Student perspectives of simulated learning to improve their dysphagia management.

BACKGROUND:  The use of simulation to enhance knowledge translation and bridge the theoretical-clinical gap to enhance clinical training and competency in health professions has received mixed reviews in the literature. OBJECTIVES:  This research examined student perspectives of a simulation laboratory in speech therapy to improve students' clinical competency when working with adults with communication and dysphagia impairments. METHOD:  An exploratory descriptive pilot study was conducted in 2022 with 16 third-year speech-language therapy students. This mixed-methods study involved students completing purposefully developed pre-and post-surveys to explore their experiences with simulated teaching and learning and their perceptions of confidence. Data were analysed using an independent t-test. Following the surveys, the students participated in a focus group discussion about their simulation experience, and data were analysed using thematic analysis. RESULTS:  Student ratings of clinical skills improved from pre to post-simulation significantly overall and across six out of the eight items. The focus group revealed insights into students' experiences, highlighting increased confidence, the benefits of making mistakes in a safe environment and improved preparedness to work with dysphagia in patients. CONCLUSION:  While simulation serves as a valuable tool in enhancing clinical skills and building confidence, it must be used as an adjunct to real-life exposure and not as a replacement.Contribution: The integration of both simulated and real-life experiences is essential to provide a comprehensive and practical learning environment for students.

The Impact of COVID-19 Service Learning on Medical Student Professional Identity Formation.

OBJECTIVE: The COVID-19 pandemic affected in-person educational activities and required medical schools to adapt and enrich their curriculum to ensure ongoing professional development. During the height of the COVID-19 pandemic, students expressed a significant desire to contribute and continue their medical education. Service learning promotes experiential learning and Professional Identity Formation (PIF). This study examines the impact that a service-learning elective had on medical students' education and PIF. METHODS: Offering a service-learning elective allowed students to remain engaged in educational activities and pandemic-relief efforts. We conducted a qualitative analysis of 132 written reflections by medical students who completed a 2- or a 4-week service-learning elective to assess for major themes and impact on PIF. RESULTS: Participation in service learning had a favorable impact on PIF as expressed by the personal qualities student identified as having developed or improved upon because of their participation. Enhancement of communication skills, teamwork skills, compassion, and empathy were major themes conveyed in student reflections. Qualities of resilience were also portrayed through the write-up as students noted how the elective allowed for active engagement in community pandemic-relief efforts and created opportunities for overcoming obstacles related to service learning projects they participated in. CONCLUSIONS: Service learning in medical school has a dual purpose of providing community support while imparting significant learning opportunities for PIF in medical students.

The effects of mindfulness-based techniques on self-rumination, cognitive reappraisal and expressive suppression among patients with major depression: a nursing perspective.

Background: Patients with major depressive disorder (MDD) often struggle with adaptive strategies like self-reflection and cognitive reappraisal, relying instead on maladaptive ones like self-rumination and emotional suppression. Mindfulness-based techniques (MBTs) have been identified as a promising complementary psychological intervention for this population. Aims: To evaluate the effects of MBTs on mindful attention awareness, self-rumination, self-reflection, cognitive reappraisal and expressive suppression in patients with MDD between patients who receive MBTs and those who do not. Methods: This quasi-experimental research was carried out at the Psychiatric Outpatient Clinics. A representative sample of 120 patients with MDD were randomly recruited to either a study group (n = 60) or a control group (n = 60). The Mindful Attention Awareness Scale (MAAS), The Rumination-Reflection Questionnaire (RRQ) and The Emotion Regulation Questionnaire (ERQ) were utilised to collect data. Results: After participation in MBTs, the study group had significantly greater improvements in the mean scores of MAAS, RRQ, Cognitive Reappraisal and Expressive Suppression compared to the control group (p < 0.001 each). Recommendations: The study recommends developing and implementing training programmes for nurses to equip them with the skills and knowledge to effectively deliver MBTs as part of patient care. Conducting longitudinal studies is necessary to assess the sustainability of these improvements.

