Reflection, Experiential Learning, and

4.1.2.1 Reflection

Reflection is a process by which students consider their experience or learning, evaluate the context and feeling, then develop an understanding of the situation that enhances their further action or practice (Schön 1987). Two types of reflection have been identified: reflection-in-action, which occurs immediately in the learning situation; and reflection-on-action which happens after the event (Kaufman and Mann 2010). Although there is no direct

evidence that reflection can improve patient care, it is generally accepted that reflection can improve student learning and performance (Sandars 2009). Students can benefit from reflection in several aspects (Mann et al. 2009; Kaufman and Mann 2010). For example, the iterative process of considering the experience and context enable students to gain insight of a learning issue. Reflection helps students dealing with a complex problem in the

healthcare setting. It also promotes development of professional competence and identity. This happens when students reflect on their performance in a clinical context.

It is claimed that there is no association between a student’s reflective skills and practice outcomes (Mann et al. 2009). This possibly implies that

reflection may not directly relate to practical skills and performance; instead, it is a basis of other learning processes including experiential learning and self-directed learning which then result in learning achievement or practice outcome (Kaufman and Mann 2010).

4.1.2.2 Experiential Learning

It is commented in the literature that experiential learning is essential for student learning and something that educators need to understand (Wall and McAleer 2000; Yardley et al. 2012). The experiential learning cycle comprise four stages (Kaufman and Mann 2010) (Figure 4.1): (1) students gain

experience in clinical practice or from laboratory practical exercise (concrete experience); (2) they reflect on experience (reflective observation); (3) they develop learning and knowledge from the reflective process (abstract

conceptualisation); and (4) they apply knowledge in a new context and gain new experience (active experimentation).

There are two issues which need consideration regarding experiential learning. Firstly, reflection is a key factor that helps students to make sense of their previous performance and practice outcomes and allows them to develop linkages between prior knowledge and new experience; this process leads to a development of new understanding/knowledge (Kaufman and Mann 2010). In this process, students take responsibility for their learning by assessing their present knowledge, exploring areas of improvement, and developing new learning. This concept relates to self-directed learning which Dornan et al. (2011) asserts is fundamental for lifelong learning.

Secondly, according to empirical studies, the majority of UG students in several countries possess the accommodating learning style in which

learning is developed by doing and feeling (i.e. practising and gaining experience) (Holtbrügge and Mohr 2010); and learning styles which stem from the principles of experiential learning also relate to cultural background (Barmeyer 2004). This indicates that experiential learning is fundamental for understanding student learning styles and developing effective teaching to support students from different backgrounds and in different contexts.

4.1.2.3 Self-Directed Learning (SDL)

New knowledge has been discovered continuously and become available rapidly, it is impossible for students to learn all new knowledge within a curriculum period. Moreover, face-to-face contact hours between educators and students are limited by curriculum time and student workload (Oliver et al. 2008). Students need to learn ‘how to learn’ and educators are the key people to support students in developing this essential skill (Haden et al. 2006). One strategy that helps students to develop independent learning skills is SDL. SDL is an on-going process in which students take

responsibility to identify learning needs, explore strategies to meet those needs, engage in the learning process, and evaluate their learning progress and achievement (Dornan et al. 2011). SDL plays an important part in enabling students to acquire knowledge and develop learning during their study while reflection is a tool for helping students to evaluate their recent knowledge and identify learning needs that are crucial for SDL. These processes require educators to create a positive learning environment and support students via mentoring and supervision (Mann et al. 2009).

Ultimately, in conjunction with higher-ordered thinking skills, reflection, experiential learning, and SDL are key competences which support the development of lifelong learning, which is fundamental part of being a professional (Dornan et al. 2011).

4.1.2.4 Implications for Dental Educators

While reflection is a skill which students need to learn and be taught by educators, it is undeniable that problems could arise with this when the educators have little experience of reflection themselves. Reflection requires practise in order to master reflective skills. It involves not only what one has done and what procedures were utilised, but also critical appraisal of

performance and the identification of areas for further development (Schutz 2007; Wilding 2008). However, some dental educators might not regularly get involved in reflective practice (if they are not full-time academics or their routine dental practice does not require reflection). These educators may not be able to perform reflection for themselves or fully support students to develop reflective skills.

For experiential learning, students may not necessarily start the cycle from concrete experience (first stage). For instance, students may already have learned theoretical aspects from a lecture, so in a phantom-head laboratory they can apply knowledge to perform a specific procedure (fourth stage), then gain practical experience and so on. This suggests that students can begin the learning process from a different stage of experiential learning depending on their preferences or contexts. This might relate to the nature of teaching and learning in dentistry where learning can also develop through a classroom-based session, clinical practice, or observation.

There are two schools of thought about SDL. The first is to plunge students straight into SDL, which is a part of a problem-based learning (PBL)

processes. This strategy is employed successfully by a PBL UG curriculum (e.g. the Malmö model) (Rohlin et al. 1998) and SDL has been shown to be an effective method for encouraging student learning. However, in the novice-expert continuum (see Chapter 2), students take responsibility for their learning gradually, developing from novice (dependent to educators) to beginner (gaining more responsibility) and then on to competent

(independent learners). This notion is relevant to the second school of

thought that SDL is a progressive philosophy whereby the method of learning moves from didactic through directed self-learning towards self-regulated learning (White and Gruppen 2010; Dornan et al. 2011). However, there is a scarcity of evidence about which strategy of SDL is more effective.

Additionally, how much knowledge dental educators need to develop relating to reflection, experiential learning, and SDL has not yet been recommended by the literature.