Reflective testing--what do our service users think?

Ann Clin Biochem. 2006 Sep;43(Pt 5):361-8. doi: 10.1258/000456306778520016.


Background: Reflective testing incorporates the clinical judgement, knowledge and experience of an individual biochemist to request additional tests appropriate to the clinical scenario. Despite being vigorously debated within the biochemistry profession, little is known about how the clinicians directly involved in patient care feel about it. We have conducted a survey to elicit our service users' opinion of reflective testing.

Methods: Ten clinical scenarios, each involving the possible addition of a specific test, were circulated to 520 hospital doctors and 152 general practitioners. The four response options were to add further tests, phone and discuss the case, add a comment to the original results or do nothing.

Results: A total of 216 (32%) responses were received. Overall, the majority were in favour of 'adding on' free triiodothyronine (86%), gamma-glutamyltransferase (78%), lipid profile (59%), thyroid peroxidase antibodies (63%), pituitary hormones (58%), troponin (55%) and serum electrophoresis (68%) in the given scenarios. However, only 30% would like a pregnancy test added and only 45% a prostate-specific antigen added without prior consultation. The response differed according to grade and specialty.

Conclusions: Reflective testing is generally welcomed by our service users, provided the nature and implications of the specific test is considered in addition to the full clinical scenario.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Clinical Chemistry Tests / methods*
  • Clinical Chemistry Tests / psychology
  • Clinical Chemistry Tests / standards
  • Clinical Competence / standards
  • Clinical Laboratory Techniques / psychology
  • Clinical Laboratory Techniques / standards
  • Health Personnel / psychology*
  • Humans
  • Middle Aged
  • Surveys and Questionnaires*