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writing prompts provided to undergraduate medical students in the portfolio module of clerkship, 2012/2013 Reflective writing exercise 1 Write about a time you felt lost Reflect on the scene the first time you saw someone diagnosed with a serious illness
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Context:
Reflective writing is a popular tool to support the growth of reflective capacity in undergraduate medical learners. Its popularity stems from research suggesting that reflective capacity may lead to improvements in skills such as empathy, communication, collaboration and professionalism. This has led to assumptions that reflective writin...
Context in source publication
Context 1
... wrote each reflection in response to a reflective writing prompt, which they selected from a list of prompts provided for each of the four reflective writing exercises completed throughout the year. Table 1 presents the complete set of writ- ing prompts from which students could choose. One of 23 faculty mentors read and responded to each student's reflections, interacting with the stu- dent online and in person to promote dialogue and professional growth. ...Similar publications
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Citations
... We embedded these questions in all variants at the end of a course module (three time points). Therefore, students answered each question three times, as recent literature indicates that a single sample is insufficient for an accurate assessment of reflectivity [51]. The students had to answer the questions to proceed in the course. ...
... Second, habituation effects must be considered: The reflection prompts were provided with the same wording across all course modules to ensure comparability and because previous research has proven single samples to be less suitable for accurate reflectivity assessments [51]. Nevertheless, students might have been less motivated to compose qualitative answers towards the end of the course, as they had to answer the same questions three times. ...
Background
Previous research indicates that reflection can foster medical communication competence. However, best practices for embedding reflection in online medical education are missing. This study examined how reflection processes can be promoted and embedded in an e-learning course on physician–patient communication to foster learning.
Methods
We investigated three differently designed e-learning conditions featuring different proportions of reflection triggers and compared their effects on students’ reflections. We had 114 medical students in their first clinical year complete one of the variants: video modelling (VM, n = 39), video reflection (VR, n = 39), or a variant merging both approaches (VMR, n = 36). Each student wrote a total of nine reflections based on the same guiding questions at three time points embedded in the course. The students’ levels of reflection were measured using an adapted version of the REFLECT rubric (scale 0–18).
Results
Students of all course variants achieved good levels of reflection beyond the descriptive level at all three time points, with no significant differences between the variants. The mean reflection scores at the end of the course were M = 14.22 for VM (SD = 2.23), M = 13.56 for VR (SD = 2.48), and M = 13.24 for VMR (SD = 2.21). Students who completed VM showed significantly improved levels of reflection over the course, whereas we found no statistically significant development for those in VR or VMR. The reflection scores correlated significantly positively with each other, as did the text lengths of the written reflections. Reflection scores also correlated significantly positively with text length.
Conclusions
Our study offers a teaching strategy that can foster good levels of reflection, as demonstrated in the three e-learning variants. The developed reflection prompts can be easily embedded in various e-learning environments and enable reflections of good quality, even in settings with limited available teaching time.
... In fact, assessing students' subjective ideas and feelings about their own unique experiences presents a number of difficulties, as noted in the literature (9). A reflective practice training program for nurse educator and further research on the reflective assessment is necessitated in optimizing the benefit of reflective practice in clinical nursing education (5,6,33). ...
Introduction: Reflective practice is a recommended approach to boost excellence in clinical nursing education frameworks. Despite its significance, the literature on this practice among nurse educators is scarce, and the comprehensive exploration of it is inadequate. Thus, this study aims to assess nurse educators' level of reflective thinking and their perception, understanding, and attitudes towards reflective practice in clinical nursing education. Methods: A mixed-method study employing a questionnaire (n = 221) was conducted among nurse educators in Ministry of Health Training Institutions across Malaysia between April and May 2022. Convenience sampling was used, and questionnaires were distributed online. The questionnaires included 16-item scales to measure reflective thinking using a 5-point Likert scale adapted from a previous study and 16 items consisting of closed-ended and open-ended questions. Quantitative data were analysed using descriptive statistics (SPSS version 26), while qualitative data underwent content analysis. Results: The study discovered that despite the high level of reflective thinking among nurse educators (mean score 4.00 ± 0.38), their inadequate understanding of the purpose of reflective practices integration into clinical nursing education led them to focus on the practice which barely benefit the learning process. However, the positive attitudes towards training indicate their willingness to enhance their knowledge and skills in this area, possibly contributing to the further development of reflective practice in clinical nursing education. Conclusion: Targeted training programmes and educational initiatives should be designed to address the gaps identified in this study and enhance reflective practices in clinical nursing education.