Developing and Implementing a Diversity, Equity, and Inclusion Curriculum Self-reflection Process at a School of Public Health.

We critically reviewed the motivations, processes, and implementation methods underlying a faculty-driven diversity, equity, and inclusion (DEI) curriculum self-reflection project in the Rutgers School of Public Health. This case study offers guidance on a curriculum self-reflection tool that was developed through the school's Curriculum Committee to promote DEI throughout the school's curricula. We review the key steps in this process and the unique aspects of developing and implementing such evaluations within higher education. The study draws on faculty experience, was informed by students and staff within the Curriculum Committee, and builds on existing knowledge and tools. A flexible 6-step framework-including guiding principles and strategic approaches to planning, developing, and implementing a DEI curriculum self-assessment-is provided to assist instructors, curriculum committees, DEI groups, and academic leaders at schools of public health interested in refining their courses and curricula. Academic units experience contextual challenges, and while each is at a different stage in curriculum reform, our findings provide lessons about integrating the assessment of DEI in school curriculum in a systematic and iterative way. Our approach can be applied to diverse academic settings, including those experiencing similar implementation challenges.

Critical Self-reflection on Racism by Hospital Physicians in Large German Cities. A Qualitative Reconstructive Study Using Episodic Interviews.

Racism permeates healthcare institutions and interpersonal interactions, impacting both staff and patients. The role of doctors, given their influential position in the healthcare system, is particularly crucial in this context. Despite this, there is a scarcity of evidence regarding the manifestation of racism among healthcare professionals in Germany. Critical whiteness studies emphasize the importance of white* individuals engaging in critical self-reflection to mitigate racism. This study aimed to explore the attitudes of white* physicians in hospitals in major German cities towards racism and their critical reflection on personal attitudes and actions concerning racism in interactions with staff members and patients. Data was collected through six episodic interviews with physicians, analyzed using the reconstructive qualitative procedure of the documentary method, leading to a sense-genetic typology. The sense-genetic typology revealed three distinct attitudes towards racism: acknowledging, individualistic, and ignoring. Four types emerged concerning the self-reflection of white doctors: self-critical, socially critical, worried, and defensive. The most promising potential for interventions to reduce racism lies within the self-critical and socially critical types, both demonstrating an acknowledging attitude. Conversely, the worrying and defensive types may present challenges in deconstruction. This suggests that interventions aimed at reducing racism should be tailored and implemented with a nuanced approach.

Contextual AI Journaling: Integrating LLM and Time Series Behavioral Sensing Technology to Promote Self-Reflection and Well-being using the MindScape App.

MindScape aims to study the benefits of integrating time series behavioral patterns (e.g., conversational engagement, sleep, location) with Large Language Models (LLMs) to create a new form of contextual AI journaling, promoting self-reflection and well-being. We argue that integrating behavioral sensing in LLMs will likely lead to a new frontier in AI. In this Late-Breaking Work paper, we discuss the MindScape contextual journal App design that uses LLMs and behavioral sensing to generate contextual and personalized journaling prompts crafted to encourage self-reflection and emotional development. We also discuss the MindScape study of college students based on a preliminary user study and our upcoming study to assess the effectiveness of contextual AI journaling in promoting better well-being on college campuses. MindScape represents a new application class that embeds behavioral intelligence in AI.

What makes an event significant: an fMRI study on self-defining memories.

