Medical students using the technique of 55-word stories to reflect on a 6-week rotation during the integrated primary care block

Abstract

Background. Reflection and reflective practice are identified as a core competency for graduates in health professions education. Students are expected to be in a position to process experiences in a variety of ways through reflective learning. In doing so, they can explore the understanding of their actions and experiences, and the impact of these on themselves and others. Objectives. To draw on 5-weekly reflections by final-year medical students during the integrated primary care block placement. These reflections explore the learning that occurred during the rotation and the change in experiences during this period, and illustrate the use of reflection as a tool to support the development of professional practice. Methods. This descriptive qualitative study analysed students’ 55-word reflective stories during a 6-week preceptorship in either a rural or urban primary healthcare centre. The writing technique of short 55-word reflective stories was used to record student experiences. Inductive thematic analysis was conducted using MAXQDA software. This involved identifying the most commonly used words for each week through a word cloud, highlighting each week’s most notable focus for learning to generate themes and sub-themes. Results. Analysis of 127 logbook entries generated 464 stories on a range of experiences that had a significant impact on learning. Students’ reflections in the first 2 weeks were linked to personal experiences and views about the block. In subsequent weeks, reflections focused on the individual responses of students to the learning experiences regarding the curriculum, patient care, ethics, professionalism and the health system. Conclusions. The reflections highlighted the key learning experiences of the medical students and illustrated how meaning is constructed from these experiences. The 55-word stories as a reflection tool have potential to support reflection for students, and provide valuable insight into medical students’ learning journey during their clinical training.