... The literature pertaining to professionalism assessment describes a tendency towards using snapshot judgements and assessment tools including longitudinal portfolios (9)(10)(11), Objective Structured Clinical Examination (OSCE) stations (12,13), re ective writing (2,9) and global rating scales (14). Little detail is captured relating to student behaviours involved in this assessment process, and the speci c de nition of what is being assessed varies from highly detailed to one word descriptors. ...
... The literature pertaining to professionalism assessment describes a tendency towards using snapshot judgements and assessment tools including longitudinal portfolios (9)(10)(11), Objective Structured Clinical Examination (OSCE) stations (12,13), re ective writing (2,9) and global rating scales (14). Little detail is captured relating to student behaviours involved in this assessment process, and the speci c de nition of what is being assessed varies from highly detailed to one word descriptors. ...
Background
Medical professionalism may be defined operationally as an amalgamation of behaviours, attributes and adherence to standards. Assessing professionalism is notoriously difficult, in part due to its broad and contextual nature, but also ambiguity around expectations of students within a given scenario. This study seeks to provide granular detail about what constitutes ‘adequate professionalism’ at defined milestones of undergraduate medical education in the opinion of students and teaching faculty at UK medical schools.
Methods
Fifteen key professionalism themes were identified from published medical regulator guidance. Four behavioural descriptors were written for each theme, using the lens of Miller’s Pyramid to describe how a medical student might progress from ‘novice’ to ‘proficient’ across four defined milestones of their undergraduate medical school career. Using an online survey, students and teaching faculty at UK medical schools were invited to provide their opinion as to what constituted ‘adequate professionalism’ at each milestone with respect to each theme.
Results
Eight medical schools participated in the study. A total of 112 responses were received from 74 (66.1%) medical students and 38 (33.9%) faculty members. The data mapped students’ journeys from ‘novice’ to ‘proficient’ as they transited the respective milestones of entering medical school, first patient contact, regular patient contact, and graduation. Student and faculty respondents broadly agreed about what defined ‘adequate professionalism’ at each milestone. However, faculty expressed higher expectations than students in one theme, while students had higher expectations than faculty for at least one milestone across 10 themes. In some themes, students were expected to perform above the ‘most novice’ descriptor at the first milestone. In other themes students were not expected to reach the ‘most proficient’ descriptor by the final milestone.
Conclusions
This study has benchmarked ‘adequate professionalism’ for medical students at defined milestones in the undergraduate medical curriculum. This enables more detailed professionalism assessments during undergraduate studies. A number of further research questions are posed.
... Reflective writing is a well-accepted tool within medical education that supports the growth of reflective capacity among medical students [1].With its consideration as an essential aspect of lifelong self-directed learning, reflective writing has become a crucial element integrated into a competence-based curriculum of the medical program [2]. The idea of reflective practice was primarily established by Schon in 1987, and it was characterized by three stages: awareness of thoughts and feelings, critical analysis of a condition, and development of a new viewpoint of the situation [3]. ...
... Reflection is also conceptualized as a process for change [4] and it is considered a fundamental aspect of enhanced learning [5] as it provides the opportunity for 'reflection-on-action' [6] and the demonstration of critical reflection by individuals. It follows that reflection allows the development and integration of new knowledge into practice leading to the core experience of greater professional competence [7] as it leads to improvements in empathy, communication, collaboration and professionalism [1]. A growing body of research has also highlighted the relationship between reflective capacity and the enhancement of physician competence [8,9]. ...
