Developing professional judgement in surgical trainees: the role of critical reflection

Abstract

Critical reflection is a disciplined process that aims to critically evaluate everyday medical practices to more fully understand and learn from them. It can lead to improved professionalism and clinical reasoning and is increasingly seen as a core component of continuing professional development in a number of disciplines. While critical reflection is a central element of expert surgical practice, its processes are often tacit and hence invisible to trainees. In this paper, we describe a pilot project aimed at introducing critical reflection techniques into a plastic surgery training program. We also discuss the use of critical reflection as a tool to allow learning surgeons to develop, observe and critique their own clinical thinking, and outline a framework for surgical supervisors and trainers to guide, monitor and assess the development of professional judgement in their trainees.