Paediatricians’ Engagement with Reflective Practice: A Scoping Review

Abstract

Introduction: This scoping review identified literature describing reflective practice amongst paediatricians and then aligned the reflective concepts with Wellington and Austin’s Orientations to Reflection: Immediate, Technical, Deliberative, Dialectical and Transpersonal. These distinctions present concepts for paediatricians to contemplate in their reflective practice.
Methods: OVID MEDLINE and APA PsycInfo databases were searched for English language articles in peer-reviewed journals using the terms “paediatric*” AND “pediatric*” AND “doctor*” and “physician*” AND “reflect*”. A data capture form was created and populated.
Results: Twenty-one articles describing reflective practice amongst paediatricians were identified. Most articles (43%; n = 9) described the immediate orientation to reflection. One article, a personal perspective from a late-career stage paediatrician, aligned with a transpersonal orientation to reflection.
Conclusions: Reflective practice of the immediate orientation is accepted by paediatricians during education initiatives. It often takes place accidentally but can be developed through awareness of reflection, role-modelling, goal-setting, and feedback. Enhancing factors include a friendly, flexible learning environment, faculty support, protected time, and sharing significant experiences. Positive effects of promoting reflection include enhancing clinical practice, increasing resilience, and entrustment. Barriers include emphasis on efficiency, lack of continuity or awareness, negative emotions, and burnout. Reflective practice should be encouraged. One should not assume “it just happens”.