title: An appraisal of medical students' reflection-in-learning.
abstract: BACKGROUND
  How do students reflect as they strive for some control of learning early in their clinical activities? The purpose of this study was to examine the reflection-in-learning profile of medical students as they started their clinical apprenticeship.
  
  
  METHODS
  A measure of reflection-in-learning was used to appraise the level and direction of change of reflection in relation to a course experience. The study involved 103 medical students of both sexes who were beginning clinical activities. Assessments of self-regulation of learning, of the meaningfulness of the learning experience, and of diagnostic thinking were also obtained.
  
  
  RESULTS
  The results showed that 81% of the students had an increase in scores for reflection-in-learning between the beginning and the end of a course. At the end of the course, the level of reflection-in-learning was significantly associated with self-perceived competence for self-regulated learning and with the meaningfulness of the learning experience. In the following term, students who had high reflection-in-learning scores at the end of the course had higher grade-point averages and greater self-reported diagnostic ability in comparison with those with low scores.
  
  
  CONCLUSIONS
  There was some evidence of an improved quality of reflection as the students strive for some control of learning. Overall, the findings support the idea that a greater effort at reflection is associated with a more positive learning experience. They also suggest that reflection-in-learning is related to readiness for self-regulation of learning and may be conducive to enhanced diagnostic ability. In conclusion, measuring reflection-in-learning may be a useful tool in the appraisal of medical students' learning profiles.
authors.affiliation: Department of Medicine, University of Brasilia, Faculty of Health Sciences, Medicine C.P. 15-3031, 70910-900 Brasilia, Brazil.
authors.forename: D T
authors.initials: DT
authors.lastname: Sobral
mesh_terms: D001290:Attitude; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D012655:Self-Evaluation Programs; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires