2011 - UCSF School of Medicine - University of California, San ...

UCSF Education Day 2011A Randomized Trial of ReflectiveLearning Guidelines and FeedbackAmong Third Year Medical StudentsLouise Aronson, MD, MFA,aronsonl@medicine.ucsf.edu; Brian Niehaus MD,Brian.Niehaus@ucsf.edu; Laura Hill-Sakurai, MD,HillSakL@fcm.ucsf.edu; Cindy Lai, MD,CLai@medicine.ucsf.edu; Patricia O'Sullivan, EdD,patricia.osullivan@ucsf.eduAreas abstract covers: UMEDomain(s) addressed: Competencies, Evaluation ofPrograms and Curricula, Feedback, ReflectionPurpose: To assess the impact of reflective learningguidelines and feedback, individually and together, onthe reflective ability demonstrated by medical students inwritten reflection exercises.Background: In response to national mandates,educators are increasingly incorporating reflection intotheir teaching. However, review of medical studentreflections from UCSF and elsewhere revealed that mostconsisted of anecdotes with few of the educationalcomponents described in the literature. We hypothesizethat learners do not reflect in an educationally useful waybecause we have not trained them to do so.Methods: We conducted a randomized, controlled trialof the impact of reflective learning guidelines and facultyfeedback on reflective skills. All third year medicalstudents wrote reflections on professionalism after their1st, 3rd and final clerkships. In a 2x2 design, half thestudents received reflective learning guidelines and halfdid not, and half in each of these groups receivedfeedback on both reflective skill and reflection contentand half received feedback on content alone. Reflectionswere scored by trained raters (r= 0.89) using apreviously validated 0 - 6 point rubric. We conducted ananalysis of covariance using 1st scores as the covariateand final scores as the dependent variable.Results: Mean reflection scores were 3.81 (sd=1.9)using guidelines and 2.22 (sd=.89) without guidelines(p