... When assessing for convergent validity, results demonstrated the emergence of a moderate, non-significant correlation between GRE-9 reflective scores and OSCE communication station scores; indicating that GRE-9's convergent validity was not supported. Other studies in the literature that have also investigated the divergent and convergent validity of reflective tools through investigating the relationship between reflective writing scores and other measured of performance [1,28,37] have also yielded differential results related to construct validity. For instance, in a study aiming to investigate issues of reliability and validity in the quantitative assessment of reflective writing using an already establish reflective tool [REFLECT], results yielded a weak non-significant correlation between students' REFLECT scores (averaged across four samples and four raters) and Year 2 MCQ examination scores which confirmed the divergent validity [1]. ...
Background
The main objective of this study is to assess the construct validity and reliability of the Grading Reflective Essays-9 (GRE-9).
Methods
This study took place in a major tertiary academic medical center in Beirut, Lebanon. 104 reflective essays written by years 1–3 residents in the department of Family Medicine at the American University of Beirut Medical Center (AUBMC) were graded by 2 trained raters who independently scored the essays using GRE-9. GRE-9 scores were then correlated with scores on communication skills OSCE stations and in-training examinations to investigate, respectively, convergent and divergent validity. One of the 2 raters scored the essays twice one month apart to assess the reliability of the GRE-9 using intra rater reliability and internal consistency.
Results
There was a weak, non-significant correlation between GRE-9 score and In training examination (ITE) score (r = − .213, p = .395). There was a moderate, non-significant correlation between GRE-9 scores and the Objective structured clinical examination (OSCE) communication station scores (r = − .412 p = .162). The correlation coefficient between trails 1 and 2 was significant (r = .832, p = .000). Intra class correlation coefficient (ICC) analysis demonstrated almost perfect intra-rater agreement (0.819; 95% CI: 0.741–0.875) of the test ratings over time.
Conclusions
GRE-9, is a short, concise, easy-to-use reliable grading tool for reflective essays that has demonstrated moderate to substantial intra-rater reliability and evidence of divergent validity. The study found non-significant correlations between reflective writing scores OSCE communication scores demonstrating a lack of relationship between reflective writing and this measure of performance.
... Re ective writing is a well-accepted tool within medical education that supports the growth of re ective capacity among medical students (Moniz, Arnt eld, Miller, Lingard, Watling & Regehr, 2015).With its consideration as an essential aspect of lifelong self-directed learning, re ective writing has become a crucial element integrated into a competence-based curriculum of the medical program (Aukes, Geertsma, Cohen-Schotanus, Zwierstra & Slaets, 2007). The idea of re ective practice was primarily established by with the three essential aspects of personal re ection in the context of medical practice and education of the GRAS (Aukes et al., 2007), the content validity of the scale was assumed and appeared to be satisfactory as it was grounded in re ection literature. ...
... Kassab et al., 2020, Lee et al., 2023) have also yielded differential results related to criterion validity. For instance, in a study aiming to investigate issues of reliability and validity in the quantitative assessment of re ective writing using an already establish re ective tool [REFLECT], results yielded a weak nonsigni cant correlation between students' REFLECT scores (averaged across four samples and four raters) and Year 2 MCQ examination scores which con rmed the divergent validity (Moniz et al., 2015). Study ndings also indicated that weak non-signi cant correlation between REFLECT scores and OSCE measures con rmed the convergent validity (Moniz et al., 2015). ...
Background
The main objective of this study is to assess the construct validity and reliability of the Grading Reflective Essays-9 (GRE-9).
Methods
This study took place in a major tertiary academic medical center in Beirut, Lebanon. 104 reflective essays written by years 1–3 residents in the department of Family Medicine at the American University of Beirut Medical Center (AUBMC) were graded by 2 trained raters who independently scored the essays using GRE-9. GRE-9 scores were then correlated with scores on communication skills OSCE stations and in-training examinations to investigate, respectively, convergent and divergent validity. One of the 2 raters scored the essays twice one month apart to assess the reliability of the GRE-9 using intra rater reliability and internal consistency.
