Real‐Time, Brief Reflections: An Efficient, Contextual and Familiar Variation of Reflective Writing: A Mixed‐Methods Analysis

BACKGROUND: Reflective writing is an important pedagogic tool for medical student professional identity formation (PIF) and empathy development. Real-time, brief reflections (RTBRs) are 280-character reflections intended to be contextual, familiar and efficient. METHODS: Fourth-year medical students completed RTBRs while rotating in a primary care clinic serving complex patients. Qualitative methodologies were used to develop a codebook to describe the RTBRs; an independent auditor verified codebook accuracy. Student feedback was elicited to understand perspectives on the tool. RESULTS: Eighteen students completed 131 RTBRs during 64 clinics; an average of 2.05 reflections per clinic and 4.39 min spent on each reflection. Three codes described the content of the RTBRs: descriptive (49%), emotional (40%) and cognitive (64%). Three derived codes described student growth and were present in 48% of RTBRs: new perspective (16%), practice change (10%) and the human component to care (30%). Many codes described elements of metacognition (cognitive, emotional, new perspective and practice change), a key component to PIF. Many also included elements reflective of the core processes of empathy including valuing others, taking perspective and humanising others (emotional, cognitive and the human component to care). Most students agreed or strongly agreed that RTBRs helped them think more deeply about (9/9, 100%) and remember (8/9, 89%) patient interactions and were a good use of their time (7/9, 78%). CONCLUSIONS: RTBRs are a well-received reflective writing tool that allows for deep reflection that is contextual, familiar and efficient and facilitates the development of professional identity and empathy.