title: What is reflection? A conceptual analysis of major definitions and a proposal of a five-component model.
abstract: BACKGROUND
  Although reflection is considered a significant component of medical education and practice, the literature does not provide a consensual definition or model for it. Because reflection has taken on multiple meanings, it remains difficult to operationalise. A standard definition and model are needed to improve the development of practical applications of reflection.
  
  
  OBJECTIVE
  This study was conducted in order to identify, explore and analyse the most influential conceptualisations of reflection, and to develop a new theory-informed and unified definition and model of reflection.
  
  
  METHODS
  A systematic review was conducted to identify the 15 most cited authors in papers on reflection published during the period from 2008 to 2012. The authors' definitions and models were extracted. An exploratory thematic analysis was carried out and identified seven initial categories. Categories were clustered and reworded to develop an integrative definition and model of reflection, which feature core components that define reflection and extrinsic elements that influence instances of reflection.
  
  
  RESULTS
  Following our review and analysis, five core components of reflection and two extrinsic elements were identified as characteristics of the reflective thinking process. Reflection is defined as the process of engaging the self (S) in attentive, critical, exploratory and iterative (ACEI) interactions with one's thoughts and actions (TA), and their underlying conceptual frame (CF), with a view to changing them and a view on the change itself (VC). Our conceptual model consists of the defining core components, supplemented with the extrinsic elements that influence reflection.
  
  
  CONCLUSIONS
  This article presents a new theory-informed, five-component definition and model of reflection. We believe these have advantages over previous models in terms of helping to guide the further study, learning, assessment and teaching of reflection.
authors.affiliation: Division of Geriatrics, Department of Medicine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Quoc Dinh
authors.initials: QD
authors.lastname: Nguyen
authors.forename: Nicolas
authors.initials: N
authors.lastname: Fernandez
authors.forename: Thierry
authors.initials: T
authors.lastname: Karsenti
authors.forename: Bernard
authors.initials: B
authors.lastname: Charlin
mesh_terms: D002983:Clinical Competence; D004501:Education, Medical; D006801:Humans; D007858:Learning; D008962:Models, Theoretical