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

Elisa Bindels1,2, Christel Verberg3, Albert Scherpbier4

  • 1Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. e.bindels@amc.uva.nl.

BMC Medical Education
|May 12, 2018
PubMed
Summary

Physicians view reflection as a fuzzy process. Creating a safe environment is crucial for fostering team-based reflection and improving healthcare performance.

Keywords:
Continuing medical educationProfessional developmentQualitative research methodsReflectionReflective practice

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Area of Science:

  • Medical Education
  • Professional Development
  • Qualitative Research

Background:

  • Physicians are expected to engage in reflective practice for continuous improvement.
  • Existing reflection studies are often theoretical and prescriptive.
  • This study explores physicians' own conceptualizations and experiences of reflection in daily practice.

Purpose of the Study:

  • To map how practicing physicians conceptualize reflection.
  • To understand physicians' experiences of reflection in their daily professional practice.
  • To identify factors influencing reflective practice among physicians.

Main Methods:

  • Qualitative study involving in-depth interviews with 13 hospital-based physicians.
  • Verbatim transcription of interviews.
  • Iterative analysis using interpretative phenomenological analysis (IPA).

Main Results:

  • Reflection is conceptualized as a fuzzy process of contemplation and action, aiming for performance and healthcare improvement.
  • Physicians' experiences of reflection differ between patient and team domains, with team reflection being more ambiguous.
  • Effective reflection requires internal dialogue (individual courage) and external dialogue (psychological safety), especially within teams.

Conclusions:

  • Reflective activity is vital for both individual physician performance and team functioning.
  • Transitioning reflection from an individual to a team activity necessitates investment in a safe, encouraging environment.
  • Fostering psychological safety is key to enabling effective team-based reflection and engagement.