The Effect of Reflective Activities on Reflective Thinking Ability in an Undergraduate Pharmacy Curriculum

Abstract

Objective. To determine the effectiveness of integrating reflective practice activities into a secondyear undergraduate pharmacy curriculum and their impact on reflective thinking ability. Design. A cross-over design with repeated measures was employed. Newly developed reflective modules based on real hospital and community pharmacy cases were integrated into the second-year pharmacy practice curriculum. A novel strategy, the Reflective Ability Clinical Assessment (RACA), was introduced to enhance self-and peer reflection. Assessment. Student responses (n5214) to the adapted Kember et al 1 Reflective Thinking Questionnaire (RTQ) were compared before and after reflective activities were undertaken. Significant improvement in three indicators of reflective thinking was shown after students engaged in reflective activities. Conclusion. Integration of reflective activities into a pharmacy curriculum increased the reflective thinking capacity of students. Enhancing reflective thinking ability may help students make better informed decisions and clinical judgments, thus improving future practice.Keywords: pharmacy curriculum, reflective practice, reflective thinking, experimental crossover design, pharmacy teaching INTRODUCTIONReflective thinking and learning capacity is regarded as an essential attribute in the health professions to link theory with application and to address the challenges that arise in clinical practice. [2][3][4][5][6][7][8] However, evidence to support the integration of these skills and curricular innovations in health education remains largely theoretical.2 Furthermore, evidence of integration of reflective practice teaching and learning modules into curriculum is scant.Reflective practice is an umbrella term used to describe the professional strategy to constantly improve one's practice. 5 It is a cognitive process of understanding and evaluating the meaning of an experience within the context of one's previous experience, previous and existing knowledge, firmly held beliefs, and assumptions. 9,10 Through reflective practice, professionals continue to critique their skills, performance, outcomes, and behavior. It can be argued that constant critiquing of practice, upgrading skills and performance, and/or changing behavior, allows for better informed decisions and clinical judgments, 11 thus enabling improvement for future practice. 5,6,12,13 Integrating reflective practices into health education settings can enhance self-reflection 6 and fundamental reflective thinking ability.14 Integrating reflective learning activities may also assist with bridging pharmaceutical theory to the complexities of pharmacy practice. 7,10,[23][24][25][26][27][28][29][30][31][32] Subsequently, enhanced reflective thinking skills may better prepare students for the challenges that may arise in future clinical practice.Moreover, adopting reflective learning and thinking skills may enhance deep learning and develop metacognitive ability. 21 Enhancing metacognitive ability of pharmacy students can assist with imp...

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