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Published Online: 11 November 2013

The Utility of Reflective Writing after a Palliative Care Experience: Can We Assess Medical Students' Professionalism?

Publication: Journal of Palliative Medicine
Volume 16, Issue Number 11

Abstract

Background: Medical education leaders have called for a curriculum that proactively teaches knowledge, skills, and attitudes required for professional practice and have identified professionalism as a competency domain for medical students. Exposure to palliative care (PC), an often deeply moving clinical experience, is an optimal trigger for rich student reflection, and students' reflective writings can be explored for professional attitudes.
Objective: Our aim was to evaluate the merit of using student reflective writing about a PC clinical experience to teach and assess professionalism.
Methods: After a PC patient visit, students wrote a brief reflective essay. We explored qualitatively if/how evidence of students' professionalism was reflected in their writing. Five essays were randomly chosen to develop a preliminary thematic structure, which then guided analysis of 30 additional, randomly chosen essays. Analysts coded transcripts independently, then collaboratively, developed thematic categories, and selected illustrative quotes for each theme and subtheme.
Results: Essays revealed content reflecting more rich information about students' progress toward achieving two professionalism competencies (demonstrating awareness of one's own perspectives and biases; demonstrating caring, compassion, empathy, and respect) than two others (displaying self-awareness of performance; recognizing and taking actions to correct deficiencies in one's own behavior, knowledge, and skill).
Conclusions: Professional attitudes were evident in all essays. The essays had limited use for formal summative assessment of professionalism competencies. However, given the increasing presence of PC clinical experiences at medical schools nationwide, we believe this assessment strategy for professionalism has merit and deserves further investigation.

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Published In

cover image Journal of Palliative Medicine
Journal of Palliative Medicine
Volume 16Issue Number 11November 2013
Pages: 1342 - 1349
PubMed: 23937062

History

Published online: 11 November 2013
Published in print: November 2013
Published ahead of print: 12 August 2013
Accepted: 30 May 2013

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Affiliations

Ursula K. Braun
HSRD Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas.
Department of Medicine, Section of Genatrics, Baylor College of Medicine, Houston, Texas.
Anne C. Gill
Department of Pediatrics and Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, Texas.
Cayla R. Teal
Department of Medicine and Office of Undergraduate Medical Education, Baylor College of Medicine, Houston, Texas.
Laura J. Morrison
Department of Medicine, Section of Genatrics, Baylor College of Medicine, Houston, Texas.

Notes

Address correspondence to:Ursula K. Braun, MD, MPHBaylor College of MedicineOne Baylor PlazaHouston, TX 77030E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist.

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