Reflection as sense-making: a phenomenological approach to clinical portfolios

E-portfolio, authenticity, reflection and clinical education

The project began with a moment of productive tension. While helping a colleague think through research questions on reflective practice, I found myself saying something that sounded to me almost provocative: I don’t really believe in reflection unless it is honest. The reaction to my own comment made me pause and ask what we actually mean when we ask students to “reflect”.

In clinical education-particularly in dentistry-we have long established reflection, often perceived by students as a requirement rather than a way of making sense of experience. Students learn how to write a reflection, but not necessarily how to experience one. That tension led me to look more closely at my own professional trajectory and ask what kinds of reflection had genuinely stayed with me.

What I realised was that the reflections that shaped my professional identity were deeply embodied. One early clinical encounter-marked by helplessness, a patient’s suffering, even the smell of disease-remains vivid decades later. That aligns strongly with phenomenological thinkers such as Husserl, with his emphasis on lived experience, and Merleau-Ponty, who insists that cognition is inseparable from the body.

Later, during a period of personal illness, writing phenomenologically helped me recover without psychological harm. That experience led me into phenomenology, narrative practice, and medical humanities. At the same time, my scholarly work on AI, particularly when applied to higher education raised questions about cognition, sense-making, and how humans - and machines - learn. I was also increasingly preoccupied with equity questions: how does reflection as currently practised privilege certain generational approaches (Gen X academic discourse versus Gen Z multimodal sense-making) and certain educational backgrounds?  The attainment gap often becomes visible in reflective writing- not because students can’t reflect, but because they lack the academic register to perform it convincingly. AI seemed uniquely positioned to bridge these gaps without erasing difference. These strands - phenomenology, embodiment, narrative practice, AI ethics and equity concerns - converged in exploring what this phenomenologically grounded approach might add to the value of e-portfolio practice.

Clinical experience, reflection, sharing, and feedback

The portfolio follows the natural arc of experience rather than imposing a predefined reflective template. It evolved from a two-column structure into a three-column design.

The first column focuses on facts: what happened clinically. The second captures thinking: reasoning, dilemmas, connections, and emotional responses. The third is a short distillation - around 120 words - of what stayed with the student.

That final stage is crucial. It asks students not to recount everything, but to identify what was meaningful enough to remain. Some work with multimodal artefacts; others stay textual. The structure supports depth without forcing disclosure and integrates clinical reasoning with professional identity formation. Students may also include these in a “scrapbook” appendix in their portfolio, grounding the experience and “speaking” beyond discursive language.

Support and scaffolding

I don’t believe reflection is an innate skill. Everyone can reflect if they are taught how. That means creating conditions of trust, safety, and structure-particularly in clinical contexts where defensiveness is common.

Scaffolding happens through workshops, prompts, examples, and dialogue. The portfolio structure itself contains the work, preventing reflection from becoming either confessional or superficial. Reflection is treated as dialogic rather than private, aligning with phenomenology’s emphasis on intersubjectivity.

At its core, the process teaches students to notice what unsettled them, what mattered, and why.

GenAI dialogue and boundaries

AI plays a limited but important role. I experimented early with AI-generated writing and quickly realised it altered my own thinking in ways I wasn’t comfortable with. Where AI is useful is as an augmented eye - helping identify patterns, themes, and what really matters.

Students may use AI to crystallise their thinking, but not to write the reflection itself. Ownership and interpretation remain with the student. Some even chose to handwrite their final reflections to make authorship explicit.

Used this way, AI supports reflection without replacing it - and, interestingly, has made embodiment and agency more visible rather than less.

Early reflections from the first run

What surprised me most was how readily students engaged once given permission and structure. Some of the most sceptical students were among the most enthusiastic. There is phenomenology already in their way of being-it simply hasn’t been invited into academic space.

The challenge now is scalability and rigour. Phenomenological work risks being dismissed as anecdotal if not carefully structured. But the early signs are encouraging. This work suggests that when reflection is grounded in lived experience and ethically augmented by AI, it can become a genuinely formative part of clinical education rather than a performative task.

Conclusion

Rather than treating reflection as a post-hoc written account, the portfolios used in this project reframe it as an active process in which experience is gradually re-worked: through artefacts, layers of noticing, writing, interpretation, editing, and carefully bounded use of GenAI aligned with a simple three-part structure. Reflection here is not something written about experience, but a process through which writing begins to “think itself”, allowing meaning to emerge rather than be prematurely resolved.

This phenomenological orientation can be read as an epistemological intervention. By anchoring reflection in lived experience, the approach offers one possible response to the defensiveness that often accompanies transitions into professional practice—where learners may retreat into theory, technical language, or compliance-driven narratives of competence. At the same time, the structure prevents reflection from becoming trapped in emotional, cognitive, or professional loops, supporting movement and integration.

The project can be understood as resisting reflection framed solely as a polished, institutionally legible narrative of professional identity—one that serves progression and power primarily through compliance. Instead, it creates space for uncertainty, partiality, and honest sense-making, while remaining rigorous, structured, and assessable.

GenAI plays a carefully constrained role in this ecology: not as a generator of finished expression, but as a temporary support for pattern recognition and distillation—helping learners resist the comfort of premature closure while keeping interpretation, ownership, and professional identity firmly with the student.