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      Thoughtful surgical practice for therapeutic self: A randomized control trial

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          Abstract

          Objectives:

          To determine the role of structured reflection in teaching basic surgical skills in undergraduate students.

          Methods:

          A randomized control trial was done in two medical colleges of Punjab, from January to December 2017 in which participants were divided into two groups through stratified random sampling. Structured reflection was done by interventional group after training. Post-test was taken to assess their surgical skills. Independent t-test compared the mean of two groups. One-way ANOVA was calculated to measure the difference within the different sub-categories of experimental group.

          Results:

          Out of 140 students that participated in the study, 138 students stayed till the end (retention rate 98.5%, attrition rate 1.5%). Independent t-test (p-value = 0.01) showed statistically significant difference in both control and interventional groups. One-way ANOVA with robust test of equality of Means showed a positive relationship of reflective capacity and acquisition of surgical skills.

          Conclusion:

          The novices who demonstrates better reflective capacity exhibit better acquisition of surgical skills.

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          Most cited references20

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          Metacognition and cognitive monitoring: A new area of cognitive-developmental inquiry.

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            Mindful Practice

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              The use of reflection in medical education: AMEE Guide No. 44.

              Reflection is a metacognitive process that creates a greater understanding of both the self and the situation so that future actions can be informed by this understanding. Self-regulated and lifelong learning have reflection as an essential aspect, and it is also required to develop both a therapeutic relationship and professional expertise. There are a variety of educational approaches in undergraduate, postgraduate and continuing medical education that can be used to facilitate reflection, from text based reflective journals and critical incident reports to the creative use of digital media and storytelling. The choice of approach varies with the intended outcomes, but it should also be determined by the user since everyone has a preferred style. Guided reflection, with supportive challenge from a mentor or facilitator, is important so that underlying assumptions can be challenged and new perspectives considered. Feedback also has an important role to enhance reflection. There is little research evidence to suggest that reflection improves quality of care but the process of care can be enhanced.
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                Author and article information

                Journal
                Pak J Med Sci
                Pak J Med Sci
                Pakistan Journal of Medical Sciences
                Professional Medical Publications (Pakistan )
                1682-024X
                1681-715X
                Nov-Dec 2020
                : 36
                : 7
                : 1466-1470
                Affiliations
                [1 ]Tausief Fatima, MBBS, FCPS, MHPE, MRCS. Associate Professor of Surgery, Islamic International Medical College, Riphah International University, Rawalpindi - Pakistan
                [2 ]Rehan Ahmed Khan, MBBS(Pak), FCPS (Pak), FRCS (Ire), JM-HPE (Ned), MSc HPE (UK), PhD (Scholar) University of Maastricht (Ned). Professor of Surgery, Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan
                [3 ]Faryal Azhar, MBBS. MRCS. FCPS. Assistant Professor of Surgery, Rawalpindi Medical College Rawalpindi, Pakistan.
                [4 ]Usman Mahboob, Director, Institute of Health Professions Education & Research, Khyber Medical University (KMU), Peshawar, Pakistan
                Author notes
                Correspondence: Dr. Tausief Fatima Present Affiliation & Address: AMC/PGMI/LGH/, Lahore Pakistan. Department of Surgery, Lahore General Hospital, Ferozepur Road. Lahore, Pakistan. Email: tauseeff@ 123456ymail.com
                Article
                PJMS-36-1466
                10.12669/pjms.36.7.3038
                7674884
                f02d2597-0b6d-4691-b9e7-d3c2f6b693b1
                Copyright: © Pakistan Journal of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 June 2020
                : 07 August 2020
                : 16 August 2020
                Categories
                Original Article

                reflective practice,clinical skill,surgical training activities,clinical skill competencies

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