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Peer-reviewedCC BY-NC-NDBMC medical education

Reflective practice as a pedagogical tool for developing cultural awareness: a qualitative study in optometric education.

  1. 1Department of Optometry, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa. [email protected].

Abstract

Background

Culturally responsive dispensing is increasingly recognised as a core component of contemporary optometric practice. Yet many optometry students continue to approach spectacle selection as a purely technical task, with limited engagement with the social and cultural needs of diverse patient groups. Reflective practice offers a pedagogical approach that may deepen students' awareness of these complexities. This study examined how optometry students used reflective writing to make sense of an assignment requiring them to design a spectacle frame for a specific population group. The aim was to explore how students' reflections revealed the development of cultural awareness, patient-centered thinking, and an understanding of socio-cultural influences on frame design. Specifically, the study addressed the following research question: How do optometry students, through reflective writing, make sense of cultural, social, and contextual influences on spectacle frame design, and how are patients and professional roles discursively positioned within these reflections?Methods

Students submitted reflective essays after completing a frame-design assignment in a third-year dispensing course. Participation in the study was voluntary and occurred only after assignment grades had been released. Essays from consenting students were anonymized by an independent assistant before being analysed. A reflexive thematic analysis was conducted, informed by sociocultural learning theory and positioning theory. The analysis focused on how students made meaning, positioned themselves and patients, and engaged with cultural and contextual considerations in dispensing practice. Reflexive journaling supported the analytic process.Results

Five themes were developed. Students often described an expanded understanding of dispensing as a relational and context-dependent encounter rather than a purely technical activity. Many reflected on the cultural, social, and lifestyle factors that shape spectacle frame design and patient preferences. Several students expressed greater empathy and awareness of patient individuality, particularly when designing for groups whose needs they had not previously considered. Collaborative dialogue, peer feedback, and exposure to diverse examples appeared to support deeper cultural reflection. Students also acknowledged the tensions between aesthetic ideals, functional requirements, and the cultural meanings associated with spectacle frames.Discussion

Reflective practice appeared to foster cultural awareness by encouraging students to interrogate their own assumptions, recognise the socio-cultural dimensions of dispensing, and adopt more patient-centred perspectives. The reflections suggested that designing for diverse population groups can prompt critical engagement with issues of accessibility, identity, and representation.Conclusion

Integrating structured reflective writing into dispensing education may foster culturally responsive practice by prompting students to consider the broader contexts that shape patients' experiences and preferences.

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BibTeX
@article{buthelezi2026reflective,
  title = {{Reflective practice as a pedagogical tool for developing cultural awareness: a qualitative study in optometric education.}},
  author = {Sanele Buthelezi},
  journal = {BMC medical education},
  year = {2026},
  month = aug,
  doi = {10.1186/s12909-026-10084-2},
  url = {https://europepmc.org/article/MED/42958231},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Reflective practice as a pedagogical tool for developing cultural awareness: a qualitative study in optometric education.
AU  - Sanele Buthelezi
PY  - 2026
DA  - 2026/08/01
JO  - BMC medical education
DO  - 10.1186/s12909-026-10084-2
UR  - https://europepmc.org/article/MED/42958231
AB  - Background  Culturally responsive dispensing is increasingly recognised as a core component of contemporary optometric practice. Yet many optometry students continue to approach spectacle selection as a purely technical task, with limited engagement with the social and cultural needs of diverse patient groups. Reflective practice offers a pedagogical approach that may deepen students' awareness of these complexities. This study examined how optometry students used reflective writing to make sense of an assignment requiring them to design a spectacle frame for a specific population group. The aim was to explore how students' reflections revealed the development of cultural awareness, patient-centered thinking, and an understanding of socio-cultural influences on frame design. Specifically, the study addressed the following research question: How do optometry students, through reflective writing, make sense of cultural, social, and contextual influences on spectacle frame design, and how are patients and professional roles discursively positioned within these reflections?Methods  Students submitted reflective essays after completing a frame-design assignment in a third-year dispensing course. Participation in the study was voluntary and occurred only after assignment grades had been released. Essays from consenting students were anonymized by an independent assistant before being analysed. A reflexive thematic analysis was conducted, informed by sociocultural learning theory and positioning theory. The analysis focused on how students made meaning, positioned themselves and patients, and engaged with cultural and contextual considerations in dispensing practice. Reflexive journaling supported the analytic process.Results  Five themes were developed. Students often described an expanded understanding of dispensing as a relational and context-dependent encounter rather than a purely technical activity. Many reflected on the cultural, social, and lifestyle factors that shape spectacle frame design and patient preferences. Several students expressed greater empathy and awareness of patient individuality, particularly when designing for groups whose needs they had not previously considered. Collaborative dialogue, peer feedback, and exposure to diverse examples appeared to support deeper cultural reflection. Students also acknowledged the tensions between aesthetic ideals, functional requirements, and the cultural meanings associated with spectacle frames.Discussion  Reflective practice appeared to foster cultural awareness by encouraging students to interrogate their own assumptions, recognise the socio-cultural dimensions of dispensing, and adopt more patient-centred perspectives. The reflections suggested that designing for diverse population groups can prompt critical engagement with issues of accessibility, identity, and representation.Conclusion  Integrating structured reflective writing into dispensing education may foster culturally responsive practice by prompting students to consider the broader contexts that shape patients' experiences and preferences.
SN  - 1472-6920
ER  -