Authentic reflection in clinical placement: Educator views on fostering reflective practitioners

Introduction: Reflection offers many benefits for medical students, improving self-awareness and integration of theory into real situations. However, like any skill, reflection must be learned and practiced. Reflective learning is also influenced by the workplace, particularly in students’ clinical training years. This study explored the factors perceived by educators to influence reflective learning amongst medical students undertaking a rural longitudinal integrated clerkship (LIC). Methods: All educators within the LIC program were invited to participate. Educators come from both a medical and nursing background. Two focus groups (FG) were conducted. FG were facilitated by experienced researchers. Transcripts were analysed by two researchers using Braun and Clark’s approach to thematic analysis. Results: Eleven educators participated in two focus groups (six medical educators; five nursing educators). Educators perceived that reflective learning was influenced at three levels: student, educator and institution. These findings aligned with workplace learning theory. Educator and institutional influences were identified as “affordances” which support or hinder reflection. Supportive affordances included labelling of reflection, multidisciplinary collaborative learning, and the longitudinal nature of the rural model. Hindering affordances included using artificial reflective assessments. Educators also identified characteristics of the individual student which may contribute to student decision-making about reflection. Conclusion: This study provides a deeper understanding about educator experiences of reflective learning within LIC settings. The findings provide insights into the ways in which educators, educational institutions and student workplace settings may support or hinder reflective practice. This study also highlighted the potential for the LIC model to support reflective practice.