University of California, San Francisco, CA 94118, USA.
Med Teach. 2011;33(10):e515-21. doi: 10.3109/0142159X.2011.599894.
Reflection is increasingly incorporated into all levels of medical education but little is known about best practices for teaching and learning reflection.
To develop a literature-based reflective learning guide for medical education and conduct a pilot study to determine whether (1) guide use enhances medical students' reflective writing skills and (2) reflective scores correlate with participant demographics and satisfaction.
Guide development consisted of literature review, needs assessment, single institution survey, and educational leader consensus. The pilot cohort study compared professionalism reflections written with and without the guide by third-year medical students on their core obstetrics and gynecology rotation. Reflections were scored using a previously validated rubric. A demographics and satisfaction survey examined effects of gender and satisfaction, as well as qualitative analysis of optional written comments. Analyses used independent t-tests and Pearson's correlations.
We developed a two-page, literature-based guide in clinical Subjective-Objective-Assessment-Plan (SOAP) note format. There was a statistically significant difference, p < 0.001, in the reflection scores between groups, but no effects of gender or satisfaction. Student satisfaction with the guide varied widely.
A single exposure to a literature-based guide to reflective learning improved written reflections by third-year medical students.
反思越来越多地融入到医学教育的各个层面，但对于教学和学习反思的最佳实践方法却知之甚少。
开发一个基于文献的医学教育反思学习指南，并进行一项试点研究，以确定（1）指南的使用是否能提高医学生的反思写作技能，以及（2）反思分数是否与参与者的人口统计学特征和满意度相关。
指南的开发包括文献回顾、需求评估、单机构调查和教育领导者共识。试点队列研究比较了使用和不使用指南的三年级医学生在其妇产科核心轮转期间所写的专业反思。使用先前验证过的评分表对反思进行评分。人口统计学和满意度调查考察了性别和满意度的影响，以及对可选书面评论的定性分析。分析使用了独立 t 检验和皮尔逊相关系数。
我们开发了一个两页的、基于文献的指南，采用临床主观-客观-评估-计划（SOAP）记录格式。两组之间的反思评分存在统计学上的显著差异（p<0.001），但性别和满意度没有影响。学生对指南的满意度差异很大。
单次接触基于文献的反思学习指南可提高三年级医学生的书面反思能力。
