Development of reflective judgement in the pre‐doctoral dental clinical curriculum

Abstract

When dental students begin patient care in the clinical curriculum, they are required to move from the well-defined problems of the classroom to the more ambiguous and real life problems encountered in the context of patient care in the clinical setting. This change in learning environment requires development of reflective thinking. Reflective thinking refers to the process of thinking about uncertainty or ill-defined problems. King and Kitchener refer to the outcome of the reflective thinking process as reflective judgement. The purpose of this study was to explore the development of reflective judgement in the initial phase of the clinical curriculum. This exploratory study used a case study approach with qualitative methods. A convenience sample of third year predoctoral dental students (n = 16) volunteered to participate in writing a clinic journal and semi-structured interviews at three time points over a time period of one year. Student compliance in writing clinical journals was poor; therefore the qualitative data was primarily gathered from interview transcripts. The qualitative interview data were analysed using a coding scheme based on King and Kitchener's Reflective Judgement Model of Intellectual Development. The Cronbach alpha was 0.76 for reliability of the coding scheme. Based on the analysis of interview data, the there was an average growth in reflective judgement over the year from Stage 4.89 to 5.59 for an overall change of +0.70. Additional research is needed to explore the growth in reflective judgement over the final year of the clinical curriculum as well as to identify the most effective educational strategies to facilitate growth in reflective judgment.

A Preliminary Study of Polish Students’ Aptitude for Thinking Reflexively, Differentiated by Higher Education Faculties and the Level of Study

“…The levels of reflexive thinking amongst master's students were placed in-between the bachelor's and the doctoral students scores, although they scored closer to this second group. The research results were not particularly surprising, as they correspond with previous studies on this topic (Boyd 2008;Fischer and Pruyne 2002;King and Kitchen 2004;Perkowska-Klejman 2014). There were however some deviations from this tendency, where reflexive thinking was demonstrated by students at lower levels of education and non-reflexive thinking in students at higher levels.…”

“…It was presupposed that most likely, the highest level of reflexive thinking would be found amongst doctoral students and master level students. The basis for such an assumption were found in statistical correlations from previous studies (Boyd 2008;Fischer and Pruyne 2002;King and Kitchen 2002;PerkowskaKlejman 2014). No hypothesis were formed about the interrelation between system of study and reflexivity level, since no previous research was found about this particular correlation.…”

Epistemic cognition in medical education: a literature review

“…Researchers should take into consideration epistemic aims and epistemic values that contribute to nuances in individuals’ conceptions and behavior 5 . Also, while few studies examine epistemic cognition in other health fields, there is evidence that sophistication of epistemic beliefs with experience occurs across professions 67 , 68 . Studies comparing epistemic orientations including biomedical or biopsychosocial orientations 68 or patterns of knowing for practice among medical, nursing and allied health fields 69 , 70 , 71   could provide further insights for both medical and inter-professional education.…”

Soft Skills of Dental Students’ Competence: What is Important for Patients and How do Students Fare?

“…Interestingly, of late there has been a greater effort to include feedbacks from recent graduates and their employees in evaluating the effectiveness of soft skills training in the dental school environment. [6][7][8] On this note, the inclusion of patients -who are recipients of dental care -has great potential as a source of authentic feedback of the students' soft skills but has yet to be fully explored. The development of a new assessment tool to evaluate dental students' communication skills was recently undertaken.…”

“…To further enhance these efforts to assess, improve, and maintain the quality of dental education in the university, evaluations are carried out using both internal and external processes. [8][9][10] Patients who receive treatment performed by dental students at the dental school constitute a group of major stakeholders in determining the quality of care as they are the direct recipients of dental care in the clinical setting. Before this study, there had not been any attempt to engage them in efforts to improve the quality of our services.…”