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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.

Abstract:We investigate direct speech quotation in informal oral narratives by analyzing the contribution of bodily articulators (character viewpoint gestures, character facial expression, character intonation, and the meaningful use of gaze) in three quote environments, or quote sequences -single quotes, quoted monologues and quoted dialogues -and in initial vs. non-initial position within those sequences. Our analysis draws on findings from the linguistic and multimodal realization of quotation, where multiple articulators are often observed to be co-produced with single direct speech quotes (e.g. Thompson & Suzuki 2014), especially on the so-called left boundary of the quote (Sidnell 2006). We use logistic regression to model multimodal quote production across and within quote sequences, and find unique sets of multimodal articulators accompanying each quote sequence type. We do not, however, find unique sets of multimodal articulators which distinguish initial from non-initial utterances; utterance position is instead predicted by type of quote and presence of a quoting predicate. Our findings add to the growing body of research on multimodal quotation, and suggest that the multimodal production of quotation is more sensitive to the number of characters and utterances which are quoted than to the difference between introducing and maintaining a quoted characters' perspective.

This is the first research to demonstrate that communication is perceived as more lively when it contains direct speech than when it does not, but yet is not more comprehensible. Individuals with Broca's and anomic aphasia are known to produce regularly direct speech constructions in elicited narratives. Given that liveliness is known to increase listeners' involvement and to help listeners stay focused, we suggest that this relative increase in direct speech by aphasic speakers may reflect a strategy to increase not only the liveliness of their discourse, but also listener focus and involvement.