Scaffolding reflective learning in clinical practice: a comparison of two types of reflective activities.
BACKGROUND
The development of reflective learning skills is a continuous process that needs scaffolding. It can be described as a continuum, with the focus of reflection differing in granularity from recent, concrete activities to global competency development.


OBJECTIVE
To explore learners' perceptions regarding the effects of two reflective writing activities designed to stimulate reflection at different degrees of granularity during clinical training.


METHODS
Totally 142 respondents (students and recent graduates) completed a questionnaire. Quantitative and qualitative data were triangulated.


RESULTS
Immediate reflection-on-action was perceived to be more valuable than delayed reflection-on-competency-development because it facilitated day-to-day improvement. Delayed reflection was perceived to facilitate overall self-assessment, self-confidence and continuous improvement, but this perception was mainly found among graduates. Detailed reflection immediately after a challenging learning experience and broad reflection on progress appeared to serve different learning goals and consequently require different arrangements regarding feedback and timing.


CONCLUSIONS
Granularity of focus has consequences for scaffolding reflective learning, with immediate reflection on concrete events and reflection on long-term progress requiring different approaches. Learners appeared to prefer immediate reflection-on-action.
University College Arteveldehogeschool Ghent , Belgium .
M P C
MP
Embo
E
E
Driessen
M
M
Valcke
C P M
CP
Van Der Vleuten
D001530:Belgium; D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D008880:Midwifery / Q000193:education*; D018794:Problem-Based Learning / Q000379:methods / Q000592:standards*; D015397:Program Evaluation; D012647:Self-Assessment; D013336:Students, Health Occupations / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors