Effectiveness of reflective learning in skill-based teaching among postgraduate anesthesia students: An outcome-based study using video annotation tool.

BACKGROUND: Medical education all over the world is undergoing paradigm shift. Video recording of student's performance and self-annotation are emerging as valuable tools for self-directed learning among students. Study was conducted to find the effectiveness of video annotation tool in reflective learning. The learning outcome was to find whether the video annotation is helping in critical reflection and improving the perception of students on guideline compliance while learning the technique of epidural insertion.
METHODS: In phase 1; following pretest, the students were made to observe three epidural insertions and perform one epidural insertion. In phase 2; following posttest, two faculty members analyzed the depth of reflection using the Reflection Rubric. Students perception was recorded using the Reflective practice survey.
RESULTS: The average score of students after pretest was 76%. The posttest score was 84% (p value 0.003). In depth analysis using the reflection rubric we found 52.38% of the total reflections had a score of two, showing they were at introspection level only. 25.71% of reflections were having score of one, showing that they were just habitual answers. Only 21.9% of the total reflections had score of three; and none of them were critically reflecting. All the students (18/18) agreed that recording the session was meaningful.
CONCLUSION: The art of critical reflection is learnt by relentless effort. Yet it helps the students to reflect on the whole process introspecting and understanding what went wrong. Video annotation turns out to be a valuable tool in reflective learning.