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Reflective practice in medicine: The hidden curriculum challenge.

Michelle Ní Mhurchú¹, Peter Cantillon¹

¹School of Medicine, University of Galway, Galway, Ireland.

The Clinical Teacher

|October 19, 2023

Summary

Medical education struggles with reflection due to hidden curricula. Doctors overcame challenges like epistemological divergence and fear of vulnerability, developing more positive views on reflective practice.

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Area of Science:

Medical Education
Qualitative Research
Reflective Practice

Background:

Reflection's benefits are known in healthcare, but its practice is limited in medical education.
Tensions between reflection's epistemology and biomedicine may hinder its adoption.
The influence of hidden curricula on doctors' engagement with reflection requires further investigation.

Purpose of the Study:

To explore doctors' experiences implementing reflection in medical education.
To understand how hidden curricula influence engagement in reflective practice.
To identify personal and contextual factors affecting reflection in medical settings.

Main Methods:

Interpretative phenomenological analysis (IPA) approach.
Four virtual semi-structured qualitative interviews.
Analysis of transcribed interviews from doctors in a postgraduate clinical education program.

Main Results:

Identified themes: epistemological divergence, fear of vulnerability, and reflection volte-face.
Challenges included epistemological differences, fear of vulnerability, and antipathy towards reflection.
Participants developed more positive perspectives on reflection through shared program experiences.

Conclusions:

Hidden curricula significantly impact doctors' engagement with reflection, both positively and negatively.
Recommendations include fostering awareness of medical discourses, reassuring doctors about reflection's initial challenges, and role-modeling openness to vulnerability.
Promoting meaningful engagement requires addressing epistemological tensions and hidden curriculum influences.