Academic journal article American Journal of Pharmaceutical Education

The Effect of Reflective Activities on Reflective Thinking Ability in an Undergraduate Pharmacy Curriculum

Academic journal article American Journal of Pharmaceutical Education

The Effect of Reflective Activities on Reflective Thinking Ability in an Undergraduate Pharmacy Curriculum

Article excerpt


Reflective thinking and learning capacity is regarded as an essential attribute in the health professions to link theory with application and to address the challenges that arise in clinical practice. (2-8) However, evidence to support the integration of these skills and curricular innovations in health education remains largely theoretical. (2) Furthermore, evidence of integration of reflective practice teaching and learning modules into curriculum is scant.

Reflective practice is an umbrella term used to describe the professional strategy to constantly improve one's practice. (5) It is a cognitive process of understanding and evaluating the meaning of an experience within the context of one's previous experience, previous and existing knowledge, firmly held beliefs, and assumptions. (9,10) Through reflective practice, professionals continue to critique their skills, performance, outcomes, and behavior. It can be argued that constant critiquing of practice, upgrading skills and performance, and/or changing behavior, allows for better informed decisions and clinical judgments, (11) thus enabling improvement for future practice. (5,6,12,13)

Integrating reflective practices into health education settings can enhance self-reflection (6) and fundamental reflective thinking ability. (14) Integrating reflective learning activities may also assist with bridging pharmaceutical theory to the complexities of pharmacy practice. (5,13) Furthermore, enhancing reflective thinking and reflective learning improves lifelong learning skills (15) such as critical thinking, (16,17) problem solving, (18-20) clinical reasoning and decision making, (11,16) communication skills, (21,22) self-directed learning, and professional development. (7,10,23-32) Subsequently, enhanced reflective thinking skills may better prepare students for the challenges that may arise in future clinical practice.

Moreover, adopting reflective learning and thinking skills may enhance deep learning and develop metacognitive ability. (21) Enhancing metacognitive ability of pharmacy students can assist with improving the application of theory to resolve issues they may encounter in future clinical practice. (21,33,34) Therefore, incorporating these fundamental skills into pharmacy curriculum maybe a sound teaching methodology.

Several scholars posit that structured reflective guides or prompts are a useful tool to enhance reflective processes (6,35) and promote the strategies for continuous professional development, (31) better clinical decisions and improvement of clinical practice. (6,11,36,37) Some researchers believe that the art of reflection is a skill that can be taught without any prerequisites of knowledge in this area as long as the learning environment is conducive for reflective activities. (10,38) Integrating learning and teaching modules into an undergraduate pharmacy curriculum to enhance such a fundamental skill has the potential to assist the pharmacy student to become prepared for the real world of pharmacy practice.

Several tools enhance reflective capacity. For example, reflective writing as a tool to enhance reflective capacity is at the forefront of the published literature. (39) Reflective writing tools such as statements, (40,41) essays, (42,43) diaries, (44,45) logbooks, (46) portfolios (47-54) and journals (55-59) have been used to enhance the reflective thinking process. Extended from these are the more technologically oriented online versions such as e-portfolios, (60-68) e-journals, and blogs. (17,69-71) Such tools enhance professional continuing education to allow a continuous critiquing of skills in practice. (15,72) Furthermore, reflective exchange blogs (REB) have been considered for effective exchange of reflective dialogue between multidisciplinary health team members. (5) To assess the depth and level of reflection, tone can draw from the theories and ideas of early researchers and leaders in the field of reflective practice: Dewey, (73) Polanyi, (74) Kolb, (75) Schon, (3,4) Boud, (76) Mezirow (77,78) and Moon. …

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