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Leung, K.H. (2009). Reflective learning in a Continuing Medical Education e-learning context. Montréal: McGill University, Faculty of Education, Department of Educational and Counselling Psychology, PhD thesis. McGill Family Medicine Studies Online, 04: e02. http://mcgill-fammedstudies-recherchemedfam.pbwiki.com/MFMSO200904e02#. Archived by WebCite® at http://www.webcitation.org/5k9mhQKQW

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Abstract

The lack of a practical operational definition of “reflective learning” suitable for characterizing observations of performance is widely acknowledged. This definition is needed for observing and documenting reflective practice in research, education, and continuing professional development. The current exploratory research aims to operationalize “reflective learning” using a conceptual framework based on a comprehensive review of the relevant literature, and to validate this framework in the context of a medium-large scale study of brief self-directed e-learning activities in continuing medical education.

Properties of reflective learning were identified in a literature review on reflective learning and higher order thinking. These properties were structured and represented in a conceptual framework, herein called the Reflective Learning Framework. Then, this framework was revised, and a related coding scheme was tested in a pilot study. The revised framework was validated in a qualitative multiple case study that involved 473 family physicians participating in writing comments and interviews. The written comments resulted in 1,776 comment cases, and 253 interview cases. A comment case was defined as one family physician reading, rating, and commenting on one research-based synopsis online. An interview case was defined as one family physician reading and rating a synopsis online, and then explaining the rationale of his/her rating.

Using thematic analysis and the framework-related coding scheme, cognitive tasks observed in these cases were categorized. Then, using cross case analysis, frequency counts of each category in all cases were compared in matrices. “Convergent” and “divergent” patterns were observed and represented using tabulations, and graphic displays. Based on these analyses, the Reflective Learning Framework was validated and refined, and a corresponding codebook was produced. Reflective learning was operationally defined in terms of four interrelated cognitive processes: Interpretation, Validation, Generalization, and Change. Each process in turn was defined by three specific cognitive tasks. This framework and the related codebook specify important observable properties of reflective learning, and can be used to develop reflective learning curricula, assessment systems, and further research.