Theory Building as Integrated Reflection: Understanding Physician Reflection Through Human Communication Research, Medical Education, and Ethics

Abstract

Grounded in a presupposition that a single explanatory framework cannot fully account for the expansive learning processes that occur during medical residency, the article examines developing physicians’ reflective writing from three disciplinary lenses. The goal is to understand how the multi-dimensional nature of medical residency translates into assembling educational experiences and constructing meaning that cannot be fully explained through a single discipline. An interdisciplinary research team across medical education, communication, and ethics qualitatively analyzed reflective entries (N=756) completed by family medicine residents (N=33) across an academic year. Results provide evidence for moving toward an integrated thematic explanation across disciplines. The authors suggest that the integration of disciplinary explanations allows for comprehensive understanding of reflection as a cornerstone in the broader formation of the physician. Examples provide evidence for an integrated understanding of a fuller human experience by considering the three thematic explanations as co-occurring, reciprocal processes.