How Does a Group Reflection Intervention (Schwartz Rounds) Work within Healthcare Undergraduate Settings? A Realist Review

How does guided group reflection work to support professional identity formation in postgraduate medical education: A scoping review

PURPOSE

In postgraduate medical education, guided group reflection is often applied to support professional identity formation. However, little is known about how guided group reflection is shaped and how it works. Our scoping review synthesizes existing evidence about various approaches for guided group reflection, their aims, components and potential working mechanisms.

METHODS

We conducted a scoping review using JBI (Joanna Briggs Institute) guidelines for conducting scoping reviews. We searched PubMed, PsycINFO, EMBASE and ERIC databases for all research articles published in English or Dutch in an iterative team approach. The articles were extracted and summarized quantitatively and qualitatively.

RESULTS

We included 71 papers (45 primary research papers and 26 non-empirical papers including program descriptions, theoretical concepts and personal experiences). We identified a diversity of approaches for guided group reflection (e.g. Balint groups, supervised collaborative reflection and exchange of experiences), applied in a variety of didactic formats and aims. We distilled potential working mechanisms relating to engagement in reflection, group learning and the supervisor's role.

CONCLUSIONS

There are significant knowledge gaps about the aims and underlying mechanisms of guided group reflection. Future systematic research on these topics is needed to understand the effectiveness of educational methods, that can help facilitate learning conditions to best shape professional identity formation (PIF) in educational curricula.

Schwartz Rounds in Higher Education Settings: A Systematic Review of the Research with Recommendations

BACKGROUND

Higher education institutions (HEIs) have recently integrated Schwartz Rounds (Rounds) as innovative ways of supporting health professional students' reflective practice, interprofessional learning and compassionate care. Emerging evidence suggests that Rounds benefit students' shared sense of belonging and insight into emotional aspects of training and care, providing safe places to share experiences and reflect. Our review examines the current literature regarding health students' evaluation of Rounds in HEIs, exploring experiences and perceived benefits of participating. We consider methodological issues with the existing literature and propose ways of addressing these in future research.

METHODS

Systematic searches were conducted on EBSCO, PsycINFO, PubMed and ASSIA to identify available literature relating to Schwartz Rounds in higher education. Eight studies - six with a mixed method design and two qualitative - were included in the review. Study quality and risk of bias were assessed. Evaluation survey data and themes generated from qualitative responses were considered together and a narrative synthesis was constructed.

RESULTS

Despite challenges with differing measurements and scale usage, five themes were identified reflecting the experience and perceived benefits for students attending Rounds. Students highlighted the value of peer connection and communication; normalisation of emotions; collaborative reflection and self-awareness; and the relevance of Rounds in their daily work and patient care. Students also commented on barriers to participation including Rounds' multidisciplinary nature, their group size, and the presence of staff. The majority of students rated Rounds as excellent or exceptional and agreed they should be integrated into the curriculum.

CONCLUSIONS

Our findings on Schwartz Rounds in higher education suggest they support student reflective practice and confidence in providing compassionate, high-quality patient care. However, the quality of research in this area is mixed, reflecting the relatively recent integration of Rounds in Higher education, and the challenges of implementing and evaluating new interventions in educational settings.