Reclaiming a theoretical orientation to reflection in medical education research: a critical narrative review

Abstract

We argue for continued theorising of and theoretically informed applications of reflection, drawing upon epistemologies of practice and critical reflection as critical social inquiry. These directions offer medical education research broad and deep potential in theories of reflection, particularly in relation to knowledge creation within uncertain and complex situations, and challenging of dominant discourses and structures. Future work could explore how dominant epistemological positions and discourses in medicine influence theories from other disciplines when these theories are deployed in medical education.

Reflective Practice in Healthcare Education: An Umbrella Review

“…Historically, these underpinnings associate reflection with plurality and a form of artistry that Schon [2] initially envisaged and described. The paradox becomes apparent when a critical assessment of the literature reveals three prevalent trends in the application of reflection in medical education: utilitarian applications of reflection, the focus on the self as the object of reflection, and reflection and assessment [32]. When these trends are problematised, reflection appears to be influenced more by a reductionist approach aligned with dominant epistemological positions in medicine, such as evidence-based medicine, than by the historically critical (artistic) philosophical underpinnings.…”

“…An epistemological paradox regarding reflection appears to exist. The two main theoretical orientations of reflection, according to the critical review by Ng, Kinsella, Friesen and Hodges [32], are reflection as epistemology of practice and reflection as critical social inquiry. Historically, these underpinnings associate reflection with plurality and a form of artistry that Schon [2] initially envisaged and described.…”

Exploring whether (and how) self-reflection can improve practice as a teacher educator

“…The most important issue is the epistemological oxymoron since theory seems to contradict application. Until this is resolved or a consistent stance is adopted by researchers, educators and practitioners, this will be an important point of critique (Ng et al 2015). The next issue remains whether reflection truly enhances learning, self-understanding and improvement in practitioner skills or it simply has a positive effect on behaviour and mood.…”

“…Although reflection is very much linked with healthcare education already (Buckley et al 2009;Chaffey et al 2012;Chen and Forbes 2014;Crowe and O'Malley 2006;Epp 2008;Fragkos 2016;Jayatilleke and Mackie 2013;Kuiper and Pesut 2004;Lethbridge et al 2011;Mann et al 2009;McGillivray et al 2015;Miraglia and Asselin 2015;Ng et al 2015;Nguyen et al 2014;Norrie et al 2012;Prasko et al 2012;Rushmer et al 2004;Tsingos et al 2015a;Tsingos et al 2015b;Van Roy et al 2015;Williams 2001), I will try to focus on self-reflection which will improve personal practice as a teacher educator.…”

“…As part of their practice, reflection is imperative either in training where it is needed with annual review of clinical progress or once fully trained for revalidation and continuing professional development (Bernard et al 2012;Koole et al 2011;Ng et al 2015;Wald 2015). In their acting, however they do so under multiple identities (Day et al 2006):…”