Self-defining memories are highly significant personal memories that contribute to an individual's life story and identity. Previous research has identified 4 key subcomponents of self-defining memories: content, affect, specificity, and self-reflection. However, these components were not tested under functional neuroimaging. In this study, we first explored how self-defining memories distinguish themselves from everyday memories (non-self-defining) through their associated brain activity. Next, we evaluated the different self-defining memory subcomponents through their activity in the underlying brain system. Participants recalled both self-defining and non-self-defining memories under functional MRI and evaluated the 4 subcomponents for each memory. Multivoxel pattern analysis uncovered a brain system closely related to the default mode network to discriminate between self-defining and non-self-defining memories. Representational similarity analysis revealed the neural coding of each subcomponent. Self-reflection was coded mainly in the precuneus, middle and inferior frontal gyri, and cingulate, lateral occipital, and insular cortices. To a much lesser extent, content coding was primarily in the left angular gyrus and fusiform gyrus. No region was found to represent information on affect and specificity. Our findings highlight the marked difference in brain processing between significant and non-significant memories, and underscore self-reflection as a predominant factor in the formation and maintenance of self-defining memories, inviting a reassessment of what constitutes significant memories.

Comfort Care.

Description Death does not thrill me anymore. I am a trauma surgeon extraordinaire! The patient had suffered a traumatic brain injury and has struggled for weeks. He is only 16. Today, the family decided to make him "comfort care." I was at the end of my call, exhausted, drained of all energy. I looked out of the ICU window and saw the fading rain and the city lights. It somehow reminded me of a precious life ebbing away, and I burst into a silent scream. I am still human.

Using Reflective Practice to Enhance Student Professionalism.

Reflective practice, critically reflecting on one's actions or attitudes to engage in the process of continuous adaptation and learning, has proven to be an effective strategy for improved patient care. Additionally, literature supports applying reflective practice for professional growth in medical providers. When contemplating professionalism training in physician assistant (PA) education, it is important to consider how to obtain buy-in from students. One way to do this is to link professionalism to the students' future career as a PA. The School of Physician Assistant Studies at Pacific University (the Program) created an Online Orientation Reflective Practice Assignment that was implemented during online orientation. Students were prompted to use reflective practice to create detailed "plans for success." The goal of this assignment was to reduce common professionalism missteps students often experienced. Data regarding the number of professionalism encounters per cohort, broken down into occurrences by curricular phase (didactic vs clinical), was tracked and collated using Microsoft® Excel®. The data was analyzed to determine trends. Implementation of the Online Reflective Practice Assignment for all PA students at the beginning of their education has increased student awareness of the Program's, and the profession's, expectations regarding professionalism and accountability. Thus far, the resulting number of professionalism missteps have not decreased year-over-year. We hypothesize that this is due to the difficulty meeting increased administrative expectations and burdens put on students during the pandemic. Students' use of reflective practice to review what went wrong and to create plans to avoid missteps in the future allows them to focus on productive next steps in building their professional identity. Implementation of the Online Orientation Reflective Practice Assignment has better prepared students for the expectations of the PA profession and provided them with a solid foundation to build their professional identity throughout their education and into their careers.

Do students' self-reflections of performance align with their graded performance in objective structured clinical exams?

INTRODUCTION: Self-awareness of strengths and weaknesses through self-reflection are important for life-long learning and development. The aim of this study was to assess the alignment in third-year undergraduate pharmacy students' self-reflections of their objective structured clinical exam (OSCE) performance to their actual OSCE scores and explore the most common aspects students reflected on as markers of perceived performance. METHODS: Students completed a three-station OSCE and a written self-reflection about their performance. These reflections were coded using a latent pattern content analysis, with categories defined as "doing well (≥ 50% on exam)" and "not doing well (< 50% on exam)" and compared to their actual OSCE exam scores, to determine the degree of alignment. RESULTS: Two hundred sixty-nine students completed the OSCE and reflection. Students had a low degree of alignment between their self-reflections and actual OSCE performance. Low alignment was overwhelmingly prevalent and significant in high-achieving students with OSCE scores of ≥90%. Most common aspects students reflected on as indicators of performance were finishing on time and communicating effectively. High-achieving students reflected on aspects such as empathy, systematic questioning, and patient teach-back as aspects of their performance. CONCLUSIONS: Student reflections on exam performance do not align with their actual performance, particularly amongst the high-achieving students. High-achieving students were more aware of the different aspects that affected their performance. To ensure that high-achieving students are aware of their strengths, educators should provide more targeted feedback mechanisms and positive reassurances to help these students become more confident in their decision-making skills.