Results
There was a weak, non-significant correlation between GRE-9 score and In training examination (ITE) score (r = − .213, p = .395). There was a moderate, non-significant correlation between GRE-9 scores and the Objective structured clinical examination (OSCE) communication station scores (r = − .412 p = .162). The correlation coefficient between trails 1 and 2 was significant (r = .832, p = .000). Intra class correlation coefficient (ICC) analysis demonstrated almost perfect intra-rater agreement (0.819; 95% CI: 0.741–0.875) of the test ratings over time.
Conclusions
GRE-9, is a short, concise, easy-to-use reliable grading tool for reflective essays that has demonstrated moderate to substantial intra-rater reliability and evidence of divergent validity. The study found non-significant correlations between reflective writing scores OSCE communication scores demonstrating a lack of relationship between reflective writing and this measure of performance.
... Reflective writing about clinical issues has gained increasing attention as a means to cope with challenging situations and enhance empathy (Borgstrom et al., 2016;Cowen et al., 2016;Campbell et al., 2020). Nevertheless, its role needs further investigation (Wald & Reis, 2010;Wittich et al., 2013;Lin et al., 2016;Ottenberg et al., 2016;Kiss et al., 2017;Brown et al., 2019), also regarding its value as a student assessment method (Moniz et al., 2015;Eppler et al., 2021). Although reflective thinking correlated with academic performance in dental students (Loka et al., 2019), its value as student assessment rated rather low for medical students (Moniz et al., 2015). ...
... Nevertheless, its role needs further investigation (Wald & Reis, 2010;Wittich et al., 2013;Lin et al., 2016;Ottenberg et al., 2016;Kiss et al., 2017;Brown et al., 2019), also regarding its value as a student assessment method (Moniz et al., 2015;Eppler et al., 2021). Although reflective thinking correlated with academic performance in dental students (Loka et al., 2019), its value as student assessment rated rather low for medical students (Moniz et al., 2015). Furthermore, male and female learning preferences are still under-investigated. ...
The presented course, established 2016 as a compulsory elective for 22nd‐year bachelor medical students, aimed to enhance deep learning of upper and lower limb anatomy from a clinical perspective by a maximum of student‐centered activities combining hands‐on skills training with team‐learning. Three cohorts (in total 60 students) participated in this study. Students rotated through body painting, ultrasound, and clinical investigation supervised by faculty or an experienced clinician. Teams of 3‐4 students prepared presentations on clinical anatomy and pathological conditions, which by teacher‐ and peer assessments on average achieved >85% (mean 17.8/20 points ± 1.06). After each activity session, the students reported their learning experience through a reflective diary. Fifty students (83%) evaluated the course by a voluntary anonymous questionnaire combining Likert‐type scale and free‐text questions to assess, predominantly, perception of course activities and their perceived influence on learning anatomy. Journal reports and questionnaires revealed that the students highly valued the course, and 92% (29 females, 17 males) rated group work satisfying or well‐perceived. The highest appreciation achieved ultrasound followed by clinical examination and body painting, which one third proposed to integrate into the regular dissection course. All students recommended the course to their younger peers. This course was feasible to integrate in the pre‐existing curriculum. Limiting factors to offer this elective course to more students are availability of clinical teachers, technical equipment, and education rooms. Being student‐directed tasks, body painting and reflective diary‐writing would be feasible to implement without additional faculty, which we recommend to educators for student engagement activation.
... Anecdotally, it seems that at some point, this became misunderstood, with many formative rubrics and frameworks now being used for the summative assessment of reflective writing. Research has found the use of existing validated rubrics has only poor to moderate inter-rater reliability in the summative assessment of reflective writing (Soemantri et al., 2022), with the need for up to five assessors and 14 previous essays to reliably assess the reflective competence of one student (Moniz et al., 2015). The pragmatic educator must therefore assure the implementation of rubrics, models and frameworks is as intended, and understand the limitations of introducing fair and reliable marking models in high stakes reflective assessments. ...
