Bespoke video vignettes - an approach to enhancing reflective learning developed by dental undergraduates and their clinical teachers.

This study explores the selective use of video as a medium to support reflective processes as related to dental undergraduate learning. With the objective of developing and enhancing high-quality adult dental care, the use of compiled video materials created in an undergraduate clinical setting was investigated. Video cameras were used to capture elements of reflection-in-action and reflection-on-action typically found during everyday clinical practice. 'Gold standard' or 'textbook outcomes' are rarely, if ever, fully achieved in dental practice. Real-life clinical experiences offer challenges and opportunities for both teachers and students to engage with reflective learning processes. The materials generated allowed for an experience of individual reflective learning and the creation of a data bank or archive with potential use for the benefit of a wider student cohort. Various aspects of the students' views and comments on the process of reflection were reported and explored by means of a semi-structured focus group moderated by a linked educational advisor.

Reflective learning for behavioral guidance in pediatric dentistry.

INTRODUCTION: Basic behavioral guidance (BBG) skills help in delivery of quality health care in pediatric dentistry. The complex nature of these skills, warrants analyzing actions performed. An appropriate scientific way to do this is by "reflection." Hence, the present study was designed to introduce "reflection of action" as means for learning BBG skills by undergraduates in pediatric dentistry. METHODS: Participants (dental undergraduate) performed oral prophylaxis (two visits) in pediatric patients (age 3-7 years) with application of BBG skills, under video recording. They were instructed regarding "reflection on action." The learners then reviewed own videos and wrote reflections. Reflections were assessed on Boud's 4R framework and feedback was given by the faculty. Reflective writing was repeated for a second visit. Knowledge of the learners in using reflections for learning was assessed by retrospective pretest posttest questionnaire. Video recordings were scored for BBG skills. Acceptability of the intervention was addressed by satisfaction questionnaire. RESULTS: There was a significant improvement in the knowledge of participants in using reflections for learning these skills. All participants were able to "revisit" (R1 level under Boud's 4R framework) patient encounter in their written reflections. Sixteen participants exhibited shift toward higher levels in the next visit. Video scores of learners also improved significantly over both visits. Students were satisfied with the content, delivery, and relevance of the new educational intervention. CONCLUSION: The strong need of improving BBG skills in pediatric dentistry was met by "reflection on action." There was improvement in the knowledge of students in using reflections for learning and application of behavior guidance skills and was well accepted.

Selecting and Performing Service-Learning in a Team-Based Learning Format Fosters Dissonance, Reflective Capacity, Self-Examination, Bias Mitigation, and Compassionate Behavior in Prospective Medical Students.

More compassionate behavior should make both patients and their providers happier and healthier. Consequently, work to increase this behavior ought to be a major component of premedical and medical education. Interactions between doctors and patients are often less than fully compassionate owing to implicit biases against patients. Such biases adversely affect treatment, adherence, and health outcomes. For these reasons, we studied whether selecting and performing service-learning projects by teams of prospective medical students prompts them to write reflections exhibiting dissonance, self-examination, bias mitigation, dissonance reconciliation, and compassionate behavior. Not only did these students report changes in their behavior to become more compassionate, but their reflective capacity also grew in association with selecting and performing team service-learning projects. Components of reflective capacity, such as reflection-on-action and self-appraisal, correlated strongly with cognitive empathy (a component of compassion) in these students. Our results are, however, difficult to generalize to other universities and other preprofessional and professional healthcare programs. Hence, we encourage others to test further our hypothesis that provocative experiences foster frequent self-examination and more compassionate behavior by preprofessional and professional healthcare students, especially when teams of students are free to make their own meaning of, and build trust and psychological safety in, shared experiences.

Using a computer simulation for teaching communication skills: A blinded multisite mixed methods randomized controlled trial.

OBJECTIVES: To assess advanced communication skills among second-year medical students exposed either to a computer simulation (MPathic-VR) featuring virtual humans, or to a multimedia computer-based learning module, and to understand each group's experiences and learning preferences. METHODS: A single-blinded, mixed methods, randomized, multisite trial compared MPathic-VR (N=210) to computer-based learning (N=211). Primary outcomes: communication scores during repeat interactions with MPathic-VR's intercultural and interprofessional communication scenarios and scores on a subsequent advanced communication skills objective structured clinical examination (OSCE). Multivariate analysis of variance was used to compare outcomes. SECONDARY OUTCOMES: student attitude surveys and qualitative assessments of their experiences with MPathic-VR or computer-based learning. RESULTS: MPathic-VR-trained students improved their intercultural and interprofessional communication performance between their first and second interactions with each scenario. They also achieved significantly higher composite scores on the OSCE than computer-based learning-trained students. Attitudes and experiences were more positive among students trained with MPathic-VR, who valued its providing immediate feedback, teaching nonverbal communication skills, and preparing them for emotion-charged patient encounters. CONCLUSIONS: MPathic-VR was effective in training advanced communication skills and in enabling knowledge transfer into a more realistic clinical situation. PRACTICE IMPLICATIONS: MPathic-VR's virtual human simulation offers an effective and engaging means of advanced communication training.

Using reflection to influence practice: student perceptions of daily reflection in clinical education.

PURPOSE: Reflection is a key element in learning from experience, but the impact of most programmes of reflection on daily practice remains unclear. We investigated students' perceptions of adding a daily written reflection assignment to a clinical rotation. METHODS: Third-year medical students on a single two-week rotation completed daily reflections analyzing their performance. Programme evaluation used a 33-question anonymized survey. Quantitative data were summarized and qualitative responses coded for recurring themes. RESULTS: Twenty-six students completed the survey (90 % response rate). Eighty-five percent of students felt that the daily reflections had a positive impact on their learning from clinical experience. Seventy-seven percent of students reported that the programme changed their awareness of their thoughts and actions, and 80 % felt that it improved their recall of experiences. A greater sense of mindfulness and focus on self-improvement were major themes that emerge from students' descriptions of the role of daily reflections in their learning. CONCLUSION: Overall, daily reflections demonstrated a positive learning influence. This exploratory study suggests students may benefit from more frequent, short reflections as opposed to more typically spaced reflective assignments.

Self-assessment, reflection on practice and critical thinking in nursing students.

UNLABELLED: In accordance with the principles of the European Higher Education Area, the aim of this study was to contribute to the implementation of self-assessment through the application of reflection on learning and critical thinking. The theoretical framework employed was Habermas's critical theory and emancipatory interest as a preliminary step to generate educational transformations. The methodological contribution is the design a student self-assessment document that promotes reflection on action and critical thinking. RESULTS AND DISCUSSION: The development of assessment through peer evaluation and other intermediate solutions until achieving self-assessment entails a shift in the educational and scientific paradigm, but also involves the implementation in practice of democratic and ethical principles, values and premises in society. Self-assessment is a novel concept for students, and obliges them to reinterpret their role. Due to the diversity of students' principles, values, motivations, interests and aspirations, this reinterpretation of their role can have a positive outcome, stimulating an active and critical attitude towards group work and self-assessment; or, on the contrary, can generate a stance characterised by disinterest, passivity and lack of critical thinking. CONCLUSIONS: The forms of assessment adopted in a given educational system reflect ways of thinking related to ideologies, values, ethical principles and educational paradigms: in order to render implementation of effective self-assessment feasible, it is necessary to undertake structural and regulatory reforms. Students have little experience of reflection on practice or critical thinking. Massification and cultural and structural factors determine the form of assessment. In this context, it would seem advisable to move towards self-assessment gradually and cautiously.