"Now once again this idea of yours ( ) how does it sound when I say that?" - Changing the perspective: how coach's questioning practices elicit self-reflecting processes in clients.

Drawing upon the transformative power of questions, the paper investigates questioning sequences from authentic coaching data to examine the systematic use of a particular succession of formulation and question and its impact on inviting self-reflection processes in the client and eliciting change. The object of investigation in this paper are therefore questioning sequences in which a coach asks a question immediately after a rephrasing or relocating action, prompting the client to respond in an explicit or implicit way. The coach hereby shifts the focus to a hypothetical scenario, prompting the client to change her perspective on the matter and reflect on her own statements, ideas and attitudes from an outside perspective. The paper aims to contribute to closing the research gap of the change potential of reflection-stimulating action techniques used by coaches, by investigating one of many ways of how questions can be powerful tools to invite a change of perspective for the client. The study focuses on one coaching process consisting of three sessions between a female coach and a female client, utilizing a single case study approach. The data collection was part of the interdisciplinary project "Questioning Sequences in Coaching", comprising 14 authentic coaching processes. The analysis follows Peräkylä's Transformative Sequences model, examining the first position including the formulation and the subsequent question, the client's response, and the coach's reaction to the response. On a practical level, the main purpose of this paper is not to contribute to the many ways practical literature recommends coaches how to do their work and how to ask questions, but rather to show in what ways the elicitation of self-reflection processes in clients has been achieved by other coaches in authentic coaching sessions.

A Longitudinal Assessment of Self-directed Learning Readiness and Development in Medical Students.

OBJECTIVES: Self-directed learning (SDL) competency is important for physicians to stay abreast of advances in their field and to provide the best available evidence-based care to their patients. Therefore, an essential responsibility of medical educators is to ensure the development of SDL skills in their students. The first objective of this study was to investigate longitudinally the degree to which medical students were ready to engage in SDL. The second objective was to examine students' perceptions of their SDL development throughout training. METHODS: A 2-part study of preclinical and clinical medical students was carried out at a midwestern U.S. university. In Study A, a longitudinal assessment of preclinical medical students' readiness to engage in SDL was conducted by administering an SDL readiness survey (SDLRS). In Study B, third- and fourth-year medical students were asked to reflect on their SDL development, in addition to completing the SDLRS. RESULTS: After validating the Hendry and Ginns version of the SDLRS in preclinical medical students during Study A, we found that 3 of the 4 subscales remained constant over the 3 iterations of the survey while the self-determination subscale increased significantly between the first and third iteration of the survey. In Study B, an analysis of the clinical medical students' comments indicated a perceived increase in their SDL abilities and a growing appreciation of SDL. However, the SDLRS scores of clinical students did not differ from the results observed in preclinical students in Study A. CONCLUSIONS: The results of the SDLRS indicated that the experience of students in our medical school has a positive influence on self-determination by the end of the preclinical years. Furthermore, analysis of the reflections of clinical students indicated ongoing development of SDL skills throughout their medical school training that were influenced by a wide range of experiences.

Reflective capacity and context of reflections: qualitative study of second-year medical students' learning diaries related to a general practice course.

