Reading the Self: Medical Students' Experience of Reflecting on Their Writing Over Time

Area of Science:

• Medical Education
• Reflective Practice
• Narrative Medicine

Background:

• A longitudinal curriculum incorporating reflective writing is crucial for medical student development.
• Narrative medicine strategies offer a framework for deep reflection and professional identity formation.
• Meta-reflection exercises, like Signature Reflections, aim to enhance students' capacity for self-assessment over time.

Purpose of the Study:

• To investigate medical students' experiences with meta-reflection writing exercises (Signature Reflections) over time.
• To understand how these exercises contribute to reflective capacity within a longitudinal curriculum.
• To explore the role of faculty mentorship in supporting student reflection.

Main Methods:

• Qualitative study involving 5 focus groups with 18 third-year medical students.
• Iterative thematic analysis of focus group transcripts to identify patterns and themes.
• Development and synthesis of codes into overarching themes of student experience.

Main Results:

• Three core themes emerged: students valued a 'safe space' for vulnerability, the 'narrative experience' of documenting their journey, and the 'mirror of self' for identity exploration.
• An overarching theme of 'moving through time' highlighted the importance of temporal perspective gained through reflections.
• Key factors supporting reflection included trusted faculty mentors and protected time.

Conclusions:

• Longitudinal narrative medicine curricula with meta-reflection are effective in helping students track growth, explore emotions, and develop self-awareness.
• Findings support the mandatory and longitudinal implementation of narrative medicine to cultivate writing for insight and strengthen students' developmental perspectives.
• Faculty relationships and sustained opportunities for reflective writing are vital for medical trainees.