Melbourne Medical School Collected Works - Theses
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ItemUnderstanding the nature of medical students reflection on learning and how it relates to feedback: an exploratory study( 2013)While there is a theoretical basis for the relationship between reflection on learning and feedback, there are still very few studies that provide empirical data about their relationship. To frame the study, a reflection on learning model was developed based on thorough theoretical and conceptual analysis. The analysis demonstrated that for students to be able to reflect on learning they need to have adequate internal motivation and self-efficacy, along with the appropriate level of cognitive and metacognitive skills and also proper feedback-seeking behaviour. Two separate studies were carried out to explore each of the two components and suggest best practice in feedback provision and a standardized way of measuring reflection on learning. This approach should advance our understanding of the nature of medical students’ reflection on learning and how it relates to feedback. Using the reflection on learning framework, the first study was conducted to determine the most appropriate instrument to measure medical students’ reflection the learning. Study one described the adaptation of the Motivated Strategies for Learning Questionnaire (MSLQ) to suit medical students learning context. The MSLQ was obtained through a systematic review of existing literature and was considered to be the most suitable instrument to measure reflection on learning. It has undergone expert panel review, pilot testing and a validation study with two groups of medical students to further establish its suitability. The findings in study one revealed that the modified MSLQ consisted of four factors: self-orientation, critical thinking, self-regulation and feedback seeking. These factors were compatible with the reflection on learning model developed as the conceptual framework in the present study. Using the modified MSLQ medical students reported only moderate reflective learning ability. Study two investigated the current process of feedback provision to medical students in the Mini Clinical Evaluation Exercise (Mini-CEX) setting. Five perspectives were pursued in order to understand how feedback was delivered and received: 1) non-participant observation of Mini-CEX, 2) analysis of Mini-CEX assessment forms, 3) structured interviews with medical students, 4) obtaining students’ perceptions of Mini-CEX feedback provision through questionnaire, and also 5) structured interviews with clinical teachers. The exploration of the feedback process in the Mini-CEX setting indicated that the feedback process was viewed as a one-way communication where students were unlikely to reflect on their learning experiences. The focus of the process was on teachers who transmitted information, whereas students’ roles and responses in receiving feedback received less attention. These approaches were not conducive for the development of reflective learning ability. The important implication of these findings is that both teachers and students need training in reflective learning practice. Both parties need to understand the concept of reflective learning in which feedback is one of the influencing factors on reflective learning. Teachers need to be trained to deliver feedback within a two-way communication process to help students develop their reflective learning ability.