gms | German Medical Science

Question: Reflection on experiences at the workplace is necessary for professional development. Support is needed to stimulate reflection, as learners do not automatically reflect. Reflection requires awareness of valuable moments for learning and thoughtful analyzing them later on. This study aims to promote both aspects of reflection in medical residents: reflection on situations at the workplace and thorough analyses of them later on. Reflection was focused on general competencies, like communication, collaboration, patient safety, ethics, and professionalism.

Methods: Catching valuable moments at work was promoted by a newly developed smartphone app for straightaway registering them as a note, audio recording, picture or video. For supporting deep reflection of caught learning moments, interdisciplinary coaching groups of about ten residents and a supervisor were organized every fortnight. In a 2x2 experimental pretest posttest design, 64 residents were randomly assigned to one of four conditions: only app, only coaching, app plus coaching, control. Effects on level of reflection and frequency of capturing learning moments were investigated over a period of two months.

Results: Results showed positive effects of both app and coaching on change in level of reflection between pretest and posttest: Self-reported learning gain from work was higher for app-users, and alertness and performed learning activities on general competencies improved by coaching groups. An interaction effect was found for alertness with highest scores in the app-plus-coaching condition. Number of registered reflections tended to be higher for app-users.

Conclusions: The app for learning moments increases capturing of learning moments and reflection, which are key elements of workplace based learning. Coaching groups for discussion of experiences are essential for reflecting on general competencies. Reflective alertness is best stimulated by a combination of support measures. A simple mobile app for registering learning moments has high added value for learning from work.