How to enhance and assess reflection in specialist training: a mixed method validation study of a new tool for global as
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RESEARCH ARTICLE
Open Access
How to enhance and assess reflection in specialist training: a mixed method validation study of a new tool for global assessment of reflection ability Gunver Lillevang1, Helle Ibsen2* , Søren Hast Prins3 and Niels Kristian Kjaer2
Abstract Background: In Danish GP training we had the ambition to enhance and assess global reflection ability, but since we found no appropriate validated method in the literature, we decided to develop a new assessment tool. This tool is based on individual trainee developed mind maps and structured trainer-trainee discussions related to specific complex competencies. We named the tool Global Assessment of Reflection ability (GAR) and conducted a mixed method validation study. Our goal was to investigate whether it is possible to enhance and assess reflection ability using the tool. Methods: In order to investigate acceptability, feasibility, face validity, and construct validity of the tool we conducted a mixed method validation study that combined 1) qualitative data obtained from 750 GP trainers participating in train-the-trainer courses, 2) a questionnaire survey sent to 349 GP trainers and 214 GP trainees and 3) a thorough analysis of eight trainer-trainee discussions. Results: Our study showed an immediate high acceptance of the GAR tool. Both trainers and trainees found the tool feasible, useful, and relevant with acceptable face validity. Rating of eight audio recordings showed that the tool can demonstrate reflection during assessment of complex competencies. Conclusions: We have developed an assessment tool (GAR) to enhance and assess reflection. GAR was found to be acceptable, feasible, relevant and with good face- and construct validity. GAR seems to be able to enhance the trainees’ ability to reflect and provide a good basis for assessment in relation to complex competencies. Keywords: Educational assessment, Reflection, Medical postgraduate education, General practice
Background Clinical practice is never simple and straight forward. Doctors are practicing complex competencies in a clinical world embedded with uncertainty and where textbook knowledge only provides some of the answers * Correspondence: [email protected] 2 The Research Unit of General Practice, Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark Full list of author information is available at the end of the article
[1, 2]. Clinical decision making therefore requires that doctors can combine experience-based knowledge with evidence-based knowledge and that doctors can constructively process all kinds of formal and informal feedback [3]. Furthermore in a clinical setting inherited with complexity, uncertainty, and time constraint, the doctors often have to shift between analytical and non-analytical decision making [3]. The non-analytical clinical decision making is efficient but also error prone due to decision biases [4–6]. The only way to compensate these decision
© The Author(s). 2020 Open Access
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