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      A systematic scoping review of reflective writing in medical education

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          Abstract

          Background

          Reflective writing (RW) allows physicians to step back, review their thoughts, goals and actions and recognise how their perspectives, motives and emotions impact their conduct. RW also helps physicians consolidate their learning and boosts their professional and personal development. In the absence of a consistent approach and amidst growing threats to RW’s place in medical training, a review of theories of RW in medical education and a review to map regnant practices, programs and assessment methods are proposed.

          Methods

          A Systematic Evidence-Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure the two concurrent reviews. Independent searches were carried out on publications featured between 1st January 2000 and 30th June 2022 in PubMed, Embase, PsychINFO, CINAHL, ERIC, ASSIA, Scopus, Google Scholar, OpenGrey, GreyLit and ProQuest. The Split Approach saw the included articles analysed separately using thematic and content analysis. Like pieces of a jigsaw puzzle, the Jigsaw Perspective combined the themes and categories identified from both reviews. The Funnelling Process saw the themes/categories created compared with the tabulated summaries. The final domains which emerged structured the discussion that followed.

          Results

          A total of 33,076 abstracts were reviewed, 1826 full-text articles were appraised and 199 articles were included and analysed. The domains identified were theories and models, current methods, benefits and shortcomings, and recommendations.

          Conclusions

          This SSR in SEBA suggests that a structured approach to RW shapes the physician’s belief system, guides their practice and nurtures their professional identity formation. In advancing a theoretical concept of RW, this SSR in SEBA proffers new insight into the process of RW, and the need for longitudinal, personalised feedback and support.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12909-022-03924-4.

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          Most cited references237

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          Using thematic analysis in psychology

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            Three approaches to qualitative content analysis.

            Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.
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              Guidance for conducting systematic scoping reviews.

              Reviews of primary research are becoming more common as evidence-based practice gains recognition as the benchmark for care, and the number of, and access to, primary research sources has grown. One of the newer review types is the 'scoping review'. In general, scoping reviews are commonly used for 'reconnaissance' - to clarify working definitions and conceptual boundaries of a topic or field. Scoping reviews are therefore particularly useful when a body of literature has not yet been comprehensively reviewed, or exhibits a complex or heterogeneous nature not amenable to a more precise systematic review of the evidence. While scoping reviews may be conducted to determine the value and probable scope of a full systematic review, they may also be undertaken as exercises in and of themselves to summarize and disseminate research findings, to identify research gaps, and to make recommendations for the future research. This article briefly introduces the reader to scoping reviews, how they are different to systematic reviews, and why they might be conducted. The methodology and guidance for the conduct of systematic scoping reviews outlined below was developed by members of the Joanna Briggs Institute and members of five Joanna Briggs Collaborating Centres.
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                Author and article information

                Contributors
                lalit.radha-krishna@liverpool.ac.uk
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                9 January 2023
                9 January 2023
                2023
                : 23
                : 12
                Affiliations
                [1 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Yong Loo Lin School of Medicine, , National University of Singapore, ; NUHS Tower Block, 1E Kent Ridge Road, Level 11, Singapore, 119228 Singapore
                [2 ]GRID grid.410724.4, ISNI 0000 0004 0620 9745, Division of Supportive and Palliative Care, , National Cancer Centre Singapore, ; 11 Hospital Crescent, Singapore, 169610 Singapore
                [3 ]GRID grid.410724.4, ISNI 0000 0004 0620 9745, Division of Medical Oncology, , National Cancer Centre Singapore, ; 11 Hospital Crescent, Singapore, 169610 Singapore
                [4 ]GRID grid.410724.4, ISNI 0000 0004 0620 9745, Division of Cancer Education, , National Cancer Centre Singapore, ; 11 Hospital Crescent, Singapore, 169610 Singapore
                [5 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Duke-NUS Medical School, , National University of Singapore, ; 8 College Rd, Singapore, 169857 Singapore
                [6 ]GRID grid.163555.1, ISNI 0000 0000 9486 5048, Medical Social Services, , Singapore General Hospital, ; Outram Rd, Singapore, 169608 Singapore
                [7 ]GRID grid.4280.e, ISNI 0000 0001 2180 6431, Lien Centre for Palliative Care, Duke-NUS Medical School, , National University of Singapore, ; 8 College Rd, Singapore, 169857 Singapore
                [8 ]Assisi Hospice, 832 Thomson Rd, Singapore, 574627 Singapore
                [9 ]GRID grid.10025.36, ISNI 0000 0004 1936 8470, Palliative Care Institute Liverpool, Academic Palliative & End of Life Care Centre, Cancer Research Centre, , University of Liverpool, ; 200 London Road, Liverpool, L3 9TA UK
                [10 ]PalC, The Palliative Care Centre for Excellence in Research and Education, PalC c/o Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436 Singapore
                Article
                3924
                10.1186/s12909-022-03924-4
                9830881
                36624494
                d6fe32eb-eae5-4db9-a26b-aa3c9cdebc41
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 10 August 2022
                : 25 November 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2023

                Education
                reflection,reflective writing,medical education,professional identity formation,undergraduate medical education,postgraduate medical education

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