Table 4 Current methods of structuring RW programs
From: A systematic scoping review of reflective writing in medical education
Methods of structuring RW programs | Elaboration |
|---|---|
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, 132,133,134, 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] Weekly [116, 122, 136, 157,158,159,160,161,162,163,164] Monthly [135] |
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 [30, 119, 128, 143, 148, 150, 167, 168] ° Small group discussions [96, 115, 148, 169,170,171,172,173,174,175] Provision of feedback/ sharing of reflections ° Assurance of confidentiality [96, 120, 148, 152, 176, 177] ° Importance of feedback for improvement of experience [30, 96, 173, 178,179,180] ° Peer to peer feedback allowed for increased sense of camaraderie with classmates [120, 181] ° Peer to peer feedback allowed for enhanced learning [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] |