Table 9 Expert experience with group reflections
From: A systematic scoping review of group reflection in medical education
Characteristics | Palliative care clinical postings which are part of the formal medical school training program. | Group reflections following the viewing of “a good death”, a recording of a local play set in a hospice. | Group reflections of medical officers following training on breaking bad news. | Interprofessional case discussions involving nurses, Social workers and physicians in a home care unit. |
|---|---|---|---|---|
Population | A group of between two to 12 peers from Duke-NUS or NUS medical school students in the final years of medical school. | 8–12 DUKE-NUS medical students. These clinical groups are mature and the participants have been working with one another for at least a few months. | Three to four medical officers and residents in Oncology and Palliative Care. | Five to nine professionals. Facilitated by the senior physician. |
Format | Case presentation of a case discussed or seen by the students. Compulsory aspect of the posting. The students are aware of the format and the expectations surrounding the session. | Group debrief facilitated by a medical humanities expert and one clinician. The students are provided with specific questions regarding a specific scene from the play. | Compulsory aspect of the oncology posting. Protected time from clinical work provided. | Ad Hoc discussions that may follow difficult cases, complex care and deaths. These discussions occur online. |
Duration | 30–60 min depending on the number of peers. Facilitated by a senior clinician. | 60 min | 30 min following the session | 30 min |
Settings | Physicians lounge or designated training room. | Teaching room | Teaching room | Online |
Lessons learnt | Smaller groups, well-established groups who have known and worked together for some time. Peers with similar sociocultural backgrounds worked better. Discussions on facets that were experienced by all the participants brought about deeper and greater sharing. Sharing was enhanced when the facilitator was known to the students and who was present at the episode being reflected upon. | The session often initiates personal insights and participation from the other participants. The nature of the discussion engenders a respectful sharing environment and the presence of a medical humanities expert who is not a clinician reduces the hierarchy in the sharing and interactions. | The small groups facilitate sharing. This sharing is enhanced when the peers know and have worked together for a while. | These groups of participants from different backgrounds share perspectives but remain largely within the confines of their specialist field of knowledge. Personal sharing is usually limited to the emotions surrounding the episode being discussed. |
Impact | As a matter of routine, all students are asked what they had learnt, what has changed the way they think, and what might affect their practice in the future. These questions bring about deeper reflection and encourages enduring effects. | Similar to clinical discussions. These sessions also surface personal issues that invite personal debriefs and sometimes referrals for further support from the Student Affairs team. | Similar to clinical discussions | Sharing may be limited given the professional environment and the culture of the team. It may also be limited by the presence of professionals of difference experience, specialities and seniority. |