Using reflection to influence practice: student perceptions of daily reflection in clinical education

Abstract

PurposeReflection is a key element in learning from experience, but the impact of most programmes of reflection on daily practice remains unclear. We investigated students’ perceptions of adding a daily written reflection assignment to a clinical rotation.MethodsThird-year medical students on a single two-week rotation completed daily reflections analyzing their performance. Programme evaluation used a 33-question anonymized survey. Quantitative data were summarized and qualitative responses coded for recurring themes.ResultsTwenty-six students completed the survey (90 % response rate). Eighty-five percent of students felt that the daily reflections had a positive impact on their learning from clinical experience. Seventy-seven percent of students reported that the programme changed their awareness of their thoughts and actions, and 80 % felt that it improved their recall of experiences. A greater sense of mindfulness and focus on self-improvement were major themes that emerge from students’ descriptions of the role of daily reflections in their learning.ConclusionOverall, daily reflections demonstrated a positive learning influence. This exploratory study suggests students may benefit from more frequent, short reflections as opposed to more typically spaced reflective assignments.Electronic Supplementary MaterialThe online version of this article (doi:10.1007/s40037-016-0293-1) contains survey questions that are available to authorized users.

Reflection in Learning

“…Agouridas and Race (2007) also agreed that we can step back and reflect on the process of assignments and think of their broader meanings. Larsen, London, and Emke (2016) argued that reflection is not just for social purpose, it can also be used to "influence students' learning from experience, increase their awareness of their thoughts and actions, and increase their perceived recall of experiences" (p. 285). When students conduct the reflections, they repeatedly retrieve the information from memory, and the retention of experience is thereby increased.…”

“…We value the importance and relationships of all parties involved" (Bowne, Cutler, DeBates, Gilkerson, & Stremmel, 2010, p. 49). Larsen, London, and Emke's (2016) research indicates that in reflection processes, learners can exchange perspectives among group members and reevaluate their original perspectives. Different perspectives and alternative ways of solving problems can be generated in this dialogic reflection process.…”

Benefits of Reflective Writing in Health Care through the Vivid Lens of House Officers

“…Reflection is a metacognitive process in which a person is engaged in attentive, critical, exploratory and iterative interactions with his thoughts and actions to change them, hence it is powerful equipment of experiential learning (Fragkos, 2016;Larsen, London and Emke, 2016;Asiah Mohd Sharif, 2017). Attention to self and critical reflection on the situation are two necessary elements for continued competence (Sanders, 2015;Fragkos, 2016).…”

“…Usually reflective diaries, portfolios, blogs, journals, poetry, some short stories, novels or books are used for written reflections (Korthagen, 1993). Most of the work on reflective writing has been done in nursing (Moattari, 2007) and Larsen et al (2016) stated that it is rarely a formal part of the daily work of medical education or practice. Checklists, portfolios and other tools that are being used to encourage reflection that are isolated from original theories of reflection and reflective practice, hence the main essence of reflection has been lost (Larsen, London and Emke, 2016).…”

“…Most of the work on reflective writing has been done in nursing (Moattari, 2007) and Larsen et al (2016) stated that it is rarely a formal part of the daily work of medical education or practice. Checklists, portfolios and other tools that are being used to encourage reflection that are isolated from original theories of reflection and reflective practice, hence the main essence of reflection has been lost (Larsen, London and Emke, 2016). Despite the importance of reflective writing, there is general lack of awareness of different purposes of reflection for learning.…”