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Enhancing and broadening clinical experience through briefing and de-briefing sessions - effect of reflection-before-action and reflection-after-action.

INTRODUCTION
This paper explores a novel pedagogy surrounding students clinical practice sessions. Before each clinical session, student clinical groups meet and each student presents their treatment planned for that session. The teachers question their understanding and explores "what if" and other management scenarios. Peers in the clinical group observe the presentation and learning dialogue. After the clinical session students gather on the clinic to debrief their performance with the tutor. Peers observe this dialogue the shared clinical experience. This paper explores students' perceptions of reflection-before-action and reflection-on-action surrounding their clinical practice.


METHODS
Focus groups were conducted to explore this phenomena and to create a questionnaire which was administered to the whole class. Transcriptions of the focus groups and open-ended response in the questionnaire were subjected to a thematic analysis to identify emerging themes and supported by closed-ended question responses.


RESULTS
Briefing sessions before clinical sessions helped students identify problems and clear doubts before entering clinics. Students were able to recall and rehearse the clinical procedural knowledge and felt well prepared and confident for patient care. Student sharing of knowledge with peers provided a broader learning experience and helped gain confidence. Students also reported to learn from the teacher facilitating their preparation for the session. Debriefing sessions after the clinical session allowed reflection and learning including error correction on their own and peer experiences. Students learnt personally, from peers as well as from the teacher and emphasized the importance of the student-teacher relation.


CONCLUSIONS
Briefing and debriefing sessions were highly valued by students for preparation and learning on clinics and in learning from peers. Briefing sessions cleared mis-understanding, prevented errors, broadened procedural knowledge and improved both confidence and clinical experience. Debriefing sessions facilitated reflective practice, error correction and prevention, and helped gain insights from teachers own experience and perspectives.