Reflective writing in dental education to improve critical thinking and learning: A systematic review

The Commission on Dental Accreditations states that "graduates must be competent in the use of critical thinking and problem-solving." With this in mind, dental education programs continually strive to enhance and deepen these skills by incorporating effective instructional strategies into the curriculum. To do this, predoctoral dental education has used a variety of techniques including problem-based learning, OSCEs, and standardized patient activities. Another technique, while less popular but potentially more effective if done well, is reflective writing. This study aimed to assess the effect of reflective writing on students' critical thinking skills and learning in dental education programs. Two database searches conducted between 2000 and 2019 resulted in 317 articles after the initial screening. Ultimately, 13 articles met inclusion criteria. The following recurring factors were identified for inclusion in dental education reflective writing initiative: reflective writing interventions, reflective writing instructions, writing prompts, evaluation frameworks, and negative perceptions of reflective writing. In answering the key aim of this review, 12 of the 13 studies determined that reflective writing had a positive impact on students' critical thinking, judgment, and/or learning. Key findings included positive effects on student growth in reflection, learning through reflective writing, reflection skills, self-assessment, critical thinking, clinical reasoning, problem solving, and motivation to change after evaluated experiences. The review indicated that dental education programs, which implemented reflective writing as an assessment tool within the curriculum as a means of developing and deepening critical thinking skills and learning were by and large successful in this effort.