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Factors Affecting Engagement With Portfolio-Based Reflection Among Internal Medicine Trainees: A Survey-Based Study.

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Summary

Most internal medicine trainees (IMT) in the UK write reflections, but many don't see the benefit. Factors like training stage and fear of GMC repercussions influence reflection, with time constraints being a major barrier.

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Area of Science:

  • Medical Education
  • Postgraduate Training
  • Reflective Practice

Background:

  • Contemporary medical education promotes reflective practice for continuous learning.
  • Internal medicine trainees (IMT) in the UK are encouraged to use electronic portfolios for written reflections.
  • Existing literature suggests varied engagement and superficiality in trainee reflections.

Purpose of the Study:

  • To quantify the percentage of IMT engaging in written reflections.
  • To identify factors influencing the likelihood of trainees reflecting.
  • To assess perceived barriers to reflective practice among trainees.

Main Methods:

  • Quasi-experimental cross-sectional study design.
  • A 15-item survey distributed to 592 IMT in the northwest deanery of England.
  • Data analysis using chi-square testing and descriptive statistics on 243 responses.

Main Results:

  • 81.5% of trainees (n=198) reported writing reflections.
  • Key reflection content included clinical outcomes, teaching, and new learning.
  • Significant influencing factors: training stage, years in practice, prior tutelage, and fear of legal/GMC repercussions; primary barriers: lack of time and perceived lack of benefit.

Conclusions:

  • The majority of IMT engage in written reflections, yet a significant portion perceives no direct benefit.
  • Trainee background and experiences demonstrably impact reflection engagement.
  • Future strategies to enhance reflective practice must address perceived barriers and acknowledge diverse trainee needs.