Reflection revisited: how physicians conceptualize and experience reflection in professional practice – a qualitative study
Abstract 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 st...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2018-05-01
|
| Series: | BMC Medical Education |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12909-018-1218-y |
| _version_ | 1818486087548403712 |
|---|---|
| author | Elisa Bindels Christel Verberg Albert Scherpbier Sylvia Heeneman Kiki Lombarts |
| author_facet | Elisa Bindels Christel Verberg Albert Scherpbier Sylvia Heeneman Kiki Lombarts |
| author_sort | Elisa Bindels |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-10T16:18:11Z |
| format | Article |
| id | doaj.art-7e217ee93f1e47b3a3764adf7f69f6b9 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-12-10T16:18:11Z |
| publishDate | 2018-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Education |
| spelling | doaj.art-7e217ee93f1e47b3a3764adf7f69f6b92022-12-22T01:41:54ZengBMCBMC Medical Education1472-69202018-05-0118111010.1186/s12909-018-1218-yReflection revisited: how physicians conceptualize and experience reflection in professional practice – a qualitative studyElisa Bindels0Christel Verberg1Albert Scherpbier2Sylvia Heeneman3Kiki Lombarts4Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht UniversityICLON, Leiden University, Graduate School of TeachingDepartment of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht UniversityDepartment of Pathology, Faculty of Health, Medicine and Life Sciences, Maastricht UniversityProfessional Performance research group, Institute for Education and Training, Academic Medical Center (AMC-UvA)Abstract 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.http://link.springer.com/article/10.1186/s12909-018-1218-yReflectionReflective practiceContinuing medical educationProfessional developmentQualitative research methods |
| spellingShingle | Elisa Bindels Christel Verberg Albert Scherpbier Sylvia Heeneman Kiki Lombarts Reflection revisited: how physicians conceptualize and experience reflection in professional practice – a qualitative study BMC Medical Education Reflection Reflective practice Continuing medical education Professional development Qualitative research methods |
| title | Reflection revisited: how physicians conceptualize and experience reflection in professional practice – a qualitative study |
| title_full | Reflection revisited: how physicians conceptualize and experience reflection in professional practice – a qualitative study |
| title_fullStr | Reflection revisited: how physicians conceptualize and experience reflection in professional practice – a qualitative study |
| title_full_unstemmed | Reflection revisited: how physicians conceptualize and experience reflection in professional practice – a qualitative study |
| title_short | Reflection revisited: how physicians conceptualize and experience reflection in professional practice – a qualitative study |
| title_sort | reflection revisited how physicians conceptualize and experience reflection in professional practice a qualitative study |
| topic | Reflection Reflective practice Continuing medical education Professional development Qualitative research methods |
| url | http://link.springer.com/article/10.1186/s12909-018-1218-y |
| work_keys_str_mv | AT elisabindels reflectionrevisitedhowphysiciansconceptualizeandexperiencereflectioninprofessionalpracticeaqualitativestudy AT christelverberg reflectionrevisitedhowphysiciansconceptualizeandexperiencereflectioninprofessionalpracticeaqualitativestudy AT albertscherpbier reflectionrevisitedhowphysiciansconceptualizeandexperiencereflectioninprofessionalpracticeaqualitativestudy AT sylviaheeneman reflectionrevisitedhowphysiciansconceptualizeandexperiencereflectioninprofessionalpracticeaqualitativestudy AT kikilombarts reflectionrevisitedhowphysiciansconceptualizeandexperiencereflectioninprofessionalpracticeaqualitativestudy |