Do critical incidents lead to critical reflection among medical students?

Abstract

Context Medical students are exposed during their training to a wide range of experiences and behaviors that can affect their learning regarding professionalism and their behavior and attitudes towards patient-centered care. The aim of the study is to explore learning associated with critical incidents and levels of critical reflection among medical students. Approach Medical students’ were invited to narrate a critical incident and reflect on the learning associated with it. All students’ narratives were audio-recorded and analyzed thematically. Mezirow’s theory of transformative learning was used to analyze the level of reflection reached in students’ narratives. Findings For the present analysis critical incidents narrated by 70 clinical students (4th–6th year) were included. Fifty-two of them were females. Students’ experiences are derived from three types of interactions: observed interactions between doctors and patients, personal interactions between students and patients, and interactions between doctors and students. Reflections deriving from the experiences included: behaving to patients as humans not as cases, emotional aspects of care, doctors as role models, skills needed when working under pressure, ‘tasting’ the real profession, emotional management, the importance of communication skills, teaching qualities of doctors, becoming a doctor, and reflections of future practice. Analyzing the actual level of reflection indicated that only 32 (45.7%) students were categorized as reflectors. Conclusions Student interactions with doctors and patients provide insights about; the daily experience of being a doctor, the most common challenges, what qualities are necessary for being a doctor and what do they need to develop their professional identity. However, it is noteworthy that while the majority of students shared a critical incident crucial to their professional development, there is little evidence of critical reflection.

Professional values at the beginning of medical school: A quasi-experimental study

“…In the analysis of the totality of the re ections of the three questions, we noticed a predominance of re ections of the objective description (OD) and diffuse description (DD) type, that is, descriptions with less re ection and critical capacity among the students who did not attend the conference on professionalism and who constitute the group that did not have any contact with the discussion of the values of the profession within the medical course. This fact is in line with the results of Montgomery (37), who observed a design with a preponderance of low levels of re ection in students in the preclinical phase, as only 45.7% of the students were able to issue re ective reports when describing the proposed questions. For Niemi (19), the scarcity of critical re ections found among groups of students in the preclinical phase of the medical course is justi ed by the absence of memorable critical experiences or incidents, which prevents them from envisioning their "professional self" at a future point in time.…”

Professional values at the beginning of medical school: a quasi-experimental study

“…In the analysis of the totality of the reflections of the three questions, we noticed a predominance of reflections of the objective description (OD) and diffuse description (DD) type, that is, descriptions with less reflection and critical capacity among the students who did not attend the conference on professionalism and who constitute the group that did not have any contact with the discussion of the values of the profession within the medical course. This fact is in line with the results of Montgomery [36], who observed a design with a preponderance of low levels of reflection in students in the preclinical phase, as only 45.7% of the students were able to issue reflective reports when describing the proposed questions. For Niemi [19], the scarcity of critical reflections found among groups of students in the preclinical phase of the medical course is justified by the absence of memorable critical experiences or incidents, which prevents them from envisioning their "professional self " at a future point in time [37]..…”

Charting the Journey of Young Leaders: A New Model of Transferability of Skills

“…Critical incidents (or memorable incidents) represent the point at which important information is revealed as to what attitudes and behaviors are valorized [30]. Critical/Memorable incidents analysis collected in the form of short narratives of incidents that the students judged to be important and relevant to their learning experiences is a well-suited method that can provide in-depth information on the impact of conflicting experiences in students [31]. Recording critical incidents positions the students in situations that allow reflection upon experiences that facilitate personal growth [32], which in turn allows the researchers to access those experiences and the meaning the participants have attributed to these experiences.…”