Best practice for teaching and learning strategies to facilitate student reflection in pre-registration health professional education: an integrative review

There is a growing expectation from registering authorities and the public for health professionals to enter their respective professions armed with the necessary skills, attitudes and behaviours to be reflective practitioners. However, there is limited and inconsistent evidence of the effectiveness of pedagogic strategies used for teaching reflective practice in health practitioner courses. We therefore conducted an integrative literature review of recent original studies (2004-2014) to gain an understanding of current initiatives for teaching reflective practice. A key finding from the review is the shift from the reliance on written reflective activities to more dialogic and social based reflection. Studies that use reflective dialogue suggest that facilitated dialogue with peers and clinical educators is the most effective approach to foster deeper reflection, critical thinking and clinical reasoning. Also the consensus evident from the review is that for reflection to be meaningful it needs to be intentionally connected to clinical programs. Although we find compelling evidence of the usefulness of embedding reflective learning strategies in health curricula, repeated reference to a lack of adequate training to prepare health educators to teach reflective practice suggests that there is an urgent need for research into how this can be achieved.