Grappling with complexity: Medical students’ reflective writings about challenging patient encounters as a window into professional identity formation

Abstract

IRW facilitates and ideally supports grappling with the lived reality of medicine; uncovering a "positive hidden curriculum" within medical education. The authors propose engaging learners in guided critical reflection about complex experiences for meaning-making within a safe learning climate as a valuable way to cultivate reflective, resilient professionals with "prepared" minds and hearts for inevitable challenges of healthcare practice.

Beyond communication training: The MaRIS model for developing medical students’ human capabilities and personal resilience

“…We now include scaffolded reflective writing, where students first learn the purposes and principles of reflection through LGS, then write formatively-assessed accounts, prior to summative assessment of later journals utilizing the Griffith University Affective Learning Scale (Rogers et al 2018). This approach enables us to illuminate students' experiential processing and professional identity development (Wald et al 2019) whilst concomitantly identifying students requiring additional support. Issues that become apparent through facilitator debriefs or students' reflective journals are managed through an established pathway that allows for targeted and appropriate additional support to be provided.…”

Navigating Cognitive Dissonance: A Qualitative Content Analysis Exploring Medical Students’ Experiences of Moral Distress in the Emergency Department

“…The themes identified here and elsewhere including challenging communication, implicit bias, medical uncertainty, and system limitations—may provide a good starting point for this process . However, the concepts discussed by students are complex and somewhat individualistic, underscoring the importance of providing students with the tools they need to identify their own triggers of moral distress . The added benefit of supporting students before the start of their clinical experience would be to decrease the extraneous cognitive load from moral distress helping them focus on the intrinsic cognitive load of the environment and germane cognitive load of their learning .…”

Fostering 2nd-year medical students' reflective capacity: A biopsychosocial model course

“…Second, students’ reflective capacity regarding “Action” increased but not to expected levels following the course. It is possible that 2 nd -year medical students do not enter their 3 rd year which marks a dramatic change in which they transition from students to practitioners [ 26 ]. Without increased experiences in medical practice, it is not easy for them to figure out what a physician should do when encountering patients’ psychological or social problems.…”

“…Without increased experiences in medical practice, it is not easy for them to figure out what a physician should do when encountering patients’ psychological or social problems. This lack of clinical experience may also explain the little growth and extreme distribution found for “Description of conflict or disorienting dilemma.” This feature may be the source of polarities as well as dissonance found in reflective writings [ 26 ]. When students fail to select critical issues in medical settings during recall, their reflections might not differ from a superficial description of the facts.…”