Medical students' honesty in summative reflective writing: A rapid review

Reflection is a highly individual metacognitive process of contextualising experiences in our environment. It is a core skill for medical students, as it helps future practitioners tackle complex scenarios. It is subject to assessment, which goes against the philosophical underpinnings of reflection, thus risking students only emulating reflective practice without actually engaging with it. We sought to provide an overview of the current literature on medical students' views of summative reflective writing.

A rapid review of literature was carried out. Keywords were searched in six databases; items were retrieved and screened against the inclusion/exclusion criteria. Ten papers were included in the final review. Their quality was appraised by utilising the CASP checklist tools.

Seven primary research papers addressed honesty of reflective practice in a variety of different settings. Students were found to 'game the system' by tailoring their reflections to meet the assessment criteria. One paper postulated that students are honest in their reflections. Three expert opinions showed congruent views on the need for diversification of reflective practice in medical school and going back to the definition of reflection.

This rapid review provides an account of medical students' views of summative reflective writing within the literature. Instrumentalising reflection can lead to students only emulating reflective practice, although not engaging with deeper learning. More primary qualitative studies exploring medical students' views of assessment of reflection would better detail the problem of emulated reflective practice.