A culture of reflection in practice at the Dutch general practitioner’s specialty training

Our research on reflection in the GP specialty training, consists of two parts. In part one, we conducted philosophical research on the concept of reflection and identified three conceptual limitations. 1) reflection is a complex concept that receives specific meaning and value in practice. With each step away from practice and toward generally applicable reflection (e.g., through generalized typologies or models of reflection), reflection risks losing its concrete value in practice. 2) reflection is a human capacity that can easily be linked to many benefits in the education of health professions, but this malleable quality also creates the danger of reflection becoming an educational panacea. 3) we argue that reflection cannot only mean ‘A leads to B,’ but is also about unique moments that require action and lead to a new montage of ideas.

In part two, we did not locate reflection and measured its effects in our data; instead, we described how participants themselves give concrete meaning and value to reflection in their education. Therefore, we described parts of the social interaction and educational repertoire of GP trainees, supervisors and teachers during various teaching moments in which reflection takes place according to those involved in GP education. We saw that the meaning of reflection takes specific shape in the existing educational culture with its collection of norms, values, as a reflection repertoire. We conclude that models and theories are important, but the oxygen that makes reflection concrete and valuable stems from practice and social interactions in education.