Medical students’ perceptions of learning reflective skills

Dear Sir

We are writing to you on behalf of the Cardiff University Journal Club, encompassing medical students from year's three to five.

The paper by Vivekananda-Schmidt et al. (2011) in the October Issue of Medical Teacher highlighted a key issue within our journal club – reflective practice. Cardiff offers early clinical integration and has a course structure similar to those universities used in this study. The GMC clearly emphasizes in ‘Tomorrow's Doctors’, Professional Development and Practice (PDP), of which reflection makes up the bulk, as crucial for the safeguarding and development of doctors.

We feel that the study reflects views similar to those of Cardiff medical students, particularly related to relevant experience, mentoring and attitude of the tutors and other personnel.

In first year we are introduced to the idea of reflective practice through professional awareness lectures and clinical placements. Likewise to the participants of the study, at times we found this difficult due to the nature of the experience.

We receive written and verbal feedback in terms of mentoring, but from different tutors. Both methods of critique clearly emphasize which aspects of reflective practice to focus on; however, in parallel to the study, attitudes of tutors were found to be variable. It would be interesting to make a comparison between second years, final years and junior doctors; in particular, to find out how reflective skills may benefit future implementation of ‘Situational Judgment Tests’ taken as part of the application process for foundation posts. Equally, it would be interesting to investigate how reflective practice (or lack of it) impacts on junior doctors in regards to their NHS e-portfolios.

One aspect of reflective practice that the study did not comment on was the teaching of reflective practice. In our third year we are assigned an ‘Oncology Project.’ Each student is attached to a patient diagnosed with cancer with the aim to write a report on our experiences – essentially assessing our reflective skills. Many students felt that they were not taught how to reflect until this project making reflective practice prior to this appear potentially futile.

It is evident that this aspect of the course needs careful consideration and we feel that it is somewhat overshadowed by the university's more academic responsibilities. On reviewing the GMC guidelines, we hope to see positive developments in the future regarding reflective practice within medical school and throughout the rest of our careers.

Catherine Morgan, Rebecca Woolf, Julia Tracy, Department of Medicine, Cardiff University, 227 Mackintosh Place, Cardiff CF24 4RP, UK. E-mail: [email protected]