The structure of reflective practice in medicine

• Published in: Medical education Vol. 38; no. 12; pp. 1302 - 1308
• Main Authors: Mamede, Silvia, Schmidt, Henk G
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.12.2004; Blackwell; Wiley Subscription Services, Inc
• Subjects: Attitude of Health Personnel; Clinical Competence - standards; continuing/methods; Curriculum subjects: programmes and methods; education; Education, Medical, Continuing - methods; Educational sciences; Family Practice - education; Family Practice - standards; family practice/education/methods; Humans; medical; Medical and paramedical education; mental processes; Primary Health Care - standards; Surveys and Questionnaires; Teaching methods; Thinking; Medicine; Skill; Higher Education; Reflection; Professional development; Reasoning
• ISSN: 0308-0110; 1365-2923
• DOI: 10.1111/j.1365-2929.2004.01917.x

Background  The capability to reflect consciously upon one's professional practice is generally considered important for the development of expertise and, hence, for education. However, to our knowledge no empirical research has been conducted to date into the nature of reflective practice in medicine. Purpose  To study the structure of reflective practice in medicine. Methods  A questionnaire based on the literature was developed and administered to a group of primary care doctors. The data were subjected to confirmatory factor analysis using structural equations modelling. Results  A 5‐factor model of reflective practice emerged. It consisted of the following factors: deliberate induction; deliberate deduction; testing and synthesising; openness for reflection, and meta‐reasoning. The model fitted the data sufficiently. Conclusion  A multidimensional structure of reflective practice in medicine was brought to light by the study. Its components in terms of reasoning processes, behaviours and attitudes were identified and measured among doctors. Once conceptualised and measured, reflective practice can be studied to gain a better understanding of its relation to expertise development in medicine. In addition, training students to apply reflective practices may become a goal in medical education.