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REVIEW ARTICLE
Year : 2021  |  Volume : 12  |  Issue : 1  |  Page : 49-51

Inculcating the practice of reflection among medical students: Role of teachers


1 Department of Community Medicine, Medical Education Unit Coordinator and Member of the Institute Research Council, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth–Deemed to be University, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission16-Apr-2021
Date of Acceptance21-Apr-2021
Date of Web Publication03-Sep-2021

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjmsr.mjmsr_11_21

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  Abstract 


Over the years, different regulatory and professional organizations have emphasized the need for medical students to reflect upon their daily learning or clinical interactions to ensure deep learning. An extensive search of all materials related to the topic was carried out in the PubMed search engine, and a total of seven articles were selected for the review. However, we must admit that the practice of reflection is not easy to inculcate, and amid the packed curriculum, it becomes the responsibility of the medical teachers to create opportunities for the students to reflect upon on a regular basis. The best approach for encouraging reflection by medical students will be to not make reflection as an add-on activity, but as a strategy which will enhance meaningful learning and improvement in daily clinical interactions. In conclusion, reflection is an important approach to ensure deep learning among medical students. However, it is the responsibility of all teachers to first teach them about reflection and then use the tool of reflection for the betterment of the students in the entire training period.

Keywords: Medical students, reflection, teachers


How to cite this article:
Shrivastava SR, Shrivastava PS. Inculcating the practice of reflection among medical students: Role of teachers. Muller J Med Sci Res 2021;12:49-51

How to cite this URL:
Shrivastava SR, Shrivastava PS. Inculcating the practice of reflection among medical students: Role of teachers. Muller J Med Sci Res [serial online] 2021 [cited 2021 Nov 27];12:49-51. Available from: https://www.mjmsr.net/text.asp?2021/12/1/49/325474




  Introduction Top


Over the years, different regulatory and professional organizations have emphasized the need for the medical students to reflect upon their daily learning or clinical interactions to ensure deep learning.[1] In fact, reflection among medical students has been identified as one of the key strategies to stay motivated, be satisfied about their learning, become a self-directed and a lifelong learner, and improve the communication skills, empathy, and professional values, which is expected from a healthcare professional.[1],[2],[3] The development in all these attributes through reflection plays an important role in the accomplishment of the desired competencies and thus production of a competent medical student who can meet the needs of the general population.[2],[3]


  Methods Top


An extensive search of all materials related to the topic was carried out in the PubMed search engine. Relevant research articles focusing on teaching reflection to medical students by teachers published in the period 2009–2020 were included in the review. A total of nine studies similar to the current study objectives were initially identified, of which two were excluded due to the unavailability of complete version of the articles. Thus, a total of seven articles were selected for the review. Keywords used in the search include reflection, teachers, and medical students. The collected information is presented under the following subheadings, namely inculcating reflection: role of teachers, methods for encouraging reflection among medical students, additional responsibilities of teachers, evaluation of reflection writing, lessons from the field, and implications for practice.


  Inculcating Reflection: Role of Teachers Top


However, we must admit that the practice of reflection is not easy to inculcate, and amid the packed curriculum, it becomes the responsibility of the medical teachers to not only reflect upon their own behaviors but also create opportunities for the students to reflect upon on a regular basis.[4],[5] The period of foundation course can be effectively utilized by the teachers to sensitize the students about the meaning of reflection in medical practice, role of reflection in making them a better clinician, reflection writing skills, etc. Subsequently, it becomes the responsibility of each of the teachers to encourage the practice of reflection by medical students under different settings and ensure that it is being followed up throughout the training period.[4],[5]


  Methods for Encouraging Reflection among Medical Students Top


The best approach for encouraging reflection by medical students will be to not make reflection as an add-on activity, but as a strategy which will enhance meaningful learning and improvement in daily clinical interactions.[4] It is always recommended to specify the learning goals for the reflection exercise so that students know why it is being done by them. Students can be either given an ethical dilemma or asked to reflect upon any clinical scenario (critical incident report) which they noticed either in hospital or community visits.[3],[4],[5] The idea is that the situation cannot be resolved using already known problem-solving strategies, rather make the medical students think about the entire scenario, and then select their approach to respond to the given scenario.[1],[3]


