Virginia F. Randall,USUHS,Frederick,MD,Anne B. Warwick,USUHS,Bethesda,MD,Phillip Matthews,USUHS,Bethsda,MD
Qualitative Analysis of Third Year Student Reflective Practice Essays: Effect of a New Curriculum
Background: Curriculum changes at USUHS (CmRef) resulted in an 18 month pre-clerkship clinical experience that introduced students to increased meaningful patient contact. In the pediatric clerkship, both before and after CmRef, students are required to write an essay describing their experiences with professional or unprofessional behaviors. This resulted in an archive of essays available for analysis and research.
Research Question: Were there differences in the themes developed by the students in their essays before and after CmRef?
Method: With IRB approval, qualitative analysis (grounded theory approach) was used in the analysis of the essays pre- and post-CmRef (pre CmRef n=123; post CmRef, n= 120). Two investigators independently reviewed all essays in both groups and coded the students’ ideas presented in each essay, after which they discussed the process until a consensus was reached for each code. These codes were aggregated into themes, again with discussion to consensus. The themes from pre- and post-CmRef were then compared to determine what differences might exist between the two groups of essays. A third researcher reviewed and concurred with the findings.
Result: Several themes emerged from the post-CmRef collection of essays that were not present in the pre-CmRef essays including: student proposes a moral principle; and student developed deep insight into how patients/parents feel (empathy).
Discussion: The development of professionalism is of great interest to the LCME. Efforts are being made in medical schools to enhance student experiences and improve professional behaviors and attitudes held by the students. In this analysis, following CmRef new themes have arisen from these students’ reported experiences with and reflections on professionalism. What did not change is that students observe professional and unprofessional behaviors in faculty and staff, and make decisions about their own standards of behavior for the future.
The views expressed are those of the authors and do not necessarily reflect the official position of the USUHS, the Departments of the Army or Air Force, or the Department of Defense.