Reflective writing is a powerful way of developing professional identity
Volume 48, Issue 5
Reflections: an inquiry into medical students’ professional identity formation
April 09, 2014
Authors – Anne Wong, Karen Trollope‐Kumar
Professional identity formation plays a crucial role in the transition from medical student to doctor. At McMaster University, medical students maintain a portfolio of narrative reflections of their experiences, which provides for a rich source of data into their professional development. The purpose of this study was to understand the major influences on medical students’ professional identity formation.
Sixty‐five medical students (46 women; 19 men) from a class of 194 consented to the study of their portfolios. In total, 604 reflections were analysed and coded using thematic narrative analysis. The codes were merged under subthemes and themes. Common or recurrent themes were identified in order to develop a descriptive framework of professional identity formation. Reflections were then analysed longitudinally within and across individual portfolios to examine the professional identity formation over time with respect to these themes.
Five major themes were associated with professional identity formation in medical students: prior experiences, role models, patient encounters, curriculum (formal and hidden) and societal expectations. Our longitudinal analysis shows how these themes interact and shape pivotal moments, as well as the iterative nature of professional identity from the multiple ways in which individuals construct meaning from interactions with their environments.
Our study provides a window on the dynamic, discursive and constructed nature of professional identity formation. The five key themes associated with professional identity formation provide strategic opportunities to enable positive development. This study also illustrates the power of reflective writing for students and tutors in the professional identity formation process.
One of the successful candidates from last year who ranked in the top 5 at interview, clearly asserts that the most important skill to be able to demonstrate at ST3 interview is “the ability to reflect”. Make sure your written pieces are accessible to interviewers by:
1) Making them short and succinct
2) Using a clear, descriptive title which says what it does on the tin!
3) Selecting the place in your portfolio where they are most likely to be seen
Reflective notes following educational activity
To demonstrate learning, you need to record how your knowledge, skills or attitudes have improved as the result of participation in any activity including courses, conferences and seminars. You should also indicate how your learning might impact on your practice and patient care. You will find a link to a template produced after extensive discussion, by the Academy of Medical Royal Colleges. This structure will help you decide what to include
1) Describe a significant event you can learn from without judgements or justifications….just what happened.
2) Considering your role…what did you do well or just OK?
3) How could you have handled things better or differently next time?
Tap it into the form below and email it to me for some feedback
Start by watching this short You Tube clip explaining what reflection is:
You aren’t alone if you consider reflective writing to be irrelevant, fluffy or even a nuisance or a waste of time. It may be that you won’t ever really enjoy it…however you might not have enjoyed biomechanics or pathology, but you still need to learn about it to be a competent surgeon. It is a clinically relevant skill you can improve and use throughout your career if you choose to. It is also, though, a GMC requirement for doctors to reflect regularly on their standards of medical practice (2006), and to be able to demonstrate it.
What is it?
Reflection can refer to a number of different processes from thinking back over events on the way home from work to formal journals to drive learning and assessment.
Effective reflection is of course reliant on accurate self assessment. It is well recognised that the least able trainees are the least able to accurately self assess. (Coltart et al 2008). Such shortfalls in competence can be identified and managed sooner rather than later. Interestingly, more junior trainees are engaging better with the process, perhaps because reflection is so firmly embedded in the Foundation e-Portfolio (Goodyear et al 2013).
The ultimate aim of reflection is to improve professional practice, both the process and the result can contribute significantly to clinical wisdom.
Just thinking about the take home message from an operation may take as little as 30 seconds, but is still reflection. Our challenge is to engage with the reflective process, move from observational descriptive writing to critical reflection and practice…. rather than just treating it as another box to tick.
Check next blog for how to do so.