In medical education, reflection is widely considered to be an important skill for physicians, and thus an important skill for medical students to learn. There is however no consensus on how reflection should be taught, and empirical research on in-situ reflective practices in medical education is fairly uncommon. This paper uses discursive psychology (DP) as theoretical and methodological framework to uncover how reflection is interactionally achieved in fiction seminars, which are used in medical education as a means to teach professional skills such as reflection and emotional awareness. In the data set of 58 h of video- and audio recordings from fiction seminars in two medical schools, 24 examples were found where students reflect on the possible learning outcomes of discussing fiction. Analysis shows that reflective practices are imbedded in fiction seminars, and that reflection is collectively achieved by students listening to each other, building on each other's reflections and challenging each other's viewpoints. These practices allow students to construct both resistance and learning while still adhering to the aims of the seminars of ‘doing reflection’.

在医学教育中，反思被广泛认为是医师的一项重要技能，因而也是医学生学习的一项重要技能。然而，对于应该如何教授反思还没有达成共识，医学教育中对原位反思实践的实证研究相当少见。本文使用话语心理学 (DP) 作为理论和方法框架来揭示反思是如何在小说研讨会中互动实现的，小说研讨会在医学教育中被用作教授反思和情感意识等专业技能的手段。在两所医学院的小说研讨会的 58 小时视频和音频记录的数据集中，发现了 24 个例子，其中学生反思讨论小说可能的学习成果。分析表明，反思实践嵌入在小说研讨会中，而反思是通过学生相互倾听、建立在彼此的反思之上并挑战彼此的观点而集体实现的。这些实践让学生在坚持“做反思”研讨会的目标的同时，构建抵抗和学习。