Medical student and postgraduate trainee attitudes to reflective practice

AIM/Background The Medical Practitioners Act 2007 has given formal recognition to the need for clinicians to maintain and develop the knowledge and skills relevant to their professional work (1). In their review of medical schools in Ireland (2007), the Medical Council list the encouragement of ‘reflective practice’ processes as one of the key indicators of good practice in assessment (2). To date in Ireland, no studies have examined medical students’ and doctors’ views about reflective practice. This study explores compares and contrasts medical students’ and postgraduate’s understanding of, and attitudes to reflective practice. METHOD A case study design was undertaken within the broad paradigm of qualitative research. Final year medical students were interviewed about their understanding of and attitudes to reflective practice at the commencement of their final year module in psychiatry. A further series of interviews examining these same issues were held with postgraduate trainees at various stages of their postgraduate training. Exploratory thematic analysis and an interpretive approach were used. A focus group was undertaken to explore emergent themes. RESULTS There were clear deficits in in understanding amongst both medical students and doctors with regard to the concept of reflective practice. The relevance of reflective practice for a career in medicine was more evident amongst postgraduate trainees. The concept of ‘reflection’ was more familiar to medical students who in general demonstrated more negative attitudes towards reflective practice. CONCLUSION This study begins to highlight medical students’ and doctors views about reflective practice. It suggests a need for greater attention to how reflective practice techniques are taught and assessed in a structured way in medical school. It suggests that their relevance for a career in medicine or psychiatry needs to be highlighted. Medical educators should be encouraged to consider introducing teaching in reflective practice as a method of formative and summative assessment earlier in the psychiatric undergraduate and postgraduate curriculum