This chapter highlights key academic contentions around assessing reflection in higher education. Through assimilating experiential, conceptual, and empirical evidence, key terms are defined: ‘reflection' as a conceptual and neuroscientific phenomenon within higher education; ‘reflective practices' as activities, models, and frameworks that facilitate it; and ‘reflective assessments' as content or process driven products of those practices. A literature review elucidates three voices that speak to reflection in higher education.
... Further encouragement to embed reflection within the curricula earlier will help students develop how, where and why they learn, which in turn will motivate students providing opportunities to develop competencies related to learning, as well as skills for future use, whether in education or employment (36). The inclusion of written reflection as a form of assessment has been debated; however, it is important that students undertake such activities to develop their personal learning approaches and transferable skills required for future employment (41). Staff may be reluctant to engage students in such reflective activities either assessment or personal reflective logs/diaries, primarily due to lack of knowledge regarding reflection and as such a workshop/shared practice event could be held to highlight the importance of written reflection within the curriculum, styles of reflection and how to successfully reflect (42). ...
Introduction: Scientific communication, particularly the dissemination of research findings to both the scientific community and the general public, are skills required of graduates embarking on post-graduate studies and employment within the biomedical sciences sector. The aims of this action research project were to i) co-design an online scientific communication and digital capabilities resource, constructively aligned to the learning objectives of a final year undergraduate investigative research project; ii) ensure resource flexibility for future adaptation by others iii) embed authentic scientific communication learning assessments, namely, the preparation of a lay summary and visual abstract and iv) promote students’ awareness of developed digital capabilities and transferable skills through written reflection.
Materials and Methods: Student engagement, self-efficacy, experiences and performance and staff perceptions (n = 15) were evaluated by a mixed methods approach. Qualitative data was gathered from focus sessions, free text responses within questionnaires and content analysis of students’ written reflections (n = 104). Quantitative data from 5-point Likert responses within student questionnaires (n = 31) and analysis of student scientific and lay writing (n = 146) using the readability parameters Flesch-Kincaid Grade Level and Flesch Reading Ease were analysed using non-parametric statistical methods.
Results: A learning resource was co-designed with students, staff, local, national and international contributors and valued by both students and staff, enabling students to prepare scientific communication outputs of a professional standard by application of digital, analytical and scientific communication skills. Students prepared lay summaries which were statistically (p < 0.0001) more readable than their paired scientific abstracts. Significant correlations between easier readability of lay summaries and awarded marks for the written elements of the module were noted. Students reported their digital and communication capabilities increased significantly (p < 0.0001) throughout, from limited to good/excellent and reflected on the numerous transferable skills developed during preparation of assessments, with 75% reflecting on their digital capabilities.
Discussion: Undergraduate students developed, appreciated and used varied scientific communication and digital skills to articulate research findings. The embedding of such activities throughout all levels of higher education will enable students to develop their digital and scientific skills and reflect on the development of such transferable skills for application in their future careers.
