#KeyLIMEPodcast 83: Reflection in #Meded

The Key Literature in Medical Education podcast discusses reflection – a perennial hot topic of discussion in health professions education.  While we all have an intuitive understanding of what reflection is, we lack a common language or framework in describing reflection.  The paper this week addresses this gap.  Keep reading for more info… or start listening for even better info. Download the podcast from iTunes here.

If you have a paper that you would like to see discussed on a future episode of KeyLIME leave a comment below.


KeyLIME Session 83 – Article under review:
Fri post_KeyLIME (Dr. Padmos)

Listen to the podcast

View/download the abstract here.

Nguyen QD, Fernandez N, Karsenti T, Charlin B. What is reflection? A conceptual analysis of major definitions and a proposal of a five-component model. Medical Education, Dec 2014, 48(12): 1176-89

Reviewer: Jonathan Sherbino

When I started grad school, the first book I picked up was Donald Schon’s Educating the Reflective Practitioner*. It was a great place to start for a career in health professions education.  The book challenged educators to move down from the “ivory tower” of discrete interventions and well-defined evaluations into the messy swamp of interesting, but complex, ideas.  The concept of reflection is indeed messy.  Intuitively, we readily understand the construct.  But in deconstructing the process things become messy.

This paper attempts to synthesize multiple conceptions of reflection providing learners and educators with a framework that is usable.

*An interesting side note is the Schon’s PhD thesis built on the work of Dewey, who pioneered the concept of reflection.

“This study was conducted in order to identify, explore and analyse the most influential conceptualisations of reflection, and to develop a new theory-informed and unified definition and model of reflection.”

Type of paper
Systematic review

Key Points on the Methods
A quasi-systematic review was performed. MEDLINE, EMBASE and PsychINFO were searched. (ERIC and Google Scholar were not included.) A restricted time frame (2008-2012) was used for reasons not readily apparent.

In a first (for me) the articles included in the search where used to identify the (arbitrary) 15 most cited authors on the topic… and not the actual manuscripts.

A thematic analysis was conducted by ONE author. With each iteration, the other authors contributed to achieve consensus on the analysis.

Key Conclusions
The authors conclude “We propose that our conceptualisation, rather than amplifying the problem of the lack of common understandings and applications of reflection, may serve as a current meta-definition and meta-model to provide a sound framework for understanding and operationalising reflection. In Kurt Lewin’s thoughtful words, there is nothing as practical as a good theory”

Spare Keys – other take home points for clinician educators
Plus ca change, plus c’est la meme chose. It is interesting to note that 85 years after reflection was introduced into the education literature it remains a « hot topic «  (and until now variably defined). What are the core principles of learning? Motivation/need, action/experience, knowledge coding, reflection, feedback?

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