Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Feasibility and value of a guided observation and reflection learning activity for medical students on clinical placement in Cancer Care (#355)

Erin Moth 1 2 , Sath Narayanan 1 2 , Jenny Gilchrist 1 2 , Abby Fyfe 2 , Janani Mahadeva 1 2 , John Turchini 1
  1. Faculty of Medicine, Health, and Human Sciences, Macquarie University, NSW, Australia
  2. Macquarie University Hospital, Macquarie University, NSW, Australia

Background

Placements in Cancer Care can be confronting and academically challenging for students. Reflection in medical education enhances learning of complex content, facilitates emotional expression, and augments professional values.

Aim

To determine whether a reflective practice learning activity (i) is feasible and acceptable to students, and (ii) improves reflective capacity.

Methods

Year 2 Macquarie University medical students completing 4-week placements in Cancer Care were asked to complete an unassessed written reflection using a guided tool for two observed clinical encounters. Students then attended a clinician-facilitated small-group discussion. Discussion was directed by students’ reflections and anchored to learning outcomes. Feasibility of Intervention (FIM), Acceptability of Intervention (AIM), and Intervention Appropriateness (IAM) measures1 were completed as part of an evaluation survey. After feasibility ‘run-in’ (rotation 1), rotation 2 and 3 students completed the Reflective Practice Questionnaire’s 16-item reflective capacity subscale (RPQ-RC)2 at baseline and end-of-placement, with mean scores (range 1-6) compared (paired t-test).

Results

Of 58 students, 81% submitted written reflections, 95% attended group discussion, and 67% completed evaluation surveys. Reflections took a median of 25 minutes (IQR=15-30). Mean rating for the learning activity (anchors ‘poor’ to ‘excellent’) was 84 out of 100 (range 61-100). Most students agreed or strongly agreed that the learning activity was valuable (95%), improved understanding of placement experiences (98%), and prompted learning (88%). Students perceived the learning activity feasible (mean FIM 4.39 out of 5), acceptable (mean AIM 4.43 out of 5), and appropriate (mean IAM 4.53 out of 5). For 25 rotation 2 and 3 students with paired RPQ-RC data, there was a significant increase in ‘reflective capacity’ from baseline to end-of-placement (mean baseline RPQ-RC 4.15, end-of-placement 4.82, t-stat=5.78, p<0.00001, Cohens d=1.15).

Conclusion

Guided observation and reflection within Cancer Care clinical placements is feasible and acceptable to students, a valued learning activity, and enhances reflective capacity.

  1. Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, Boynton MH, Halko H. Psychometric assessment of three newly developed implementation outcome measures. Implement Sci. 2017 Aug 29;12(1):108. doi: 10.1186/s13012-017-0635-3. PMID: 28851459; PMCID: PMC5576104.
  2. Rogers SL, Van Winkle L, Michels N, Lucas C, Ziada H, Da Silva EJ, Jotangia A, Gabrielsson S, Gustafsson S, Priddis L. Further development of the reflective practice questionnaire. PeerJ. 2024 Feb 8;12:e16879. doi: 10.7717/peerj.16879. PMID: 38344297; PMCID: PMC10859078.