Reflection revisited: how physicians conceptualize and experience reflection in professional practice – a qualitative study

Autor: Christel P. M. Verberg, Albert J. J. A. Scherpbier, Kiki M. J. M. H. Lombarts, Elisa Bindels, Sylvia Heeneman
Přispěvatelé: RS: SHE - R1 - Research (OvO), O&O medewerkers SHE, Promovendi SHE, Fac. Health, Medicine and Life Sciences, Onderwijs instituut FHML, Pathologie, Center for Evidence Based Education, APH - Quality of Care
Rok vydání: 2018
Předmět:
Male
Adult
Reflective practice
020205 medical informatics
COMPETENCES
lcsh:Medicine
Reflection
Psychological safety
02 engineering and technology
Continuing medical education
Education
Thinking
MEDICAL-EDUCATION RESEARCH
03 medical and health sciences
0302 clinical medicine
Medical Staff
Hospital
Medical Staff
0202 electrical engineering
electronic engineering
information engineering
Humans
030212 general & internal medicine
Qualitative Research
lcsh:LC8-6691
Medical education
lcsh:Special aspects of education
Interpretative phenomenological analysis
lcsh:R
Professional development
Dialogical self
Professional Practice/standards
Professional Practice
Medical Staff
Hospital/psychology
General Medicine
PERFORMANCE
Middle Aged
Quality Improvement
Hospital/psychology
PSYCHOLOGICAL SAFETY
Action (philosophy)
HEALTH-CARE
Female
Qualitative research methods
Psychology
Delivery of Health Care
BEHAVIOR
Research Article
Qualitative research
Zdroj: BMC Medical Education
BMC Medical Education, 18:105. BioMed Central Ltd
BMC Medical Education, Vol 18, Iss 1, Pp 1-10 (2018)
BMC medical education, 18(1):105. BioMed Central
ISSN: 1472-6920
Popis: Background For the purpose of continuous performance improvement, physicians are expected to reflect on their practice. While many reflection studies are theoretically oriented and often prescriptive in the sense that they conceptualize what reflection should look like, the current study starts with practicing physicians themselves and maps how these physicians conceptualize and experience reflection in daily professional practice. Methods We conducted a qualitative study using in-depth interviews with 13 hospital-based physicians from various specialties and institutions. The interviews were transcribed verbatim and were analyzed iteratively, following the interpretative phenomenological analysis approach. Results Data analysis resulted in the identification of three main topics: fuzziness, domain specificity and dialogical dynamics of reflection in professional practice. Reflection was conceptualized as a fuzzy process of contemplation and action, leading to change and hopefully improvement of personal performance and health care in general. Physicians’ experiences with reflection were different for the patient domain and the team domain. Whereas experiences in the patient domain were recalled first and discussed in relatively clear terms, those in the team domain came second and were discussed in more ambiguous terms. In order to achieve improvement in daily practice, honest and open dialogues were perceived as necessary. These dialogues were regarded as the result of an interplay between an internal and an external dialogue. The internal dialogue required sensitivity and courage of the individual; the external dialogue required psychological safety and encouragement of the environment. Within the team domain however, handling the external dialogue effectively was not self-evident, underlining the importance of psychological safety. Conclusions This study draws attention to the interdependence between the individual and the collective contributions to reflective activity in professional practice. Apart from its importance to physicians’ individual medical performance, reflective activity is also important to the functioning of a team of physicians. To allow reflection to rise from an individual activity to a team activity, it is necessary to invest in a safe environment in which people are encouraged to think, act, and be engaged.
Databáze: OpenAIRE
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