Article Figures & Data
Figures
- Figure 1. Phases of recruitment. HEE = Health Education England
Tables
Interview participants (n = 11) Survey participants (n = 422) Sex Male 5 (45.5%) 188 (44.5%) Female 6 (54.5%) 230 (54.5%) Prefer not to say 0 (0%) 4 (1.0%) Ethnicity Arab 1 (9.1%) 34 (8.1%) Asian 5 (45.5%) 161 (38.2%) Black 5 (45.5%) 153 (36.3%) Mixed 0 11 (2.6%) White 0 41 (9.7%) Other 0 15 (3.6%) Prefer not to say 0 7 (1.7%) Area of the world in which primary medical qualification achieved Africa 3 (27.3%) 158 (37.4%) EEA Europe 0 (0%) 52 (12.3%) Non-EEA Europe 1 (9.1%) 10 (2.4%) Middle East 2 (18.2%) 41 (9.7%) Oceana 0 (0%) 2 (0.5%) Rest of Asia 2 (18.2%) 19 (4.5%) South Asia 2 (18.2%) 127 (30.1%) South, Central, Latin America, and Caribbean 1 (9.1%) 13 (3.1%) Total 11 422 EEA = European Economic Area;
Theme Survey example Interview examples Reflection as an effective learning approach 'Reflective learning makes you responsible for your own learning and engages you as a clinician. I find it super beneficial.' (S268) 'I think learning is the biggest thing about reflection … it’s like revising things … like a problem-solving point of view.' (ID) a. Opportunity 'Gives the clinician the opportunity to step aside from daily practice and think insightfully about events.' (S94) 'It gives you an opportunity to reassess your decision making … you will always find room for improvement.' (IH) b. Helps 'Helps me think about how I felt in a situation in hindsight and to learn from my experience.' (S407) 'I think it’s a very good exercise, it helps you learn a lot about yourself and the scenario.' (IK) c. Consolidate 'It enables me to consolidate my learning regularly, practically and positively.' (S344) 'Sitting down and reflecting on what you have learnt … Putting it on paper … it tends to stay with you longer.' (ID) Reflection for self-assessment 'Reflection allows me to think about what I am doing right or doing wrong. Is there another way I can learn? Why do I feel anxious about this or that and is there another method to improve on?' (S25) 'I’ve been finding that it’s a sort of internal dialogue with oneself of “I’m doing good enough, this isn’t good.”' (IF) a. Learning needs 'It gives an opportunity to self-assess and to identify leaning needs.' (S3) 'I found that when I was reflective I could identify my gaps and what I needed to learn.' (IG) b. Strengths and weaknesses 'It exposes my deficiencies and strengths which helps direct my learning.' (S224) 'I think the purpose would be … appreciate the good things that happened … to identify where your weaknesses are …' (IG) Reflection for professional development 'It helps to objectively analyse scenarios and creates a learning opportunity for better medical practice.' (S29) 'You tend to change your practice … it was more effective when I saw a consultant doing it this way so yes, I should apply that next time …' (IC) a. Mistakes 'It helps in improving our knowledge and also preventing repeating mistakes.' (S250) 'Each of those learning events I have written I know would not be repeated, because I have learned to be better from them … mistakes you make teach you more.' (IJ) Developing self-awareness 'Helps to know myself and my thinking process better.' (S376) 'I’ve learned so much about myself through reflection and I keep asking, why have I acted so …?' (IE) a. Emotions 'It makes me to think of aspects of patient encounters I wouldn't normally think about, like how a case made me feel.' (S227) 'I think the best part of the reflection is that it changes you — you stop being a doctor without emotions and you become more human.' (IA) Document or record 'Sometimes its useful to document certain cases as reference for future practice.' (S295) 'I feel it also helps you to write it down … because you can go back and have a look at it.' (II) Dialogue with trainer 'I enjoy writing so it can sometimes be fun to put my thoughts, view, feelings etc about situations into words and share that with my trainer.' (S167) 'What’s the best thing? It’s to see the comment from my supervisor. I’m like “this is a fun chat.”' (IG) Vague 'Makes you think more.' (S189) Theme Survey example Interview example Time 'Having to sit aside and taking time to think and then write … with my kid and family I find it difficult.' (S297) 'The time it takes … I think I’m a perfectionist, so it can take me a whole week to write one reflection.' (IA) Mandatory or forced 'The fact that there is a stipulated number of reflection entries in each training period means sometimes the trainee makes entries just to meet up with the required number.' (S386) 'It’s just being forced … that restricts you and makes you tailor stuff … it should be more open … we should be able to reflect how we feel a reflection should be.' (IC) Difficult and unfamiliar process 'As we do not have previous reflections, it was very difficult to know what they mean by reflect and how to do this. And when I did that, I am not sure is it the right way or not.' (S299) 'When I started ST1 I was always anxious if I‘m saying and writing the right things, if I’m reflecting properly because as I say it’s not something we do.' (II) Fear of consequences 'Difficult to reflect on mistake because of fear of GMC scrutiny or providing evidence for our own weaknesses.' (S115) 'I find myself saying’"Okay, delete that, you don’t want that on record". Because some smart lawyer somewhere can twist your words out of context and put you in trouble.' (IH) Boring or repetitive 'Sitting down, recalling the events of a particular case or event, putting on a writer’s hat can be tedious.' (S5) 'Sometimes when you’ve had an uneventful week you just think "Okay what do I reflect on?"… everything that we’ve seen, I’ve reflected on it already.' (ID) Distressing 'Sometimes looking back at things and realising things you could have done and you did not makes you feel low, and sometimes that can be overwhelming.' (S366) Documenting 'We all reflect on the events always, some of us do that in the mind, some do it in writing form. I find it hard to reflect in writing form but does that make me a bad clinician? I don’t think so.' (S143) 'We are doing the reflection, but the writing down bit and realising what you have done is the tricky bit for IMGs.' (IE) Negative 'Waste of time.' (S25) Vague 'Writing too much.' (S331)
In this issue
‘I feel many of my reflections are forced’: International medical graduates’ perspectives on reflection in UK general practice training: a mixed methods qualitative study
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