Assessing student reflection in medical practice. The development of an observer-rated instrument: reliability, validity and initial experiences

Boenink, A. D.; Oderwald, AK; Jonge, Peter de; Tilburg, W. van; Smal, J. A.

doi:10.1046/j.1365-2923.2004.01787.x

Cited by 108 publications

(104 citation statements)

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“…In addition, the durations of Sobral's and our studies were 3 years and 1 year, respectively. Consistent with our findings, Boenink et al (2004) has observed a trend towards a lesser reflective ability. However, students in this study were more proficient in reflecting on their learning methods at baseline.…”

Section: Reflective Abilitysupporting

confidence: 92%

“…Case scenarios are commonly used to elicit reflective responses in terms of professional judgement, ethical values and presumed moral behaviour in conflictual clinical situations (Boenink et al 2004;Norcini 2004). In this study, the themes depicted were patient confidentiality, trust and record keeping (Case Scenario 1), inappropriate consultant behaviour (Case Scenario 2), response to an emergency (Case Scenario 3) and clinical mismanagement by a senior colleague (Case Scenario 4).…”

Section: Methodsmentioning

confidence: 99%

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Reflective ability and moral reasoning in final year medical students: A semi-qualitative cohort study

2011

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Background: Moral reasoning and reflective ability are important concepts in medical education. To date, the association between reflective ability and moral reasoning in medical students has not been measured. Aim: This study tested the hypotheses that, amongst final year medical students, (1) moral reasoning and reflective ability improve over time and (2) positive change in reflective ability favourably influences moral reasoning. Methods: With Institutional Ethical approval, 56 medical students (of a class of 110) participated fully both at the beginning and end of the final academic year. Reflective ability and moral reasoning were assessed at each time using Sobral's reflectionin-learning scale (RLS), Boenink's overall reflection score and by employing Kohlberg's schema for moral reasoning. Results: The most important findings were that (1) Students' level of reflective ability scores related to medicine decreased significantly over the course of the year, (2) students demonstrated a predominantly conventional level of moral reasoning at both the beginning and end of the year, (3) moral reasoning scores tended to decrease over the course of the year and (4) RLS is a strong predictor of change in moral reasoning over time. Conclusion: This study confirms the usefulness of Sobral's RLS and BOR score for evaluating moral development in the context of medical education. This study further documents regression and levelling in the moral reasoning of final year medical students and a decrease in reflective ability applied in the medical context. Further studies are required to determine factors that would favourably influence reflective ability and moral reasoning among final year medical students.

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Section: Reflective Abilitysupporting

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Reflective ability and moral reasoning in final year medical students: A semi-qualitative cohort study

2011

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“…Findings of increased stress levels have motivated a variety of interventions designed to provide sensitivity training (Dashef et al 1974;Hilberman et al 1975), self-awareness (Cadden et al 1969), self-reflection (Killion & Todnem 1991;Maudsley & Fryer-Edwards 2003;Boenink et al 2004), sharing of feelings and well-being (Dashef et al 1974;Coombs & Virshup 1994) discussion of roles as a physician improvement in health habits (Ball & Bax, 2002) and emotional competence (Flowers 2005) as mechanisms for reducing stress and improving coping skills. Observed outcomes included greater awareness of emotional issues in students, improved faculty/ student communication (Cadden et al 1969), less personal isolation and more sensitivity in communication among classmates (Dashef et al 1974).…”

Section: Author Manuscriptmentioning

confidence: 99%

“…While medical teaching on self-reflection and professionalism is more wide spread in the UK (Maudsley & Fryer-Edwards 2003), curricula focusing on MBS and the promotion of self-awareness and self-reflection is less well established in medical schools in the United States (Dannoff & Corbet 2005). The learning objectives of self-awareness and reflection are often challenging to integrate into a medical school curriculum and equally difficult to assess (Boenink et al 2004). There have been a variety of interventions employed to help students alleviate stress, promote well-being and self-reflection, this paper describes the results of an experiential intervention focusing on MBS techniques to achieve these outcomes.…”

mentioning

confidence: 99%

Promoting self-awareness and reflection through an experiential Mind-Body Skills course for first year medical students

et al. 2007

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Background-This research examines student evaluations of their experience and attitudes in an 11 week mind-body skills course for first year medical students.Aims-The aim is to understand the impact of this course on students' self-awareness, selfreflection, and self-care as part of their medical education experience.Methods-This study uses a qualitative content analysis approach to data analysis. The data are 492 verbatim responses from 82 students to six open-ended questions about the students' experiences and attitudes after a mind-body skills course. These questions queried students' attitudes about mind-body medicine, complementary medicine, and their future as physicians using these approaches.Results-The data revealed five central themes in students' responses: connections, self discovery, stress relief, learning, and medical education.Conclusions-Mind-body skills groups represent an experiential approach to teaching mindbody techniques that can enable students to achieve self-awareness and self-reflection in order to engage in self-care and to gain exposure to mind-body medicine while in medical school. IntroductionMedical school is a challenging environment in which students are confronted with multiple psychological and physical stressors; teaching students how to deal with these stressors is important for their health and well-being. Training physicians to focus on self-awareness, self-reflection and self-care may produce more reflective and well balanced doctors who may provide better patient care. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptOne approach to helping students to deal with the stressors of medical school focuses on teaching mind-body skills (MBS) that promote self-awareness, self-reflection and self-care. While medical teaching on self-reflection and professionalism is more wide spread in the UK (Maudsley & Fryer-Edwards 2003), curricula focusing on MBS and the promotion of self-awareness and self-reflection is less well established in medical schools in the United States (Dannoff & Corbet 2005). The learning objectives of self-awareness and reflection are often challenging to integrate into a medical school curriculum and equally difficult to assess (Boenink et al. 2004). There have been a variety of interventions employed to help students alleviate stress, promote well-being and self-reflection, this paper describes the results of an experiential intervention focusing on MBS techniques to achieve these outcomes.Medical students have been surveyed about the physical and psychological challenges of medical school since the early 1970s (Pitts et al. 1961;Linn & Zeppa 1984;Firth 1986;Wolf 1989;Mosley et al. 1994;Stewart et al. 1997). Findings of increased stress levels have motivated a variety of interventions designed to provide sensitivity training (Dashef et al. 1974;Hilberman et al. 1975), self-awareness (Cadden et al. 1969), self-reflection (Killion & Todnem 1991;Maudsley & Fryer-Edwards 2003;Boenink et al. 2004), sharing of feeli...

