The Explicitation Interview as a Tool Promoting Reflective Practice in Health Education and Practice

Abstract

Introduction: Reflective practice is an effective component of any educational process. The field of health is no exception, especially since future practitioners may be encouraged to leave aside who they are and what they feel in order to focus on patients’ issues and symptoms, missing as a consequence opportunities to acquire meaningful formative self-knowledge. What do practitioners and patients actually experience when they meet? What do they do, think or feel, and how do barely perceptible actions or perceptions impact on the therapeutic relationship and outcome? Answering these questions is challenging but can offer practitioners insights to better understand their practice. Method: We promote a first-person approach to the previous questions, namely explicitation interviews conducted with health practitioners and patients. They consist in guided retrospective introspections, which aim at guiding an interviewee in the recall of a past situation in order to build a detailed and holistic description of their lived experience during it. The emphasis is on acquiring specific descriptions rather than generalizations about know-how or habits, accessing pre-reflective aspects of the experience, and bringing to light the micro-dynamics of activity. Findings: We review some outputs of the Thésée project, which examines the lived experience of health practitioners and patients when they meet for the first time. Informed by interviews conducted with a range of caregivers, we highlight i) the complex sequences of external or internal information-taking, judgements, interventions and regulations underlying any intervention, ii) how expert knowledge manifests itself through intuitive embodied judgments, and iii) the experiential component of building a therapeutic alliance. Conclusion: We promote the explicitation interview both as a research methodology to investigate the experiential side of health interventions, and as a tool to better inform their actors. As such, it can complement current educational approache s in health, but also reaffirm the human dimension of care relationships.