Developing a Reflection Guiding Tool for underperforming medical students: An action research project
Abstract
The ability to reflect is an important generic competence especially for underperforming students as they have to analyse their previous learning experiences to improve on future academic performances. This action research describes the process of a team when developing a reflection guiding tool (RGT). As the underperforming students may have difficulty in comprehending what is expected from them while using a reflective approach, we designed the RGT based on the six steps in Gibbs cycle; 1) Description, 2) Feelings/Reactions, 3) Evaluation, 4) Analysis, 5) Conclusions, and 6) Personal action plan. These underperforming students reflected on how, and why, they failed their assessments based on the proposed RGT. Findings revealed that RGT was able to make students aware of what reflection skill is and thus fulfilled its objective. It helped Year 1 and Year 2 underperforming medical students to reflect on their academic failure.
Received: 05 September 2019
Accepted: 22 November 2019
Published online: 29 November 2019
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References
Bean, John P. “Dropouts and turnover: The synthesis and test of a causal model of student attrition.” Research in Higher Education 12, no. 2 (1980): 155-187.
Boud, David, Rosemary Keogh, and David Walker. Reflection: Turning learning into experience. London: Kogan Page, 1985.
Brand, Sarah, Patrick Lancaster, Irene Gafson, and Helen Nolan. “Encouraging reflection: Good doctor or bad doctor?.” Medical Education 51, no. 11 (2017): 1173-1174.
Braun, Virginia, and Victoria Clarke. “Using thematic analysis in psychology.” Qualitative Research in Psychology 3, no. 2 (2006): 77-101.
Bulman, Chris, Judith Lathlean, and Mary Gobbi. “The process of teaching and learning about reflection: Research insights from professional nurse education.” Studies in Higher Education 39, no. 7 (2014): 1219-1236.
Bulpitt, Helen, and Peter J. Martin. “Learning about reflection from the student.” Active Learning in Higher Education 6, no. 3 (2005): 207-217.
Carr, Sandra E., and Paula H. Johnson. “Does self reflection and insight correlate with academic performance in medical students?.” BMC Medical Education 13, no. 1 (2013): 113.
Chaffey, Lisa Jane, Evelyne Johanna Janet de Leeuw, and Gerard Anthony Finnigan. “Facilitating students’ reflective practice in a medical course: Literature review.” Education for Health 25, no. 3 (2012): 198.
Çimer, Atilla, Sabiha Odabaşi Çimer, and Gülşah Sezen Vekli. “How does reflection help teachers to become effective teachers.” International Journal of Educational Research 1, no. 4 (2013): 133-149.
Creswell, John. Educational Research: Planning, Conducting and Evaluating Quantitative and Qualitative Research. 4th ed. Boston: Pearson, 2011.
Dekker, Hanke, Johanna Schönrock-Adema, Jos W. Snoek, Thys van der Molen, and Janke Cohen-Schotanus. “Which characteristics of written feedback are perceived as stimulating students’ reflective competence: An exploratory study.” BMC Medical Education 13, no. 1 (2013): 94.
Devi, Vasudha, Reem Rachel Abraham, and Ullas Kamath. “Teaching and assessing reflecting skills among undergraduate medical students experiencing research.” Journal of Clinical and Diagnostic Research: JCDR 11, no. 1 (2017): JC01.
Dewey, John. “Chapter One - What Is Thought?”. In How We Think, 1-13. Boston: D.C. Heath & Co, 1910.
Dressler, Jeremy A., Beth A. Ryder, Michael Connolly, Megan Dias Blais, Thomas J. Miner, and David T. Harrington. ““Tweet”-Format writing is an effective tool for medical student reflection.” Journal of Surgical Education 75, no. 5 (2018): 1206-1210.
Foong, Chan Choong, Nik Nadia Nik Nazri, and Nurul Atira Khairul Anhar Holder. “I am Becoming a Doctor: Mine or Someone Else’s Will? Or Does it Even Matter? A Qualitative Investigation.” EURASIA Journal of Mathematics, Science and Technology Education 14, no. 7 (2018): 3253-3267.
Gibbs, Graham. “Learning by doing: A guide to teaching and learning methods.” Further Education Unit (1988).
Gill, Gobinder Singh. “The Nature of Reflective Practice and Emotional Intelligence in Tutorial Settings.” Journal of Education and Learning 3, no. 1 (2014): 86-100.
Hargreaves, Ken. “Reflection in medical education.” Journal of University Teaching and Learning Practice 13, no. 2 (2016): 6.
Hayton, Amy, Ilho Kang, Raymond Wong, and Lawrence K. Loo. “Teaching medical students to reflect more deeply.” Teaching and Learning in Medicine 27, no. 4 (2015): 410-416.
Husebø, Sissel Eikeland, Stephanie O’Regan, and Debra Nestel. “Reflective practice and its role in simulation.” Clinical Simulation in Nursing 11, no. 8 (2015): 368-375.
Kalet, Adina, Jeannette Guerrasio, and Calvin L. Chou. “Twelve tips for developing and maintaining a remediation program in medical education.” Medical Teacher 38, no. 8 (2016): 787-792.
Koshy, Elizabeth, Valsa Koshy, and Heather Waterman. Action Research in Healthcare. Sage, 2010.
