Mode of access: World Wide Web. / Thesis (Ph. D.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references (leaves 346-360). / Electronic reproduction. / Also available by subscription via World Wide Web / xviii, 360 leaves, bound ill. 29 cm

Thesis (Ph. D.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references (leaves 346-360).

Abstract The formation of a physician's professional identity and conception of him/herself as a doctor is often taken for granted and considered a by-product of learning. During professional socialization, medical students internalize knowledge, skills, attitudes, behavioral models as well as ethical and moral values of medicine. However, certain critical experiences may trigger an active construction of professional identity. The aim of this research was to explore the process of constructing professional identity during medical education in the framework of cultural-historical activity theory. Multiple methods (questionnaires, videotapes of medical students' reflection group sessions, and interviews of the supervisors) were used in data collection and analysis. Medical students were found to have differing orientations towards learning and practising medicine. Some of the students, more commonly females, expressed a need for more support for their professional development. Reflection groups offered medical students a possibility to share their experiences of critical situations. The topics of discussion dealt with career choice, medical education (teaching, patient encounters, communication), working experiences and career opportunities. Medical students' narratives of their experiences in university hospital learning situations revealed the way in which various interaction situations laid the basis for the development of professional identity. In constructing a physician's professional identity, medical students had to solve dilemmas encountered in three different activity systems: Personal life, Medical education and Work. Encountering critical situations is part of the daily practice in medical schools. These situations may induce reflection on action and conscious development of professional identity. Medical students should be provided with more possibilities to elaborate on especially dilemmas concerning professionalism, communication skills, encountering death, and biomedical versus psychosocial aspects of medicine during their medical education.

Benefits to using a reflective journal include developing critical awareness and new perspective, problem-solving skills, and independent learning skills. The training of advanced piano students could be enhanced by the addition of journals to assist with their piano practice, specifically when learning new repertoire. Using the model by Plack and colleagues (2005) for developing and assessing reflection in reflective journal entries, we examined the journal entries of 18 advanced piano students to explore the development of reflection over a period of four weeks. Results suggest that reflectively trained piano students develop more critical reflection compared to a control group. Reflectively trained students perceive the same benefits to journaling as their counterparts in other disciplines. The most frequently referenced reflective elements include listing practice strategies and expressing feelings about the learning process. The reflective training model used in this study can be implemented by piano teachers and piano students.

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Formal assessment in education focuses on summative assessment in the form of grade allocation. This has limitations on the learning process for students. Formative assessment should also be incorporated into learning as an integral part as it offers many benefits. Reflective learning in the form of self-assessment is central to the process of formative assessment. Students, however, tend not to engage in the process of self-assessment. This skill can be developed by educators in an educational setting, but educators tend not to create an environment in which students can self-assess. The study explored students’ perceptions of the self-assessment process once they had been exposed to it over a period of time in a facilitated environment. This encouraged them to engage in the process and develop the skill of self-assessment. The research method was exploratory in nature and was conducted by means of a design experiment in which students were encouraged to self-assess on three occasions during the 2012 academic year. Data was then collected from the students by means of a structured survey. The results of this study indicated that students tended not to self-assess if not encouraged to do so. However, once given the opportunity to do so in an environment which supported it, students were positive about the process of self-assessment. They believed that it would improve their overall academic performance and indicated that they would continue to apply self-assessment to their studies in future. This study concluded that students were positive about self-assessment and that they applied it accurately and in a meaningful manner to their studies in an environment which supported it. / Dissertation (MCom)--University of Pretoria, 2013. / lmchunu2014 / Taxation / unrestricted

