Council on Medical Student Education in Pediatrics


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COMSEP 2012 Indianapolis Meeting

Poster Presentation:

Reflections in Advocacy Training: Does Thematic Content of Reflective Writing Differ Between Medical Students and Residents?

Daniel Walmsley, DO - Jefferson Medical College/Nemours; Alisa LoSasso, Jefferson Medical College/Nemours - MD; James D Plumb, MD, MPH - Jefferson Medical College; J. Lindsey Lane, BMBCh - University of Colorado School of Medicine; Esther K Chung, MD, MPH - Jefferson Medical College/Nemours

Background: Medical educators are increasingly recognizing the importance of reflective writing in the professional development of trainees. To date, there is limited information on whether reflective essays related to advocacy differ between students and residents.

Objective: 1) To analyze reflective essays written by students and residents as part of an advocacy curriculum. 2) To assess differences in thematic content of essays between medical students and residents.

Design/Methods: Students and pediatric residents completed reflective essays as part of JEFFSTARS, an advocacy curriculum. We utilized a coding rubric previously developed by conducting a qualitative analysis of reflective essays based on grounded theory. The rubric consisted of three themes: 1) Writing tone coded as detached, engaged or passionate. 2) Broadening perspective, based on identification of health problem barriers, sharing personal experiences, and demonstration of self-reflection. 3) Empowerment, categorized as passive or active; subthemes included evidence of new actions and attitudes. Using this rubric, we compared themes and subthemes between student and resident essays. Theme frequencies were calculated and bivariate analyses were performed using SPSS 17.0.

Results: The rubric was applied to 38 reflective essays (by 19 of each students and residents). The writing tone of the essays was primarily engaged or passionate (84%), with the remainder being detached.  Tone did not differ between groups. Discussion of health problem barriers occurred in 87% of the essays, and did not differ between the 2 groups. Students were more likely than residents to include personal experiences and self-reflection (68% vs 16% P < 0.01; 78% vs 42%, P < 0.05). Student essays when compared to resident essays were more likely to demonstrate new actions (90% vs 26% P < 0.001) and note a defining moment (90% vs 16% p=0.000).  

Conclusions: These results indicate that there was a difference in the thematic content of student reflective essays on advocacy when compared to those of residents. When discussing health advocacy, students were more likely to include personal experiences, demonstrate self-reflection and new actions, and note a defining moment.