Strides in Development of Medical Education

Document Type : Original Article

Authors

1 Assistance Professor, School of Public Health, Medical Education Department, Education Development Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Meybod Faculty of Nursing, Shahid Sadoughi University of Medical Sciences, Yazd, Iran .

Abstract

Background: Reflection plays an important role in in-depth learning. Reflective ability must develop among students of medical sciences.
Objectives: The aim of this study was the psychometric assessment of the Reflection in Learning Scale and evaluating this ability among nursing students.
Methods: This descriptive-analytical cross-sectional study was conducted on nursing students of Shahid Sadeghi University of Medical Sciences (Yazd, Iran) in 2019.The participants selected by the census. The research was conducted in two phases. In the first phase, the validity (qualitative and quantitative methods), Confirmatory factor analysis, and reliability of Reflection in Learning Scale were evaluated. In the second phase, the reflection in learning was assessed using this tool. Data were analyzed using descriptive and analytical tests by SPSS software.
Results: The content and face validity of the scale were confirmed. Internal consistency of the instrument was 0.92 using Cronbach's alpha coefficient and ICC of 0.90 determined. Confirmatory factor analysis revealed acceptable indices: goodness of fit index =0.89, standardized root mean square residual (SRMR) = 0.06, root mean square error of approximation = 0.18. Learners' reflection ability with a mean score of 4.37 ± 1.04 was at a moderate level.
Conclusion: The Persian version of Reflection in Learning Scale is a valid and reliable tool and can be used to assess reflection abilities in learners. Nursing students' reflection ability was at a moderate level. Therefore, planning to assess reflection ability in nursing education by the tool is recommended.

Keywords

  1. Rahimi M, Haghani F. Reflection in Medical Education: a Review of Concepts, Models, Principles and Methods of Teaching Reflection in Medical Education. Research in Medical Education. 2017; 9(2): 13-24. doi:10.29252/rme.9.2.24. [In Persian]
  2. Swing SR. The ACGME outcome project: retrospective and prospective. Med Teach. 2007; 29(7): 648-54. doi:10.1080/01421590701392903. [PMID:18236251].
  3. Moattari M, Abedi H. Nursing students' experiences in reflective thinking: A qualitative study. Iran J Med Educ. 2008; 8(1): 101-12. [In Persian]
  4. Dehghany Z, Abaszadeh A, Moattari M, Bahreini M. Effective reflection on clinical competency of nursing students. Interdisciplinary Journal of Virtual Learning in Medical Sciences. 2011; 2(1): 12-8. [In Persian]
  5. Karimi Mooanaghi H, Sadeghnezhad M. Reflective Learning, A New Approach In Nursing Education. Research in Medical Education. 2013; 5(2): 55-7. [In Persian]
  6. Moradi E. Reflection paper: A Tool to Improve Teaching and Learning process. Nurs Midwifery J. 2018; 15(12): 885-7. [In Persian]
  7. Abdolrahimi M, Razaghi N, Ghiyasvandian SH, Shokoh V. Reflection in Nursing Education: Why and How?. Iran J Med Educ. 2015; 14(12): 1068-77. [In Persian]
  8. Abedini Z, Begloo J, RaeisiM, Dadkhah Tehrani T. Effectiveness of reflection in clinical education: Nursing students’ perspective. Iran Journal of Nursing. 2011; 24(71): 74-82. [In Persian]
  9. Epp Sh. The value of reflective journaling in undergraduate nursing education: A literature review. Int J Nurs Stud. 2008; 45(9): 1379-88. doi: 10.1016/j.ijnurstu.2008.01.006. [PMID:18325522].
  10. Pai HC. The effect of a self-reflection and insight program on the nursing competence of nursing students: a longitudinal study. J Prof Nurs. 2015; 31(5): 424-31. doi:10.1016/j.profnurs.2015.03.003. [PMID:26428348]
  11. Knobloch NA. Is experiential learning authentic?. Journal of Agricultural Education. 2003; 44(4): 22-34. doi:10.5032/jae.2003.04022.
  12. Young L, Rego P, Peterson R. Clinical location and student learning: outcomes from the LCAP program in Queensland, Australia. Teach Learn Med. 2008; 20(3): 261-6. doi.org/10.1080/10401330802199583. [PMID:18615302].
  13. Chalmers P, Dunngalvin A, Shorten G. Reflective ability and moral reasoning in final year medical students: A semi-qualitative cohort study. Med Teach. 2011; 33(5): 281-9. doi: 10.3109/0142159X.2011.558531. [PMID:21517680].
  14. Sobral DT. An appraisal of medical students’ reflection-in-learning. Med Educ. 2000; 34(3): 182-7. doi: 10.1046/j.1365-2923.2000.00473.x. [PMID:10733703]
  15. Lawsche CH. A Quantitative Approach To Content Validity. Personnel Psychology. 1975; 28(4): 563-5. doi:10.1111/j.1744-6570.1975.tb01393.x.
  16. Polit DF, Beck CT. The content validity index: are you sure you know what's being reported? Critique and recommendations .Res Nurs Health. 2006; 29(5): 489-97. doi:10.1002/nur.20147. [PMID:16977646].
  17. Gipe JP, Richards JC, Levitov J, Speaker R. Psychological and personal dimensions of prospective teachers' reflective abilities. Educational and Psychological Measurement. 1991; 51(4): 913-22. doi:10.1177/001316449105100411.
  18. Mamede S, Schmidt HG, Penaforte JC. Effects of reflective practice on the accuracy of medical diagnoses. Med Educ. 2008; 42(5): 468-75. doi.org/10.1111/j.1365-2923.2008.03030.x [PMID:18412886].
  19. Gordon J. Assessing students' personal and professional development using portfolios and interviews. Med Educ. 2003; 37(4): 335-40. doi: 10.1046/j.1365-2923.2003.01475.x. [PMID:12654118].
  20. Aukes LC, Geertsma J, Cohen-Schotanus J, Zwierstra RP, Slaets JP. The effect of enhanced experiential learning on the personal reflection of undergraduate medical students. Med Educ Online. 2008; 13(1): 15. doi.org/10.3402/meo.v13i.4484. [PMid:20165543]. [PMCid:PMC2779594].
  21. Embo M, Driessen E, Valcke M, Van der Vleuten C. Relationship between reflection ability and clinical performance: A cross-sectional and retrospective-longitudinal correlational cohort study in midwifery. Midwifery. 2015; 31(1): 90-4. doi:10.1016/j.midw.2014.06.006. [PMID:25017173].
  22. Lachman N, Pawlina W. Integrating professionalism in early medical education: the theory and application of reflective practice in the anatomy curriculum. Clin Anat. 2006; 19(5): 456-60. doi:10.1002/ca.20344. [PMID:16683241].
  23. Seif A. Methods of learning and reading. second ed. Tehran: Dowran; 2010. [In Persian]