Personal reflection in medical education

Personal reflection is seen as an essential and trainable professional quality in doctors and other health care practitioners and is increasingly promoted in health care education. A more precise understanding of its nature and value for optimal patient care is needed for its purposeful use in practice and for effective encouragement in education. This article offers a conceptual framework to help recognize, use and encourage personal reflection. At the meta-level of reflective practice, ‘scientific reflection’ is distinguished from ‘personal reflection’, while at the operational level, ‘information processing’ and ‘determinative judgment’ are distinguished from ‘sense making’ and ‘reflective judgment’. The main difference between both modes of reflection is their focus on operational processes. Scientific reflection is mainly oriented towards testing the evidence of expert information processing, thereby aiming for the augmentation of determinative clinical judgment, while personal reflection is mainly oriented towards clarifying the process of sense making, which aims to augment reflective judgment. The article also describes the properties of ‘sense making’ and ‘reflection on sense making’ and examines the implications of this analysis for a more profound definition of reflection as a competence necessary for effective educational encouragement.