Langendyk, Vicki, Glenn Mason, and Shaoyu Wang. “How do medical educators design a curriculum that facilitates student learning about professionalism?.” International Journal of Medical Education 7 (2016): 32.
Larsen, Douglas P., Daniel A. London, and Amanda R. Emke. “Using reflection to influence practice: Student perceptions of daily reflection in clinical education.” Perspectives on Medical Education 5, no. 5 (2016): 285-291.
Lewin, Linda Orkin, Nancy J. Robert, John Raczek, Carol Carraccio, and Patricia J. Hicks. “An online evidence based medicine exercise prompts reflection in third year medical students.” BMC Medical Education 14, no. 1 (2014): 164.
Mann, Karen, Jill Gordon, and Anna MacLeod. “Reflection and reflective practice in health professions education: A systematic review.” Advances in Health Sciences Education 14, no. 4 (2009): 595.
Miller-Kuhlmann, Rebecca, Patricia S. O’Sullivan, and Louise Aronson. “Essential steps in developing best practices to assess reflective skill: A comparison of two rubrics.” Medical Teacher 38, no. 1 (2016): 75-81.
Mitchell, Veronica Ann. “Diffracting reflection: A move beyond reflective practice.” Education as Change 21, no. 2 (2017): 165-186.
Moen, Charlotte, and Patricia Prescott. “Embedding a patchwork text model to facilitate meaningful reflection within a medical leadership curriculum.” International Journal of Medical Education 7 (2016): 372.
Moniz, Tracy, Shannon Arntfield, Kristina Miller, Lorelei Lingard, Chris Watling, and Glenn Regehr. “Considerations in the use of reflective writing for student assessment: Issues of reliability and validity.” Medical Education 49, no. 9 (2015): 901-908.
Nguyen, Quoc Dinh, Nicolas Fernandez, Thierry Karsenti, and Bernard Charlin. “What is reflection? A conceptual analysis of major definitions and a proposal of a five-component model.” Medical Education 48, no. 12 (2014): 1176-1189.
O’Reilly, Sharleen L., and Julia Milner. “Transitions in reflective practice: Exploring student development and preferred methods of engagement.” Nutrition & Dietetics 72, no. 2 (2015): 150-155.
Ottenberg, Abigale L., Dario Pasalic, Gloria T. Bui, and Wojciech Pawlina. “An analysis of reflective writing early in the medical curriculum: The relationship between reflective capacity and academic achievement.” Medical Teacher 38, no. 7 (2016): 724-729.
Perrella, Andrew. “Room for improvement: Palliating the ego in feedback-resistant medical students.” Medical Teacher 39, no. 5 (2017): 555-557.
Philip, Lucy. “Encouraging reflective practice amongst students: A direct assessment approach.” Planet 17, no. 1 (2006): 37-39.
Pintrich, Paul R. “The role of metacognitive knowledge in learning, teaching, and assessing.” Theory into Practice 41, no. 4 (2002): 219-225.
Plack, Margaret M., Maryanne Driscoll, Sylvene Blissett, Raymond McKenna, and Thomas P. Plack. “A method for assessing reflective journal writing.” Journal of Allied Health 34, no. 4 (2005): 199-208.
Pretorius, Lynette, and Allie Ford. “Reflection for Learning: Teaching Reflective Practice at the Beginning of University Study.” International Journal of Teaching and Learning in Higher Education 28, no. 2 (2016): 241-253.
Rodgers, Carol. “Defining reflection: Another look at John Dewey and reflective thinking.” Teachers College Record 104, no. 4 (2002): 842-866.
Sandars, John. “The use of reflection in medical education: AMEE Guide No. 44.” Medical Teacher 31, no. 8 (2009): 685-695.
Sandars, John, Rakesh Patel, Helen Steele, and Martin McAreavey. “Developmental student support in undergraduate medical education: AMEE Guide No. 92.” Medical Teacher 36, no. 12 (2014): 1015-1026.
Schon, Donald A., Educating the reflective practitioner. San Franscisco: Jossey- Bass, 1987.
Seymour, Patricia, and Maggie Watt. “The Professional Competencies Toolkit: Teaching reflection with flash cards.” Medical Education 5, no. 49 (2015): 518.
Shapiro, Johanna, Deborah Kasman, and Audrey Shafer. “Words and wards: A model of reflective writing and its uses in medical education.” Journal of Medical Humanities 27, no. 4 (2006): 231-244.
Trumbo, Silas P. “Reflection fatigue among medical students.” Academic Medicine 92, no. 4 (2017): 433-434.
Tsingos, Cherie, Sinthia Bosnic-Anticevich, John M. Lonie, and Lorraine Smith. “A model for assessing reflective practices in pharmacy education.” American Journal of Pharmaceutical Education 79, no. 8 (2015): 124.
Wagenschutz, Heather, Erin McKean, Katie Zurales, and Sally A. Santen. “Facilitating guided reflections on leadership activities.” Medical Education 50, no. 11 (2016): 1149-1150.
Wald, Hedy S., Jeffrey M. Borkan, Julie Scott Taylor, David Anthony, and Shmuel P. Reis. “Fostering and evaluating reflective capacity in medical education: Developing the REFLECT rubric for assessing reflective writing.” Academic Medicine 87, no. 1 (2012): 41-50.
Wilding, Peter Mark. “Reflective practice: A learning tool for student nurses.” British Journal of Nursing 17, no. 11 (2008): 720-724.
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