The structure of reflective practice in medicine
Abstract
Background The capability to reflect consciously upon one's professional practice is generally considered important for the development of expertise and, hence, for education. However, to our knowledge no empirical research has been conducted to date into the nature of reflective practice in medicine. Purpose To study the structure of reflective practice in medicine. Methods A questionnaire based on the literature was developed and administered to a group of primary care doctors. The data were subjected to confirmatory factor analysis using structural equations modelling. Results A 5‐factor model of reflective practice emerged. It consisted of the following factors: deliberate induction; deliberate deduction; testing and synthesising; openness for reflection, and meta‐reasoning. The model fitted the data sufficiently. Conclusion A multidimensional structure of reflective practice in medicine was brought to light by the study. Its components in terms of reasoning processes, behaviours and attitudes were identified and measured among doctors. Once conceptualised and measured, reflective practice can be studied to gain a better understanding of its relation to expertise development in medicine. In addition, training students to apply reflective practices may become a goal in medical education.
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Methods such as reflective medical practice and debiasing through feedback can help reduce the number of cognitive errors.
“methods such as reflective medical practice36, which help clinicians enhance their ability to navigate complex cases37, or debiasing through feedback to identify and correct cognitive biases38 can help in reducing the number of cognitive errors.”
From Large Language Models lack essential metacognition for reliable medical reasoning (2025) · cites this paper as [36]
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- Authors
- Mamede, S., & Schmidt, H. G.
- Affiliations
- Erasmus University Rotterdam (NL)
- Corresponding author
- Schmidt, Henk G
- ORCID
- Schmidt, Henk G
- Venue
- Medical Education
- Publisher
- Wiley
- Published
- 2004-09-15
- Volume
- 38
- Issue
- 12
- Pages
- 1302-1308
- ISSN
- 0308-0110 (ISSN-L)
- 1365-2923
- OpenAlex
- W2158002939
- Cited by
- 345
- References
- 26
- Citations by year
- 2026: 19 · 2025: 17 · 2024: 10 · 2023: 14 · 2022: 20 · 2021: 14 · 2020: 12 · 2019: 18 · 2018: 15 · 2017: 12 · 2016: 18 · 2015: 13 · 2014: 19 · 2013: 24 · 2012: 19
- FWCI
- 46.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Education (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Topics
- Social Sciences › Education › Reflective Practices in Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
- Keywords
- reflective practice, medical expertise, primary care physicians, meta-reasoning, Big Five personality traits, professional reasoning
- MeSH terms
- Attitude of Health Personnel, Clinical Competence, Education, Medical, Continuing, Family Practice, Humans, Primary Health Care, Surveys and Questionnaires, Thinking
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