Critical reflection on required service to the community propels prospective medical students toward higher empathy, compassion, and bias mitigation but are these gains sustainable?

Abstract

PurposeWe observed increased cognitive empathy and reflective capacity scores when prospective medical students wrote critical reflections on mandatory team service-learning in a Medical Humanities course, but these findings did not include a control group. Here we compare these survey results in similar courses with and without required service-learning.MethodsForty-three prospective medical students completed a Medical Humanities course requiring critical reflection on team service-learning. In comparison, 32 students finished a similar course in which service to the community was not mandatory. Before starting the courses, students completed reliable surveys of their cognitive empathy and reflective capacity, and more than 93% of the students completed the same surveys after finishing the courses.ResultsStudents' cognitive empathy and reflective capacity scores increased significantly when service-learning was required, but the scores did not increase significantly when service to the community was not required. The effect size for the empathy increase was of crucial practical importance (r = 0.50), whereas it was of moderate practical importance for the increase in reflective capacity (r = 0.34).ConclusionsThese and prior findings strongly support the conclusion that students' critical reflection on mandatory team service-learning fosters development of their cognitive empathy and reflective capacity. We present a model program to incorporate critical reflection on service to the community throughout the curricula of all healthcare professions trainees.

Critical Reflection on Using ChatGPT in Student Learning

“…Afterward, students discussed the advantages and disadvantages of using ChatGPT and wrote a critical reflection. They can inspire and evolve new insights and understanding that support their professional development through dialogue and critical reflection 2. Three guiding questions were provided: What questions will you ask to understand what is happening in the family?…”

“…They can inspire and evolve new insights and understanding that support their professional development through dialogue and critical reflection. 2 Three guiding questions were provided: What questions will you ask to understand what is happening in the family? What nursing interventions will you provide to the family?…”

Further development of the reflective practice questionnaire

“…Studies have been conducted utilising the RPQ with medical students ( Bari et al, 2021 ; Horst et al, 2019 ; Khoshgoftar & Barkhordari-Sharifabad, 2023a , 2023b ; Lee et al, 2023 ; Rogers et al, 2019 ; Schwartz et al, 2020 ; Van Winkle et al, 2021 , 2022 ), surgeons/physicians ( Aitken et al, 2021 ; Whelehan, Conlon & Ridgway, 2021 ), nurses ( Aitken et al, 2021 ; Al-Osaimi, 2022 ; Gabrielsson et al, 2022 ; Gustafsson et al, 2020 ; Khalil & Hashish, 2022 ), psychologists ( Sadusky & Spinks, 2022 ), allied health professionals ( Aurora, Mawren & Fullam, 2023 ; Or & Golba, 2023 ; Parrott et al, 2023 ), pre-service teachers ( Day, Webster & Killen, 2022 ; Fuertes-Camacho, Dulsat-Ortiz & Alvarez-Canocas, 2021 ), qualified teachers ( Chen & Chen, 2022 ; Gross, 2020 ; Moeder-Chandler, 2020 ), and sport coaches ( Da Silva et al, 2022 ). In these studies the RPQ has been used for a range of purposes, such as assessment of the reliability of the RPQ scales ( e.g ., Gustafsson et al, 2020 ), comparison between different sub-groups of participants ( e.g ., Day, Webster & Killen, 2022 ), and comparison across different time points to explore student development ( e.g ., Van Winkle et al, 2021 ).…”

“… Van Winkle et al (2021) have published work that demonstrates how the RPQ can be used as part of an evaluation of teaching methods ( Horst et al, 2019 ; Schwartz et al, 2020 ; Van Winkle et al, 2021 , 2022 ). For example, Van Winkle et al (2021) found that self-reported reflective practice and a self-report empathy measure significantly increased for most medical students enrolled in a 4-month online course that included activities designed to facilitate the development of reflective practice.…”

“…For example, Van Winkle et al (2021) found that self-reported reflective practice and a self-report empathy measure significantly increased for most medical students enrolled in a 4-month online course that included activities designed to facilitate the development of reflective practice. In another example, Van Winkle et al (2022) found that the magnitude of increase in self-reported reflective practice and empathy was higher for prospective medical students who completed a course that included reflection specifically on their service-learning activities compared to students that completed a similar course with reflection only upon conflict interactions outside of their work environment.…”