Factors associated with reflection among students after an advanced pharmacy practice experience (APPE) in Sweden.

OBJECTIVE To identify individual and social factors associated with pharmacy students' level of reflection in an advanced pharmacy practice experience (APPE). METHODS A postal questionnaire, including a reflective assignment, was sent to all pharmacy interns (n=262) at Uppsala University, Sweden, for 4 semesters in 2005-2007. RESULTS In a univariate analysis, 7 factors were found to be associated with students' level of reflection. After controlling for covariates, 3 social factors were found to be independently associated with reflection: having a formal preceptor (OR=5.3), being at a small pharmacy (OR=19.8), and students' perception of the importance of discussing critical thinking with the preceptor (OR=1.2). No correlation could be observed between level of reflection and critical thinking, nor learning style. CONCLUSION Social components seem to be of higher importance than individual components in students' reflective levels after pharmacy internship experience. Trained preceptors are important to foster reflection skills.