... Structured vs unstructured reflection Orientation of user to benefits of reflection and key aspects of reflection [25,96,[112][113][114][115][116] ° Novices requiring explicit instructions [130] ° Practice sessions for reflective journaling at the beginning of program [114] Prompt questions and suggested frameworks ° To recount and describe event [114,121,131,132] ° To retrospectively analyse own behaviour and rationalise actions [114,121,131,[133][134][135][136][137] ° To reflect on emotions and feelings [121,[127][128][129] ° Action for learning [114, 121, 132-134, 136, 138, 139] ° No frameworks, structure or prompts given to users [120,140,141] Suggested events to reflect on ° On self-identified significant clinical encounters [37,[116][117][118][119][120][121][122] ° On competency domains [113,119,142,143] ° On hypothetical scenarios [144] Examples of good reflection given to users [96,115,116] Benefits of scaffolding ° Frameworks help users to obtain greater breadth and depth in their reflective capacity [76,79,105,123,124] and can be used as an assessment rubric and guide for self-reflection processes [99,123,125,126], especially for new users [138] ° Simple frameworks allow for RW to be assessed with limited faculty training time or high volume of written reflections to be scored [145] ° Ease of use allows users to peer assess one another [126] Cons of scaffolding ° Prompts could restrict ability of users to engage in reflective writing [146] Frequency of reflection Once-off [112,115,118,123,139,142,144,145,[147][148][149][150][151][152][153][154] Thrice weekly [155,156] Weekly [116,122,136,[157][158][159][160][161][162][163][164] Bi-weekly [117,133,165] Monthly [135] Daily [119,134] Modality of reflection Modality of reflection ° Electronic portfolios ° Written reflective essays/ journals ° Oral narration (i.e. interviews, focused groups discussion) ° Written and verbal adjunct ° Written and video adjunct Comparison of e-journals with hardcopy journals ° Benefits of e-journals: convenience, ease of use, immediacy in terms of feedback, accessibility and visual impact [29,162,166] Use of video journals ° Allows for more authentic responses which can later be reviewed, discussed and reflected upon in sessions [167] Group vs individual activity Face to face meetings for feedback/ discussion ° One-on-one meetings [ [69], increased awareness of personal strengths, while self-reflection enhanced personal weaknesses [173] ° Peer to peer relationships oscillate between support and judgement [149] Formative vs summative assessment Formatives Summative No assessment given Dilemmas regarding assessment of RW ° Compulsory assessments encourage users to take assignments seriously and participate [114,182] ° Assessments allow for developing of reflective skills [183] ° Compulsory assessments result in users writing down what they believe is expected of them instead of their own genuine responses [114,143,155,184] ...
... Structured vs unstructured reflection Orientation of user to benefits of reflection and key aspects of reflection [25,96,[112][113][114][115][116] ° Novices requiring explicit instructions [130] ° Practice sessions for reflective journaling at the beginning of program [114] Prompt questions and suggested frameworks ° To recount and describe event [114,121,131,132] ° To retrospectively analyse own behaviour and rationalise actions [114,121,131,[133][134][135][136][137] ° To reflect on emotions and feelings [121,[127][128][129] ° Action for learning [114, 121, 132-134, 136, 138, 139] ° No frameworks, structure or prompts given to users [120,140,141] Suggested events to reflect on ° On self-identified significant clinical encounters [37,[116][117][118][119][120][121][122] ° On competency domains [113,119,142,143] ° On hypothetical scenarios [144] Examples of good reflection given to users [96,115,116] Benefits of scaffolding ° Frameworks help users to obtain greater breadth and depth in their reflective capacity [76,79,105,123,124] and can be used as an assessment rubric and guide for self-reflection processes [99,123,125,126], especially for new users [138] ° Simple frameworks allow for RW to be assessed with limited faculty training time or high volume of written reflections to be scored [145] ° Ease of use allows users to peer assess one another [126] Cons of scaffolding ° Prompts could restrict ability of users to engage in reflective writing [146] Frequency of reflection Once-off [112,115,118,123,139,142,144,145,[147][148][149][150][151][152][153][154] Thrice weekly [155,156] Weekly [116,122,136,[157][158][159][160][161][162][163][164] Bi-weekly [117,133,165] Monthly [135] Daily [119,134] Modality of reflection Modality of reflection ° Electronic portfolios ° Written reflective essays/ journals ° Oral narration (i.e. interviews, focused groups discussion) ° Written and verbal adjunct ° Written and video adjunct Comparison of e-journals with hardcopy journals ° Benefits of e-journals: convenience, ease of use, immediacy in terms of feedback, accessibility and visual impact [29,162,166] Use of video journals ° Allows for more authentic responses which can later be reviewed, discussed and reflected upon in sessions [167] Group vs individual activity Face to face meetings for feedback/ discussion ° One-on-one meetings [ [69], increased awareness of personal strengths, while self-reflection enhanced personal weaknesses [173] ° Peer to peer relationships oscillate between support and judgement [149] Formative vs summative assessment Formatives Summative No assessment given Dilemmas regarding assessment of RW ° Compulsory assessments encourage users to take assignments seriously and participate [114,182] ° Assessments allow for developing of reflective skills [183] ° Compulsory assessments result in users writing down what they believe is expected of them instead of their own genuine responses [114,143,155,184] ...