BACKGROUND: Reflective capacity is a prerequisite for transformative learning. It is regarded as an essential skill in professional competence in the field of medicine. Our aim was to investigate the reflective capacity and the objects of action (themes) which revealed reflective writing of medical students during a general practice/family medicine course. METHODS: Second-year medical students were requested to write learning diaries during a compulsory course in general practice/family medicine consisting of the principles of the physician-patient relationship. The course included a group session supervised by a clinical lecturer and a 3-day training period in a local health centre. We conducted data-driven content analysis of the learning diaries. In the learning diaries, student observations were most commonly directed to events during the training period and to group sessions. Occasionally, observation was directed at inner experience. RESULTS: The following themes were related to reflective writing: feelings towards the end of life, demanding situations in practice, physician's attitude to patient, student's inner experiences, and physician's well-being. The entries indicated different types of reflective capacity. Three subgroups were identified: 'simple reporting,' 'reflective writing,' and 'advanced reflective writing.' CONCLUSION: Professional growth requires the development of reflective capacity, as it is essential for successful patient care and better clinical outcomes. To develop and enhance the reflective capacity of medical students during their education, the curriculum should provide frequent opportunities for students to assess and reflect upon their various learning experiences.

Illustration of self-perceived knowledge, skills, and interests in undergraduate dental students using a visual metaphor- results of a monocentric cross-sectional study.

BACKGROUND: Self-assessment and self-reflection of competencies are crucial skills for undergraduate students. This monocentric cross-sectional study aims to assess the self-perceived knowledge, skills and interests in conservative dentistry and periodontology of third-, fourth-, and fifth-year dental students by the Pictorial Representation of Illness and Self-measure (PRISM). METHODS: Seventy-five undergraduate dental students (n = 25 of each year) who studied between 2021 and 2022 at the Department of Cariology, Endodontology and Periodontology at the University of Leipzig, Germany, were included. All of them underwent a PRISM-based interview regarding their perceived knowledge, practical skills, and interests in conservative dentistry as well as its sub-disciplines. The distances in the PRISM task (in millimeters) were measured and compared between the groups. Spearman's Rho was used to reveal correlations between knowledge, skills, and interests in the cohort. RESULTS: Perceived theoretical knowledge and practical skills differed significantly between groups for the sub-disciplines periodontology, cariology, restorative dentistry and preventive dentistry (p < 0.05). However, students' interests did not significantly vary between groups (p > 0.05). In the field of conservative dentistry and its sub-disciplines, significant moderate to high positive correlations were found between knowledge and skills (p < 0.01), and weak to moderate positive correlations were found between interests and knowledge (p < 0.05). Regarding the relationship between perceived interests and skills, only restorative dentistry, endodontology and periodontology were significant and only moderate to weak correlations were found (p < 0.05). CONCLUSION: PRISM revealed differences in perceived knowledge and skills between third-, fourth-, and fifth-year dental students. Correlations were found between perceived knowledge and skills, as well as between interests and knowledge. PRISM may be a promising tool to support students and teachers in dental education.

Professional values at the beginning of medical school: a quasi-experimental study.

BACKGROUND: Teaching professionalism in medical schools is central to medical education and society. We evaluated how medical students view the values of the medical profession on their first day of medical school and the influence of a conference about the competences of this profession on these students' levels of reflection. METHODS: We studied two groups of medical students who wrote narratives about the values of the medical profession and the influence of the COVID-19 pandemic on these values. The first group wrote the narratives after a conference about the competences of the medical profession (intervention group), and the second group wrote the same narratives after a biochemistry conference (control group). We also compared the levels of reflection of these two groups of students. RESULTS: Among the 175 medical students entering in the 2022 academic year, 159 agreed to participate in the study (response rate = 90.8%). There were more references to positive than negative models of doctor‒patient relationships experienced by the students (58.5% and 41.5% of responses, respectively). The intervention group referred to a more significant number of values than the control group did. The most cited values were empathy, humility, and ethics; the main competences were technical competence, communication/active listening, and resilience. The students' perspectives of the values of their future profession were strongly and positively influenced by the pandemic experience. The students realized the need for constant updating, basing medical practice on scientific evidence, and employing skills/attitudes such as resilience, flexibility, and collaboration for teamwork. Analysis of the levels of reflection in the narratives showed a predominance of reflections with a higher level in the intervention group and of those with a lower level in the control group. CONCLUSIONS: Our study showed that medical students, upon entering medical school, already have a view of medical professionalism, although they still need to present a deeper level of self-reflection. A single, planned intervention in medical professionalism can promote self-reflection. The vision of medical professional identity was strongly influenced by the COVID-19 pandemic, positively impacting the formation of a professional identity among the students who decided to enter medical school.

