The structure of reflective practice in medicine

TLDR

Reflective practice is considered essential for developing expertise and medical education. The study aims to conceptualize and measure the structure of reflective practice in medicine to better understand its link to expertise development and inform medical education. A literature‑based questionnaire was administered to primary care doctors and the responses were analyzed with confirmatory factor analysis using structural equation modeling. A five‑factor model—deliberate induction, deliberate deduction, testing and synthesising, openness for reflection, and meta‑reasoning—was identified and fit the data, revealing a multidimensional structure measured among doctors.

Abstract

The capability to reflect consciously upon one's professional practice is generally considered important for the development of expertise and, hence, for education. However, to our knowledge no empirical research has been conducted to date into the nature of reflective practice in medicine.To study the structure of reflective practice in medicine.A questionnaire based on the literature was developed and administered to a group of primary care doctors. The data were subjected to confirmatory factor analysis using structural equations modelling.A 5-factor model of reflective practice emerged. It consisted of the following factors: deliberate induction; deliberate deduction; testing and synthesising; openness for reflection, and meta-reasoning. The model fitted the data sufficiently.A multidimensional structure of reflective practice in medicine was brought to light by the study. Its components in terms of reasoning processes, behaviours and attitudes were identified and measured among doctors. Once conceptualised and measured, reflective practice can be studied to gain a better understanding of its relation to expertise development in medicine. In addition, training students to apply reflective practices may become a goal in medical education.