Dental trainees reflect more critically on negative experiences: portfolio analysis using a pragmatic approach and a rubric in Japan

BACKGROUND: Dental trainees have various clinical experiences during their internships and they grow by experiencing success and failure. When looking back on an event, it is not apparent which experiences result in more critical reflection. Therefore, we qualitatively analyzed the portfolios of dental trainees using Significant Event Analysis to investigate their depth of reflection. METHODS: We asked all Hiroshima University Hospital dental trainees who completed a 1-year training program between 2010 and 2016 to describe their most memorable event from the past year. We coded the text using a qualitative analysis method. Then, we classified the responses as positive or negative events. We evaluated the depth of reflection following a pragmatic approach to categorizing reflective material (Sandars method) and a reflective ability rubric and user guide (O’Sullivan method) and compared these results. The evaluation was performed separately by two researchers and a good rate of agreement was confirmed by the weighted kappa statistic. Comparison of the depth of reflection was performed by the Mann-Whitney U test. RESULTS: The assessments of the positive event group and negative event group were compared with the respective evaluation criteria of the Sandars and O’Sullivan methods, and reflection was found to be deeper in the negative event group. The Mann-Whitney U test revealed a significant difference (p < 0.05) in the median values of the two groups for both methods. CONCLUSIONS: Both positive and negative experiences are important for dental practitioners to grow, but negative experiences are associated with critical reflections. In promoting the growth of training dentists, it is considered important to encourage deep reflections on positive experiences that are likely to be shallow.