Implementation and Feedback on the Use of Reflective Writing as a Component of a Clinical Assessment
المؤلف:
Pauline Cho & Catherine Tang
المصدر:
Enhancing Teaching and Learning through Assessment
الجزء والصفحة:
P352-C30
2025-08-03
509
Implementation and Feedback on the Use of Reflective Writing as a Component of a Clinical Assessment
Education in Hong Kong is very much assessment-driven but there are signs that this is becoming unsatisfactory. In clinical courses, such as Optometry, there is an increasing pressure for a change from emphasis on factual knowledge and didactic teaching to emphasis on professional and personal skill development. With the pressure to change, it is time to take a look at the assessment system of a training clinic, to identify problems from the perspective of the students and to solicit information on the implementation of reflective writing as an assessment tool to enhance clinical learning. Problems identified may perhaps be solved or minimized via some changes but some, no doubt will remain unsolved or, to be more optimistic, to be solved. The latter however should not be from lack of trying.
In the Department of Optometry & Radiography of The Hong Kong Polytechnic University (PolyU), the Contact Lens Clinic (CLC) assessment (referring to the on-site assessment of students' clinical performance) had undergone various changes over the years. End-of-year clinical examination was phased out years ago, as it is the opinion of the faculty that a single assessment is artificial, does not say much about the competency of the student, compromises the standards of patient care, and is time-consuming. Each optometry student has to attend one CLC session per week in his/her final year of study and may see up to four contact lens patients per session.
For some years, students were given a grade (criterion-based) for their overall performance, irrespective of the number of patients seen. This was introduced because students had raised the concern that some supervisors graded them by taking into account all the patients they saw in each session while others did not, and supervisors had complained about the numerous forms to be completed at each session if each patient consultation was assessed.
For our students to be effective practitioners, it is desirable for them to become reflective practitioners - to develop critical thinking and self - evaluation. However, the situation in our CLC did not encourage or facilitate on-site reflection. Time constraints limited students' reflection on their cases, feedback from supervisors and students' exposure to different types of cases. Since reflection and critical thinking are very important in clinical education, reflective writing (RW) was considered to be a potentially good exercise to introduce to the students as it has been claimed to be a powerful medium to facilitate reflection (Walker, 1985; Hettich, 1990; Ballantyne & Packer, 1995). Hence, in the academic year of 2000/2001, reflective writing (RW) (reflective diaries or reflective journals) was introduced to final year students to encourage reflection.
The objectives of this study were to:
1. obtain feedback from the students on the usefulness of RW as a component of CLC assessment in enhancing/facilitating clinical learning and reflective thinking in CLC,
2. compare RW scores and CLC (on-site assessment) scores,
3. invite students to comment and suggest ways of improving the use of RW in CLC assessment.
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