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“…Los e-diarios han sido utilizados para fomentar la práctica reflexiva en numerosos campos de la educación superior como por ejemplo trabajo social (Rutter, 2006), medicina (Boenink, Oderwald, De Jonge, Van Tilburg y Smal, (2004)), psicología (Jucks, Schulte-Löbbert y Bromme, 2007) o magisterio (Otienoh, 2009;Moon 2006Moon , 2010. La mayoría de estudios que utilizan el diario reflexivo online, lo hacen con el objeto de desarrollar y promover la práctica reflexiva entre el estudiantado tal y como puede revisarse en King y Kitchener (1994), Ross (1990) El diario online puede llevarse a cabo de manera interactiva y dialógica o de manera autobiográfica (Keating, 1993).…”

Section: El Diario Reflexivo Onlineunclassified

Pensamiento reflexivo en el Prácticum I del alumnado de Grado de Maestro en Educación Primaria a través de diarios online

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Diseño y maquetación de portada y tesis: Jose V. Martínez (hando.es) Cada uno de los capítulos que contiene esta tesis doctoral, así como las imágenes incluidas, si no se indica lo contrario, se encuentra sujetos a la Licencia Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional de Creative Commons. Para ver una copia de esta licencia, visite http://creativecommons.org/ licenses/by-nc-nd/4.0/ o envíe una carta Creative Commons, PO Box 1866, Mountain View, CA 94042, USA."Las cosas nunca son como a primera vista las figuramos, y así ocurre que cuando empezamos a verlas de cerca, cuando empezamos a trabajar sobre ellas, nos presentan tan raros y hasta tan desconocidos aspectos, que de la primera idea no nos dejan a veces ni el recuerdo." La familia de Pascual Duarte Camilo José Cela Informe AgradecimientosQuiero manifestar todo mi agradecimiento a aquellas personas que han estado de una u otra forma apoyando este proyecto.En primer lugar agradezco a Jordi Adell y a Lidón Moliner, mis directores de tesis, su dedicación y sus valiosos consejos así como la absoluta confianza que han tenido en mí a pesar de ir siempre contrareloj. Sois un amor.En mis agradecimientos, aunque ya no esté, no puede faltar Marisa Sanchiz.En este camino has sido y eres importante. Tu calidad humana y entrega siempre me servirán de ejemplo e inspiración.A mis padres, por su infinita paciencia, generosidad y apoyo no solo en esta tesis sino en la vida entera.A Jose, por su cariño y su humor, por soportar durante todo este tiempo las renuncias que conlleva la vida del doctorando y por ayudarme a mejorar infinitamente el aspecto de este trabajo.A Esther, por su incondicional amistad y por toda una vida de aventuras.A este tren me he subido sola pero cuando puedas, cuando quieras, aquí estoy para echarte una mano.Por supuesto muchas gracias los profesionales que han dedicado desinteresadamente su tiempo y esfuerzo a este trabajo doctoral. Quienes me ayudaron a validar la entrevista, quienes motivaron a los alumnos para que participaran y quienes se ofrecieron a revisar y mejorar la tesis. Sin duda os debo una.Gracias a todos los alumnos y alumnas que participaron en la investigación y que compartieron sus experiencias a pesar de su siempre escaso tiempo.Gracias también a mi familia, carnal y política, hermano, tios, cuñadas, cuñados y queridísimos sobrinos, por vuestra presencia, cariño y ánimos hasta la meta.También quiero agradecer a los miembros de nuestro recién nacido grupo GREAT no solo los ánimos y los consejos que me habéis dado en el presente sino, especialmente, los que me daréis en el futuro.Y por último, mi más sincero agradecimiento a la web Sci-Hub y a todos aquellos investigadores que comparten de forma libre su conocimiento.

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Assessing student reflection in medical practice. The development of an observer-rated instrument: reliability, validity and initial experiences

Cited by 108 publications

References 10 publications

Reflective ability and moral reasoning in final year medical students: A semi-qualitative cohort study

Reflective ability and moral reasoning in final year medical students: A semi-qualitative cohort study

Promoting self-awareness and reflection through an experiential Mind-Body Skills course for first year medical students

Pensamiento reflexivo en el Prácticum I del alumnado de Grado de Maestro en Educación Primaria a través de diarios online

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