Changes in self-reflective thinking level in writing and educational needs of medical students: A longitudinal study

Goal-Oriented and Habit-Oriented Reflective Models to Support Professional Identity Formation and Metacognitive Thinking

Professional identity formation (PIF) is a multi-year, complex, social, and intellectual process that culminates in trainees "thinking, acting, and feeling like a doctor." Some of the processes of PIF, particularly the Hidden Curriculum, may result in suboptimal outcomes in student's cognition, including implicit bias and poor clinical decision-making. Many have recognized the importance of reflective writing, particularly metacognition, in undergraduate medical education. However, there are few concrete examples and explanations for fully integrating reflective writing exercises across multiple situations, experiences, and levels of growth. The authors provide conceptual frameworks, concrete curricular structures, and reflective tools used at two medical schools.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-023-01752-9.

A systematic scoping review of reflective writing in medical education

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.