflection is prescriptive and measurable. There is paucity of literature that explores the personal ways students may experience authentic reflection outside of curricular time. The purpose of this study was to understand how social networks might shape dimensions of reflection. Methods: This study employed a qualitative social network analysis approach with a core sample of seven first year undergraduate medical students who described their relationships with 61 individuals in their networks. Data consisted of participant generated sociograms and individual semi-structured interviews. Results: Many learners struggled to find significant ways to involve their social networks outside of medicine in their new educational experiences. It appeared that some medical students began in-grouping, becoming more socially exclusive. Interestingly, participants emphasized how curricular opportunities such as reflective portfolio sessions were useful for capturing a diversity of perspectives. Conclusions: Our study is one of the first to characterize the social networks inside and outside of medical school that students utilize to discuss and reflect on early significant clinical experiences. Recent commentary in the literature has suggested reflection is diverse and personal in nature and our study offers empirical evidence to demonstrate this. Our insights emphasize the importance of moving from an instrumental approach to an authentic socially situated approach if we wish to cultivate reflective lifelong learning.

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Section: Discussionmentioning

confidence: 99%

Section: The Power Of Reflectionmentioning

confidence: 99%

Section: The Power Of Reflectionmentioning

confidence: 99%

Section: Data Generation: Social Network Sociogramsmentioning

confidence: 99%

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The ways social networks shape reflection on early significant clinical experiences in medical school

2022

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“…Critical reflection is the process by which adults identify the assumptions governing their actions, locate the historical and cultural origins of the assumptions, question the meaning of assumptions, and develop alternative ways of acting. (Cranton, 1996, p. 6) Structured opportunities for critical reflection (Maudsley & Strivens, 2000) have been uncommon in health professional training (H. Wilson, 2020). Amongst other benefits, such opportunities may enable students to identify the strengths and weaknesses of the biomedical model, to use this model judiciously when appropriate and to realise when its naïve application to complex or "messy" clinical issues can inadvertently create further problems, including over-investigation and over-treatment (Levinson et al, 2018).…”

Section: Critical Reflectionmentioning

confidence: 99%

Walking backwards into the future of health professional practice

Wilson,

O'Hagan,

Williamson

2023

FoHPE

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Health professional education needs to be designed so that future practitioners are well equipped for clinical and professional challenges. While the biomedical model has enabled major biological advances in all health professions, its inherent presuppositions have prevented progress in many of the more complex issues within healthcare, examples being health inequities, somatisation, chronic pain and student/clinician burnout. We suggest that students learn about the scientific origins and tacit assumptions of the biomedical model, such as reductionism, biological plausibility and clinical objectivity. Critical reflection, including interprofessional discussion, can enable students to explore its strengths and limitations. Although biomedicine will remain the dominant paradigm in both training and clinical practice, other “ways of seeing” may be helpful, including biopsychosocial and Indigenous models. Complexity sciences now provide additional understandings of human physiology and socio-cultural processes within healthcare and could also be taught explicitly as core curricula. Student-selected components may enable faculty to pilot educational initiatives in relation to specific professional challenges, which could then be further developed for all students. Critical reflection and teaching innovation are core values of the Australian and New Zealand Association of Health Professional Educators (ANZAHPE). “Walking backwards into the future” in healthcare education means identifying and critiquing our taken-for-granted assumptions, then providing future clinicians with broader frameworks and skills to respond more effectively to persistent challenges in healthcare.

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A participant perspective on collaborative reflection: video-stimulated interviews show what residents value and why

Braak

Giroldi

Huiskes

et al. 2021

Adv in Health Sci Educ

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The potential of reflection for learning and development is broadly accepted across the medical curriculum. Our understanding of how exactly reflection yields its educational promise, however, is limited to broad hints at the relation between reflection and learning. Yet, such understanding is essential to the (re)design of reflection education for learning and development. In this qualitative study, we used participants’ video-stimulated comments on actual practice to identify features that do or do not make collaborative reflection valuable to participants. In doing so, we focus on aspects of the interactional process that constitute the educational activity of reflection. To identify valuable and less valuable features of collaborative reflection, we conducted one-on-one video-stimulated interviews with Dutch general practice residents about collaborative reflection sessions in their training program. Residents were invited to comment on any aspect of the session that they did or did not value. We synthesized all positively and negatively valued features and associated explanations put forward in residents’ narratives into shared normative orientations about collaborative reflection: what are the shared norms that residents display in telling about positive and negative experiences with collaborative reflection? These normative orientations display residents’ views on the aim of collaborative reflection (educational value for all) and the norms that allegedly contribute to realizing this aim (inclusivity and diversity, safety, and efficiency). These norms are also reflected in specific educational activities that ostensibly contribute to educational value. As such, the current synthesis of normative orientations displayed in residents’ narratives about valuable and less valuable elements of collaborative reflection deepen our understanding of reflection and its supposed connection with educational outcomes. Moreover, the current empirical endeavor illustrates the value of video-stimulated interviews as a tool to value features of educational processes for future educational enhancements.

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Critical reflection in medical training and the biomedical world view

Abstract: Reflection has long been promoted as a means to encourage medical student professional development, but can it do more? This commentary encourages reflection to help students examine and critique the underlying assumptions of modern medicine.

Cited by 5 publications

References 16 publications

The ways social networks shape reflection on early significant clinical experiences in medical school

The ways social networks shape reflection on early significant clinical experiences in medical school

Walking backwards into the future of health professional practice

A participant perspective on collaborative reflection: video-stimulated interviews show what residents value and why

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