The development of a scale to measure personal reflection in medical practice and education

Med Teach. 2007 Mar;29(2-3):177-82. doi: 10.1080/01421590701299272.


Aim: Personal reflection is important for acquiring, maintaining and enhancing balanced medical professionalism. A new scale, the Groningen Reflection Ability Scale (GRAS), was developed to measure the personal reflection ability of medical students.

Method: Explorative literature study was conducted to gather an initial pool of items. Item selection took place using qualitative and quantitative methods. Medical teachers screened the initial item-pool on relevance, expert-analysis was used for screening the fidelity to the criterion and large samples of medical students and medical teachers were used to investigate the psychometric characteristics of the items. Finally, explorative factor analysis was used to investigate the structure of the scale.

Results: The psychometric quality and content validity of the GRAS are satisfactory. The items cover three aspects of personal reflection: self-reflection, empathetic reflection and reflective communication. The 23-item scale proved to be easy to complete and to administer.

Conclusion: The GRAS is a practical measurement instrument that yields reliable data that contribute to valid inferences about the personal reflection ability of medical students and doctors, both at individual and group level.

Publication types

  • Evaluation Study

MeSH terms

  • Aptitude*
  • Communication
  • Education, Medical*
  • Empathy
  • Humans
  • Professional Competence*
  • Professional Practice*
  • Psychometrics / methods*
  • Psychometrics / standards
  • Reproducibility of Results
  • Students, Medical / psychology*
  • Thinking*