Reflective practice in medicine: The hidden curriculum challenge

Author:

Ní Mhurchú Michelle1ORCID,Cantillon Peter1ORCID

Affiliation:

1. School of Medicine University of Galway Galway Ireland

Abstract

AbstractBackgroundDespite the known benefits of reflection in various health care professions, it is still not a thriving practice in medical education. The literature suggests that this may be due to tensions between epistemological tenets of reflection and biomedicine. Further research is needed into experiences of doctors as they implement reflection in medical education settings. We set out to explore how these experiences were influenced by hidden curricula to provide insights into personal and contextual features of medical settings influencing engagement in reflection.MethodsUsing an interpretative phenomenological analysis (IPA) approach, four semi‐structured qualitative interviews were conducted virtually. Participants were doctors who graduated from a postgraduate diploma in clinical education with core reflective practice components. Interviews were recorded, transcribed, coded and analysed using IPA. Opportunities to review and amend transcriptions were provided.FindingsThree superordinate themes were identified including epistemological divergence, fear of showing vulnerability and reflection volte‐face. Challenges in engaging in practices epistemologically different to predominant discourses in medicine were compounded by fears of vulnerability and a common antipathy towards reflection. All developed more accommodating perspectives towards reflection with shared experiences of a programme incorporating reflective practice.ConclusionThe hidden curriculum can have positive and negative impacts on doctors' engagement in reflection. In facilitating reflective practice for this group, we recommend assisting with awareness of ways of thinking and being in medicine, offering reassurance that reflection may initially feel like running contrary to predominant discourses and finally, role modelling openness to vulnerability to better integrate and promote meaningful engagement in reflection.

Publisher

Wiley

Subject

Review and Exam Preparation,General Medicine

Reference30 articles.

1. Canadian Medical Association.CMA 2021 National Physician Health Survey 2022.

2. Doctor, how can we help you? Qualitative interview study to identify key interventions to target burnout in hospital doctors

3. Academy of Medical Royal Colleges UK Conference of Postgraduate Medical Deans General Medical Council Medical Schools Council.The reflective practitioner: guidance for doctors and medical students United Kingdom2021.

4. Reflection and reflective practice in health professions education: a systematic review

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