Indiana University-Purdue University Indianapolis (IUPUI) / For nursing students to be successful in current and future practice they must be proficient critical thinkers and be able to use reflective judgment skills to manage the daily dilemmas of healthcare practice. Critical thinking and reflective judgment are not elements of nursing curricula unless faculty explicitly design learning activities to develop these skills. This study examined the relationship between reflective judgment and critical thinking by comparing a measure of reflective judgment, the Reasoning about Current Issues (RCI) test, with a measure of critical thinking in nursing (the HESI Exit Exam) in a sample population of senior associate degree nursing (ADN) students (N = 108). The descriptive variables of individual ADN student’s age, grade point average (GPA) in nursing courses and the number of completed college/university credit hours were also examined. A modest correlation (r = .370, p < .01) was found between critical thinking and reflective judgment indicating a positive relationship between these two variables. However, the results supported the hypothesis that these are separate concepts; while the students achieved an acceptable level on the measure of critical thinking, they did not exhibit the skill level of an effective reflective thinker. Positive correlations were found between reflective judgment and individual student age and nursing program GPA (p < .01). Critical thinking was also positively correlated with age (r = .351) and GPA (r = .426). There were no statistically significant correlations noted between the number of credits or previously earned baccalaureate degrees with either reflective judgment or critical thinking. An appreciation of the unique commonalities and differences between reflective judgment and critical thinking is essential for the development of innovative strategies and pedagogies meant to advance teaching/learning within schools of nursing with an explicit focus on both concepts and an ultimate goal of improving competence in newly graduated nurses. The implication for nurse educators is in changes and innovations that can lead to more effective thinkers. Careful pedagogical planning and a mindful inclusion of learning activities to develop both reflective judgment and critical thinking skills may lead to increased competence as nursing students and as new graduate nurses.

This thesis explores why instructors should use narrative intentionally and effectively with reflection to better understand adult students' perceptions of experiential learning activities in technical communication. The frequent use of narrative in technical discourse reminds us that the tone of technical texts is often appropriately informal, personable, and reflective. A closer analysis of narratives provides instructors with valuable opportunities to learn more about the motivations for and barriers to learning for adult students and to better understand how these students situate themselves in larger social and cultural narratives. Narrative serves many purposes in technical communication. Not only does narrative add a human element to technical discourse, but it also invites interrogation and inquiry into the technical communicator's decision-making process. For these reasons, narrative is commonly paired with reflection exercises in experiential learning programs as a way for students to make sense of their learning experiences. If instructors can capture the essence of how adult students make sense of their learning experiences, they can determine if experiential learning is an effective pedagogical approach to teaching technical communication to adult students. Using examples of ongoing, initial and summative, and alternative reflection exercises, I illustrate how narrative can be used to facilitate the learning process in adult students and gain access to these students' perceptions of experiential learning activities in technical communication.

The major part of care in type 2 diabetes is in the hands of the patient so the focus of educational interventions should be on the person behind the disease. An experience-based group education programme that actively promotes participants’ reflection and understanding has been designed and implemented in cooperation with the Swedish Pharmacy. The regression model presented in Paper I revealed the importance of self-perceived role in diabetes management. Blood glucose control two years after baseline was improved for participants who described themselves as having an active role in their treatment, compared to those taking on a passive or a compliant role. Paper II described the resulting categories from content analysis of three open-ended questions about participants’ role, goal and support needs in diabetes management. The people taking care of diabetes most effectively and needing least support were called Disease Managers; those following the health professionals’ orders and depending on regular controls were categorised as Compliant, whereas the Disheartened had difficulties in achieving good metabolic control and often described both medical and social obstacles. These three self-management profiles were strongly correlated to metabolic outcomes. In Paper III perceptions of diabetes management were reassessed: perceptions were only stable in approximately half of participants, thus providing evidence for a dynamic model of learning self-management in diabetes. The three self-management profiles still correlated with metabolic outcomes. In paper IV the long-term metabolic outcome (HbA1c) of the study population was investigated. Metabolic control was stable up to seven years following the intervention, in contrast to the metabolic deterioration often present in diabetes. The main message of this thesis is that participants’ self-perceived role had a major influence on metabolic outcomes. Assessing self-management profiles both in diabetes and possibly other chronic conditions can help health care providers to tailor their educational efforts accordingly. Furthermore, this experience-based patient education programme outside the framework of routine diabetes care has the potential to stabilise metabolic control on the long run effectively.