Cultural threads in writing mastery: a structural analysis of perfectionism, learning self-efficacy, and motivation as mediated by self-reflection in Chinese EFL learners.

BACKGROUND: The study explores language acquisition in Chinese English as a Foreign Language (EFL) education, where English proficiency is crucial for global opportunities. As China gains prominence, the demand for English skills rises beyond communication to include academic and business success. The Chinese education system emphasizes proficient English writing for further education and professional achievement. This research investigates the complex linguistic context for EFL learners in China, analyzing the intersection of psychological factors, cultural nuances, varied pedagogy, and individual experiences. METHODS: Structural Equation Modeling (SEM) is utilized for analysis, enabling the creation of a metric set to explore intangibles such as perfectionism, learning self-efficacy, motivation, study habits, cultural influences, and introspection. The research utilizes a diverse sample from multiple universities across different regions of China, incorporating demographic factors to encompass the varied characteristics within the EFL learner community. RESULTS: Results reveal that perfectionism (ß = 0.30, p < 0.001), learning self-efficacy (ß = 0.25, p = 0.005), motivation (ß = 0.35, p < 0.001), study habits (ß = 0.20, p = 0.01), and self-reflection (ß = 0.28, p < 0.001) significantly predict writing proficiency. Cultural effects (Beta = 0.15, p = 0.05) show a statistically significant, albeit minimal, impact. Mediation-moderation analysis underscores perfectionism as a mediator (Beta = 0.25, p = 0.005), emphasizing its influence on other predictors. Cultural factors act as moderators (Beta = 0.15, p = 0.01), shaping the link between predictors and writing skills. The combined mediation and moderation effects on writing proficiency are positively significant (Beta = 0.20, p = 0.02). CONCLUSIONS: This study makes a significant theoretical contribution, enhancing existing models and providing practical insights for EFL educators and policymakers. Emphasizing the intricate relationship between psychological factors and cultural dynamics underscores the necessity for a sophisticated, culturally sensitive approach to language acquisition in Chinese EFL instruction. Beyond language skills, the research recognizes the importance of fostering a conducive environment that encourages personal development, socio-cultural awareness, and a holistic learning approach.

Further development of the reflective practice questionnaire.

Background: This article provides an update of the Reflective Practice Questionnaire (RPQ). The original RPQ consisted of 40-items with 10-sub-scales. In this article, the RPQ is streamlined into a 10-item single reflective practice construct, and a 30-item extended version that includes additional sub-scales of confidence, uncertainty/stress, and work satisfaction. Methods: A total of 501 university students filled out an online questionnaire that contained the original Reflective Practice Questionnaire, and two general measures of reflection: The Self-Reflection and Insight Scale, and the Rumination-Reflection Questionnaire. Results: Based on factor analysis, the RPQ was streamlined into a brief 10-item version, and an extended 30-item version. Small positive correlations were found between the RPQ reflective practice measure and the two measures of general reflection, providing discriminant validity evidence for the RPQ. The RPQ was found to be sensitive to differences among industries, whereas the general measures of reflection were not. Average reflective practice scores were higher for health and education industries compared to retail and food/accommodation industries.

Mindfulness and impulsive behavior: exploring the mediating roles of self-reflection and coping effectiveness among high-level athletes in Central China.