  Additional Responsibilities of Teachers Top


Further, the teachers should predetermine the settings (viz., in class or in home) and the type (such as oral or written or audio recordings or digital) of reflection by medical students.[4],[6] In the field of medicine, reflection usually happens after the occurrence of a specific event and thus helps the student to improve their behavior in future similar settings.[4] Considering that reflection writing might make the medical students to share their ethical or emotional concerns, the teachers should be ready with a strategy to deal such emotional thoughts and not disregard it. As the idea of reflection is to enhance learning, there has to be a mechanism which helps the student to bridge their learning gaps either via feedback given by the teachers or by developing a shared action plan to pace their learning.[3],[4],[5]


  Evaluation of Reflection Writing Top


Another important aspect is an evaluation of reflection since it gives a feeling to the students that their opinions are being given importance and thereby it motivates learning.[7] The teachers can give feedback to the students either in groups or in person, but it has to be practiced. The process of teaching reflection cannot be considered complete unless the teachers also reflect upon the way they are teaching reflection to medical students and how it can be further improved.[4],[5],[7] Thus, it has to be a dynamic process, wherein teachers remain dedicated to the entire process and help medical students to become proficient in different skills, including team building.[4]


  Lessons from the Field Top


At Shri Sathya Sai Medical College and Research Institute, a constituent unit of Sri Balaji Vidyapeeth, Deemed-to-be University, Puducherry, multiple steps have been taken to encourage undergraduate and postgraduate students to record their reflections about their learning. For undergraduate medical students enrolled under the competency-based undergraduate curriculum, as a part of their daily learning, students are motivated to not only maintain logbook (as per the regulatory body norms) but even encourage to record their reflections. Further, the undergraduate students are being involved as participants in the faculty projects in the medical education projects so that their reflection skills can be improved.

For postgraduate medical students, specific sessions have been organized to train them about reflection writing. Moreover, as a part of the task of maintenance of e-portfolio, postgraduate students are being encouraged to write reflections. In fact, to assist then in this task, each postgraduate student has been associated with one of the department-level faculty members, who motivates the student to always document their reflections in all areas of learning (viz., seminars, case presentation, unique cases, journal clubs, procedures, conference presentations, and participation in camps).


  Implications for Practice Top


Teachers have a crucial role to play in developing reflection writing skills among undergraduate and postgraduate medical students. However, to assist them in doing so, it is a must that they are themselves first trained. The Medical Education Unit of any medical college has to play a defining role in the process of capacity building by conduction of sensitization sessions and workshops. These sessions should orient the teaching staff about what is reflection, how to do (different frameworks to record reflection), the role of reflection in ensuring learning progression, and training them about the ways to encourage medical students to reflect upon. It is always a nice thing that the teachers should first start reflecting themselves using a structured framework, as then only they can guide the students also about the same.


  Conclusion Top


Reflection is an important approach to ensure deep learning among medical students. However, it is the responsibility of all the teachers to first teach them about reflection and then use the tool of reflection for the betterment of the students in the entire training period.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sandars J. The use of reflection in medical education: AMEE Guide No. 44. Med Teach 2009;31:685-95.  Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS. Scope of reflection in medical education. Int J Acad Med 2018;4:187-8.  Back to cited text no. 2
    
3.
Winkel AF, Yingling S, Jones AA, Nicholson J. Reflection as a learning tool in graduate medical education: A systematic review. J Grad Med Educ 2017;9:430-9.  Back to cited text no. 3
    
4.
Aronson L. Twelve tips for teaching reflection at all levels of medical education. Med Teach 2011;33:200-5.  Back to cited text no. 4
    
5.
Wear D, Zarconi J, Garden R, Jones T. Reflection in/and writing: Pedagogy and practice in medical education. Acad Med 2012;87:603-9.  Back to cited text no. 5
    
6.
Sandars J, Murray C. Digital storytelling for reflection in undergraduate medical education: A pilot study. Educ Prim Care 2009;20:441-4.  Back to cited text no. 6
    
7.
Veno M, Silk H, Savageau JA, Sullivan KM. Evaluating one strategy for including reflection in medical education and practice. Fam Med 2016;48:300-4.  Back to cited text no. 7
    




 

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