Abstract：
The concepts of metacognitive reflection, reflection, and metacognition are distinct but have undergone shifts in meaning as they migrated into medical education. Conceptual clarity is essential to the construction of the knowledge base of medical education and its educational interventions. We conducted a theoretical integrative review across diverse bodies of literature with the goal of understanding what metacognitive reflection is. We searched PubMed, Embase, CINAHL, PsychInfo, and Web of Science databases, including all peer-reviewed research articles and theoretical papers as well as book chapters that addressed the topic, with no limitations for date, language, or location. A total of 733 articles were identified and 87 were chosen after careful review and application of exclusion criteria. The work of conceptually and empirically delineating metacognitive reflection has begun. Contributions have been made to root metacognitive reflection in the concept of metacognition and moving beyond it to engage in cycles of reflection. Other work has underscored its affective component, transformational nature, and contextual factors. Despite this merging of threads to develop a richer conceptualization, a theory of how metacognitive reflection works is elusive. Debates address whether metacognition drives reflection or vice versa. It has also been suggested that learners evolve along on a continuum from thinking, to task-related reflection, to self-reflection, and finally to metacognitive reflection. Based on prior theory and research, as well as the findings of this review, we propose the following conceptualization: Metacognitive reflection involves heightened internal observation, awareness, monitoring, and regulation of our own knowledge, experiences, and emotions by questioning and examining cognition and emotional processes to continually refine and enhance our perspectives and decisions while thoughtfully accounting for context. We argue that metacognitive reflection brings a shift in perspective and can support valuable reconceptualization for lifelong learning.
摘要：
元认知反射的概念，反射,和元认知是不同的，但随着它们迁移到医学教育中，它们的含义发生了变化。概念清晰对于医学教育及其教育干预知识基础的构建至关重要。我们对不同的文献进行了理论综合审查，目的是了解什么是元认知反射。我们搜索了PubMed,Embase,CINAHL,PsychInfo,和WebofScience数据库,包括所有同行评审的研究文章和理论论文以及解决该主题的书籍章节，没有日期限制，语言,或位置。在仔细审查和应用排除标准后，共确定了733篇文章，并选择了87篇。从概念上和经验上描绘元认知反射的工作已经开始。已经做出了贡献，将元认知反思植根于元认知的概念中，并超越了元认知，参与了反思的循环。其他工作强调了它的情感成分，变革性的性质，和上下文因素。尽管合并了线程以开发更丰富的概念化，关于元认知反射如何工作的理论是难以捉摸的。辩论涉及元认知是否驱动反射，反之亦然。也有人认为，学习者从思维中不断发展，与任务相关的反思，自我反省，最后是元认知反思。基于先前的理论和研究，以及这次审查的结果，我们提出了以下概念化：元认知反射涉及加强内部观察，意识,监测,调节我们自己的知识，经验,通过质疑和检查认知和情感过程来不断完善和增强我们的观点和决策，同时深思熟虑地考虑上下文。我们认为元认知反思带来了视角的转变，可以支持终身学习的有价值的重新概念化。
