Reflection as a tool to facilitate the acquisition of diagnostic skills in clinical biochemistry.




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REDES-INNOVAESTIC 2019. Libro de actas. Alacant: Institut de Ciències de l’Educació (ICE) de la Universitat d’Alacant, 2019.



Peer reviewed



Future health professionals need to acquire analytic and diagnostic skills for prognosis and management of disease. However, the exponential advances in biomedical knowledge are making available new techniques and increasing the generation of data that require professionals equipped with the appropriate skills to interpret and process this new information. This is especially evident in biochemistry in which a myriad of new biomarkers can be currently monitored in a clinical tissue sample but, in turn, will require that the health professional is undertaking continuous learning to understand their meaning and interpretation. Reflection has been shown to be effective in facilitating continuous learning and gaining practical skills. Our innovative teaching group at De Montfort University (DMU, UK) implemented a novel pedagogic reflective strategy in the module “Clinical Biochemistry” shared in the BSc Biomedical Science (BMS) and BMedSci Medical Science (BMedSci) programmes in 2016/17, to encourage these final year students to think critically and use reflection to resolve three clinical biochemistry case studies of increasing difficulty distributed throughout the year. Students voluntarily resolved each case study and were provided with comprehensive feedback and marks for three main criteria, which students used to answer the case study: a) ability to extract all the fundamental concepts; b) ability to synthesise information and clarity of expression; and c) ability to reflect and comment. Preliminary results were not reliable due to poor engagement with this voluntary work, only 23 out of 142 students completed the first two case studies. For the 2017/18 iteration of the project, we performed small modifications and restricted the completion of the three case studies to the first term to encourage participation (as these final students are required to complete a demanding laboratory based final project in the second term). A total of 48 students (38 BMS and 10 BMedSci) voluntarily completed the first case study, although there was a notable reduction in the number of students that attempted the last case study. Marks gained for each of the criteria were compared statistically between them and between both academic years the project ran, to determine the effects of participation. Data analysed for both academic years indicated a significant increase in the marks received for ability to synthesise information and clarity of expression (p=0.01) and ability to reflect (p<0.02). An ANOVA of repeated measures for all the marks collected in the first two case studies launched in 2017/18 would confirm our previous results showing a significant increase in the performance of students as a result of participation in this project. Seventeen participants from this second cohort also provided comprehensive feedback, indicating high levels of enjoyment and satisfaction (58.8% agreed, 42% strongly agreed) by participating in this voluntary experience. Additionally, 88.2% considered that their critical thinking had improved and 81.2% had learnt to reflect and resolve general and frequent pathologies using clinical biochemistry information. Moreover, students documented different benefits from their participation other than learning, e.g. 88% considered that the reflective project has helped them to prepare their exams and a similar percentage indicated a positive impact on their professional development. In conclusion, and despite its short duration, the reflective pedagogy implemented was shown to facilitate the acquisition and development of critical thinking and reflection, relevant skills for any future healthcare professional. In addition, this pedagogic intervention has improved communication and scientific writing in participants, which would have benefited the performance of these students in other relevant modules.



Reflection, Critical thinking, Clinical biochemistry, Diagnostic skills


Peña-Fernández A., Evans MD., Young C., Escalera B., Angulo S., Peña MÁ. Reflection as a tool to facilitate the acquisition of diagnostic skills in clinical biochemistry. Roig-Vila, Rosabel (coord.). REDES-INNOVAESTIC 2019. Libro de actas. Alacant: Institut de Ciències de l’Educació (ICE) de la Universitat d’Alacant, 2019. ISBN 978-84-09-07185-2, pp. 224-225. Available at:


Research Institute

Institute for Allied Health Sciences Research