title: Peer-facilitated virtual action learning: reflecting on critical incidents during a pediatric clerkship.
abstract: OBJECTIVE
  Action learning (AL) facilitates reflection, critical thinking, and learning while solving real-world problems. Virtual AL is an asynchronous collaborative process that encourages students to analyze their critical incidents and learn from these experiences. The researchers sought to: 1) determine whether medical students engaged in peer-facilitated virtual action learning (VAL) demonstrated reflection and critical thinking around complex issues during their pediatric clerkship; and 2) identify challenges students face during their clerkships.
  
  
  METHODS
  Seventy clerkship students were introduced to reflection and participated in VAL by using an electronic discussion board. Each posted 1 critical incident and group members responded with thought-provoking questions and comments to facilitate reflection and analysis. Weekly, students who posted incidents revisited their incidents, pondered the questions posed, and wrote essays summarizing their reflections and insights gained. Data were analyzed using qualitative methods.
  
  
  RESULTS
  Seventy incidents, 210 responses, and 70 revised incidents/essays were analyzed. Outcomes included broadened perspectives (44/70), questioned assumptions (12/70), and reconfirmed thinking (14/70). Content themes included communication, role identification, medical treatment concerns, and limited voice and power.
  
  
  CONCLUSIONS
  Most of the students engaged in VAL demonstrated reflection on complex clinical issues. Themes portrayed struggles encountered and exposed issues in the hidden curriculum, suggesting a lack of voice and power that may lead to missed learning opportunities. Discussion threads offered the clerkship director insights into the overall student experience to improve future clerkship experiences.
authors.affiliation: Department of Health Care Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA. hspmxp@gwumc.edu
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Plack
authors.forename: Maryanne
authors.initials: M
authors.lastname: Driscoll
authors.forename: Maria
authors.initials: M
authors.lastname: Marquez
authors.forename: Larrie
authors.initials: L
authors.lastname: Greenberg
mesh_terms: D000328:Adult; D002982:Clinical Clerkship; D003479:Curriculum; D006801:Humans; D007858:Learning; D010372:Pediatrics / Q000193:education*; D010379:Peer Group; D036301:Qualitative Research; D013850:Thinking