A review of “Reflection and reflective practice in health professions education: a systematic review”

By: Brook Sattler, PhD, and Lauren Thomas, PhD
CPREE multi-campus coordinators

In this work, Mann, Gordon, and MacLeod (2009) conducted a systematic literature review of the use of reflective practices in health care. The aim of their work “was to understand the key variables influencing this process, identify gaps in the evidence, and to explore any implications” (p. 596). In their initial search, they identified over 600 papers that included the use of the word reflection or related terms. From a paring down process, they then identified 29 papers that explicitly addressed reflective practice in health professional education and practice. In coding these papers, they explored the questions: (1) Do practicing health professionals engage in reflective practice?; (2) What is the nature of students’ reflective thinking?; (3) Can reflective thinking be assessed?; (4) Can reflective thinking be developed?; (5) What contextual influences hinder or enable the development of reflection and reflective capability?; (6) What are the potential positive or negative effects of promoting reflection?

Tips for educators presented in this work:

  • Have discussions about reflection. Discussions about reflective thinking and reflection activities are not a common topic, and often it’s assumed that we are on the same page when we are talking about reflection. The authors encourage more open discussion about these topics.
  • Balance reflection on positive and negative experiences. It’s important for people to look back on and make sense of both positive and negative experiences. While the authors do not connect to The Stanford Resilience project, they do raise a similar point–the importance and role of reflecting on failure, in addition to reflecting on successes.

Questions or challenges presented in this work:

  • See the bigger picture. The authors do a great job of describing the papers and putting them together; however, there is room for synthesis and more information about bigger picture connections.
  • Recognize the different language used to describe reflection. Clearly there is a lot of work going on in health care related to reflection (as seen from the initial pass of identifying 600 papers); however, in culling this corpus down the authors went from 600 to 29. While the scholarship represented in these 600 articles use reflection in some way, many use different language or reflection isn’t the main focus. The findings suggest that there is no common definition of reflection, and the varied terminology and theory is a result of people drawing on different communities. In this systematic literature review, the authors do not normalize the language, so this may contribute to challenges.


Mann, K., Gordon, J., & MacLeod, A. (2009). Reflection and reflective practice in health professions education: a systematic review. Advances in Health Sciences Education : Theory and Practice, 14(4), 595–621.