Is reflection like soap? a critical narrative umbrella review of approaches to reflection in medical education research

Abstract

Reflection is a complex concept in medical education research. No consensus exists on what reflection exactly entails; thus far, cross-comparing empirical findings has not resulted in definite evidence on how to foster reflection. The concept is as slippery as soap. This leaves the research field with the question, ‘how can research approach the conceptual indeterminacy of reflection to produce knowledge?’. The authors conducted a critical narrative umbrella review of research on reflection in medical education. Forty-seven review studies on reflection research from 2000 onwards were reviewed. The authors used the foundational literature on reflection from Dewey and Schön as an analytical lens to identify and critically juxtapose common approaches in reflection research that tackle the conceptual complexity. Research on reflection must deal with the paradox that every conceptualization of reflection is either too sharp or too broad because it is entrenched in practice. The key to conceptualizing reflection lies in its use and purpose, which can be provided by in situ research of reflective practices.

Mind The Gap: A Philosophical Analysis of Reflection’s Many Benefits

“…Based on our conceptual analysis of reflection in the tradition of philosophy, and how these relate to contemporary research on reflection, we think that reflection occurs in its situated use. 18 We support that there is no "one-size-fits-all" to reflection. 58 Nonetheless, this does not relieve us from critically approaching reflection, and our philosophical considerations led us to certain preferred recommendations for medical education.…”

“…Thus, we advise restraint in pursuing and empirically validating potentially endless specific benefits of reflection. 18 As Stella Ng and colleagues argued, the pursuit to pinpoint all benefits of reflection plays heavily into a reductive understanding of reflection as a means to utilitarian ends. 12,14 Practitioners "may eventually perceive [reflection] as falling short of its goals because it is difficult to 'prove' reflection 'works' ."…”

“…42(p876) Second, when it comes to using reflection for one's professional identity, we recommend using formal guidelines and models for reflection as sources of inspiration to reflect, and not as normative models that dictate how practitioners should reflect. 18,61 We ground our recommendation in the Kantian argument that reflection resists systematization and that formally learning rules is something other than reflection. 26,62 Thus, for Kant, reflection is trained by practice and by being confronted with (situated) examples.…”

“…For this article, we conducted a philosophical, conceptual analysis of reflection. [18][19][20] We questioned the theoretical presuppositions surrounding reflection, and traced background premises and values that affect this educational practice and its (potential) benefits. 21,22 We drew our philosophical considerations from the continental philosophical tradition, particularly the work of Immanuel Kant, Martin Heidegger, Hannah Arendt and Jacques Derrida.…”

Mentoring is in the ‘I’ of the beholder: supporting mentors in reflecting on their actual and preferred way of mentoring

“…Based on these findings, we believe that the merit of the MERIT survey for mentors lies in offering support during their professional development. Critical reflections on experiences from their daily practice can help mentors to identify and prioritize learning needs [15,37,38], thereby serving as an entry point for their professional development [12]. This enables mentors to acquire, refine, or broaden their mentor-specific knowledge and skills [28,[39][40][41][42][43].…”