Introduction: In the highly competitive field of sports, impulsive behavior by athletes not only threatens personal and team harmony but also poses significant risks to their careers and public image. Despite these behaviors often becoming the focus of public attention, their underlying causes and prevention strategies remain relatively unknown. This study delves deep into the impact of mindfulness on athletes' impulsive behavior, revealing the mediating roles of self-reflection and coping effectiveness. Methods: Using a combination of snowball and convenience sampling, a sample of 403 athletes from high-level sports teams in the Central China region participated in a questionnaire survey. The data were analyzed using Amos v.23 software. Results: The findings indicate a positive correlation between mindfulness and coping effectiveness (standardized coefficient = 0.336, p < 0.001), as well as between self-reflection and coping effectiveness (standardized coefficient = 0.406, p < 0.001). There is a negative correlation between coping effectiveness and impulsive behavior (standardized coefficient = -0.476, p < 0.001). The positive impact of mindfulness on impulsive behavior (standardized coefficient = -0.371, p < 0.01) is mediated by self-reflection and coping effectiveness. The explanatory power of this study is R2 = 0.35. Discussion: Mindfulness reduces impulsive behavior by enhancing self-reflection capabilities and improving coping effectiveness. Based on these substantive research results, to mitigate impulsive behavior in athletes, it is recommended that the National Sports Administration and coaches actively implement mindfulness training. Additionally, targeted psychological intervention strategies should be developed to enhance athletes' mental health levels and optimize their sports performance.

The development and validation of the S-scan-parental self-management support (S-scan - PS): A self-reflection tool for child healthcare professionals.

BACKGROUND: Professionals providing self-management support to parents regarding the care for their child with a chronic condition nowadays is an important aspect of child healthcare. This requires professionals to orient themselves towards partnership and collaboration with parents. The aims of the current study were the development and validation of the S-Scan-Parental self-management Support (S-scan - PS) as a tool for healthcare professionals to reflect on their attitude and practices regarding the support for parental self-management. METHODS: An existing instrument was adapted together with field experts for professionals to self-evaluate their support for self-management of parents. The resulting 36-item self-report questionnaire was filled in by healthcare professionals in the Netherlands working with children and their parents. Cognitive interviews, exploratory and confirmatory factor analysis (CFA), and test-retest reliability analysis were part of the development and validation process. RESULTS: In total, 434 professionals, including physicians, physiotherapists, occupational therapists, and nurses, from 13 rehabilitation institutes and 5 medical centres participated. The cognitive interviews with child healthcare professionals indicated adequate face and content validity. The S-scan - PS scale had acceptable internal consistency (0.71 ≤ α ≤ 0.91) for the total score as well as the domain scores. CFA showed acceptable root mean square error of approximation (RMSEA) model fit (0.066), though not on other tested goodness-of-fit indices. Test-retest reliability of the instrument was moderate with an average intraclass correlation coefficient (ICC) = 0.61. CONCLUSIONS: The S-scan - PS fulfils important psychometric criteria for use by child healthcare professionals to reflect on parental self-management support. Such self-reflection might help to improve their approach towards supporting self-management of parents in the care for their child with a chronic condition. Further research is needed into the construct validity and test-retest reliability of the instrument.

A randomized controlled trial comparing the effects of self-reflective writing focused on successful and unsuccessful coping experiences on resilience.

Evidence supports the effectiveness of self-reflective training approaches for the development of resilience. Building this work, the objective of this study was to investigate the impact of the focus of coping self-reflective activities on resilience by applying a self-reflection approach to a sample of 254 Australian ministry workers. This randomized controlled trial included three attention-matched conditions: (1) self-reflective writing focused on successful coping, (2) self-reflective writing focused on unsuccessful coping or (3) written descriptions of stressor events alone. Participants were assessed across four time points: prior to, immediately post, 3-months, and 6-months after the intervention. Results demonstrated that self-reflective writing was more effective in enhancing perceived resilience than descriptive writing. Analyses also showed greater maintenance of beneficial effects in the successful self-reflection condition, compared to the unsuccessful condition. These findings support the use of self-reflection training to strengthen individuals' psychological resilience, particularly when focused on successful coping situations for those who initially experience more ruminative thought.