... RW is also limited by poorly prepared physicians and misaligned expectations whilst a lack of privacy and a safe setting may precipitate physician anxiety at having their private thoughts shared [129,149,209,231]. RW is also compromised by a lack of faculty training [143,145,239], mentoring support [37,50,119,133,196] and personalised feedback [50,114,136,167,229] which may lead to self-censorship [37,114,136,149,160,183] and an unwillingness to address negative emotions arising from reflecting on difficult events [114,168,176,193,230], circumventing the reflective process [118,142,165,196] . ...
Background
Reflective writing (RW) allows physicians to step back, review their thoughts, goals and actions and recognise how their perspectives, motives and emotions impact their conduct. RW also helps physicians consolidate their learning and boosts their professional and personal development. In the absence of a consistent approach and amidst growing threats to RW’s place in medical training, a review of theories of RW in medical education and a review to map regnant practices, programs and assessment methods are proposed.
Methods
A Systematic Evidence-Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure the two concurrent reviews. Independent searches were carried out on publications featured between 1st January 2000 and 30th June 2022 in PubMed, Embase, PsychINFO, CINAHL, ERIC, ASSIA, Scopus, Google Scholar, OpenGrey, GreyLit and ProQuest. The Split Approach saw the included articles analysed separately using thematic and content analysis. Like pieces of a jigsaw puzzle, the Jigsaw Perspective combined the themes and categories identified from both reviews. The Funnelling Process saw the themes/categories created compared with the tabulated summaries. The final domains which emerged structured the discussion that followed.
Results
A total of 33,076 abstracts were reviewed, 1826 full-text articles were appraised and 199 articles were included and analysed. The domains identified were theories and models, current methods, benefits and shortcomings, and recommendations.
Conclusions
This SSR in SEBA suggests that a structured approach to RW shapes the physician’s belief system, guides their practice and nurtures their professional identity formation. In advancing a theoretical concept of RW, this SSR in SEBA proffers new insight into the process of RW, and the need for longitudinal, personalised feedback and support.
... Reflective writing is increasingly seen as an important educational practice in medical and health professional education to help achieve desired learning outcomes such as communication, empathy, and professionalism (Moniz et al. 2015). Medical educators may use a variety of writing tasks and forms to engage students and foster reflection, including focused essays, journal entries, and creative writing tasks (Green et al. 2016;Kerr 2010). ...
Medical educators recognize the value of reflection for medical students and the role creative writing can play in fostering this. However, direct creative writing tasks can be challenging for many students, particularly those with limited experience in the arts and humanities. An alternative strategy is to utilize an indirect approach, engaging students with structured tasks that obliquely encourage reflection. This paper reports one such approach. We refer to this approach as in-verse reflection, playing on both the structure of the writing and its novel approach to reflection. Students were invited to write, in verse-like structures, about their personal and clinical experiences as medical students. Thematic analysis of their creative outputs and reactions identified four principal themes: the challenges of life as a medical student, the emotional demands of the medical course, a sense of connectedness and solidarity with fellow students, and a sense of marginality within the hospital system. Students generally found the tasks highly engaging and conducive to reflection, producing texts representing significant insights into their experiences as medical students. The reported method offers a relatively simple, structured, and guided approach to reflective writing, adding to the repertoire of methods available to educators in the medical humanities.
