Medical students' reflections on professional behavior: cognitive style as a predictor of content and level of integrative complexity

UnrestrictedThis mixed methods, exploratory study examined the content and characteristic levels of integrative complexity of 45 first year medical students' written reflections upon a personal challenge/dilemma they had encountered in the clinical or classroom setting. As well, cognitive style was examined as a possible predictor of integrative complexity. All incoming medical students at the University of Southern California's Keck School of Medicine (USC-KSOM) take the Myers-Briggs Type Indicator; as well, each first year student is asked to provide written reflections on their experiences. Through a purposeful random sample strategy, reflections of 45 students were examined; they were selected so that three students represented each of the 16 Myers-Briggs personality types. Two doctoral students reviewed the reflections and identified four themes: Personal Interaction, Encounter with a Patient, Interaction with a Peer, and Interaction with an Educator. A team of four doctoral students, which included the two who identified the themes, and one professor, assigned a level of integrative complexity (LIC) score to each reflection through consensus, using Hatton and Smith's (1995) framework. The typical score was relatively low, with a M of 2.16 (possible range: 1 - 4). In fact, the reflections of only three students were assigned a LIC score of Level Four.; No combination of MBTI preferences predicted medical students' LIC scores. However there was an interesting relationship between the LIC scores of those 11 medical students whose Keirsey temperament type were NF Idealists and their pattern of LIC scores. Specifically, nine had a LIC score of Level Two. Also, in post hoc analyses, it was found that the number of words in a particular reflection was an excellent predictor of the LIC score. Limitations and delimitations of the study, recommendations for future research, and implications for medical education practitioners (faculty and administrators) were also discussed