3. How do we write reflective essays?
Understanding the assignment
Read your assignment guidelines carefully to determine which kind of reflections your lecturer wants and what they expect; and what content, such as an event, experience, reading or process, your lecturer wants you to reflect on.
Structuring your essay
A reflective essay typically follows the familiar organisational pattern: Introduction – Body Paragraphs – Conclusion. In the body paragraphs, reflective writing involves a number of formats, and this guide will sugguest a DIEP approach, that is, to describe , interpret , evaluate and plan (Boud et al., 1985).
· Introduction
o Introduce the topic and the scope (What?)
o Justify the topic (Why?)
o Present the purpose of your essay (Thesis statement)
o Give an overview of what you will cover, i.e., description, interpretation, evaluation and plan (How?)
· Body Paragraphs (DIEP)
o Describe objectively what happened
v Give the details of what happened (Include the necessary who, what, when, where, how and why. You may not need to recall the whole experience, e.g., an incident/ lecture/ reading, but just a key aspect of the experience itself.)
v Answer: “What did you do, read, see, hear, etc.?”
o Interpret what happened
v Explain why things happened in the way they did
v Answer: “What might this experience mean?”
v Answer: “How did it make you feel?”
v Answer: “How does it relate to what you know/ have learned?”
v AbswerL “What new insights have you gained from it?”
v Answer: “What are your hypothesis/ conclusions?”
o Evaluate the effectiveness of the experience
v Make judgments on whether the experience is effective for you and how beneficial and useful the experience has been
v Answer: “What is your opinion about this experience?”
Answer: “Why do you have this opinion?”
Answer: “What is the value of this experience?”
o Plan how this experience might help you in the future
v Outline a plan for how the experience may impact your thinking or behaviour in your course, programme, future career and life in general
v Answer: “How will you transfer or apply your new knowledge and insights in the future?”
v Answer
· Conclusion
o Restate your thesis statement
o Summarise the main ideas of the body paragraphs
o State your overview of the experience regarding its usefulness and effectiveness for you and your future
This website is an open access website to share our English Writing Requirement (General Education) writing support materials to support these courses
This platform provides access to generic genre guides representing typical university assignments as well as links to subjects offered by faculties with specific disciplinary genres and relevant support materials.
The materials can be retrieved by students by choosing the genres that interest them on the landing page. Each set of materials includes a genre guide, genre video, and a genre checklist. The genre guide and video are to summarize the genres in two different ways (i.e. textual and dynamic) to fit different learning styles. The genre checklist is for students to self-regulate their writing process. The genre guide and checklist include links to various ELC resources that can provide further explanation to language items (e.g. hedging and academic vocabulary).
The platform also acts as a one-stop-shop for writing resources for students, language teachers and subject leaders. Information about the English Writing Requirement policy can also be found on this platform. There are training materials for new colleagues joining the EWR Liaison Team.
What is reflection why do it.
“Whether we focus on problematic experiences or positive ones, reflecting on them will provide us with opportunities for growth and development.” Bassot, The reflective journal
To build on the definition of reflection from the previous page, it is useful to consider its purpose while you are at university. The following points are the core reasons why you may be asked to reflect (or why you may want to reflect yourself):
1) Consider the process of our own learning
Think about how you learn with the aim of improving this process. This is particularly useful for revision.
2) Critically review something
Think about a particular event or personal aspect. This could be your own behaviour, that of others or the product of behaviour.
3) Build theory from observations
Think about your experiences and observations to construct your own theories. Often we use the theories of other authors and this provides you with an opportunity to construct your own.
4) Engage in personal or self-development
Reflection is focused on producing useful outcomes from the future. It can help you becoming more self-aware and can make you a better learner, researcher, practitioner or employee.
5) Make decisions or resolve uncertainty
Thinking about previous experiences can help you make decisions about new ones
Note: While all of these reasons for reflection are valid, different disciplines place emphasis on different areas. You do not necessarily need to cover all of the above in every reflective assignment. Think about why you are being asked to reflect and make sure you focus on the most appropriate area.
Having an experience in itself is not a guarantee that learning will take place. All the major theories of reflective practice suggest that reflection on an experience provides the context for learning. It is this reflection that leads to the formulation of new concepts and ways of thinking - not the act of having an experience. Gibbs (1988 ), for example, maintains that:
‘It is not sufficient simply to have an experience in order to learn. Without reflecting upon this experience it may quickly be forgotten, or its learning potential lost. It is from the feelings and thoughts emerging from this reflection that generalisations or concepts can be generated. And it is generalisations that allow new situations to be tackled effectively.’
Gibbs (1988 ) in Learning by doing: a guide to teaching and learning methods
A positive by-product of engaging in the reflective process is that it can help you grow in self-confidence. Some of the other areas of self-change could include:
Therefore, whether you are examining yourself or your academic work, you need the ability to stand back and see the broader picture.
Reflection is an important part of learning through experience. By reflecting on our experiences, we maximise the potential of any new learning. This is particularly important when considering positives. They are often harder to recall than the bad elements of any experience.
Reflective Essay
Published on: Sep 21, 2020
Last updated on: Jul 23, 2024
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A reflective essay is a form of writing where the writer reflects on a personal experience. Have you been assigned one but don’t know how to write?
Don’t fret!
Read on to learn in simple steps and follow the useful tips and examples given below. By the end of the blog, you will know everything you need to write an excellent reflective essay.
So let’s dive in!
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A reflective essay is a type of essay where the writer describes a personal experience or event that they observed or examined. Reflective writing involves thinking or pondering about a specific topic and writing your thoughts.
The content of a reflective essay is subjective. This means, the writer discusses the topic from their own personal point of view.
The writer presents their thoughts and reflections in a structured and coherent manner. It combines elements of storytelling, analysis, and introspection to create a narrative that engages the reader and offers valuable insights.
Self-reflective essays are often used as an opportunity to explore your thoughts and feelings more deeply. The main goals of reflective writing are to;
Here is a video that reflective writing in simple terms:
Reflective essays can be very difficult to write. However, following the steps below can make your writing process easier and more effective.
The first step in writing a great reflective essay is to choose a good topic. You need to do a lot of brainstorming, mind mapping , and a bit of research to come up with a good topic.
Choose a topic that holds personal significance for you. It could be a specific event, a challenging situation, a memorable encounter, or a period of personal growth. Select a topic that allows for deep introspection and provides ample material for reflection.
Ponder on your chosen topic and explore your thoughts, feelings, and reactions associated with it.
Ask yourself probing questions, such as " How did this experience impact me? " or " What did I learn from this situation? " This introspective phase forms the foundation of your essay, allowing you to dig deep and extract valuable insights.
Craft a concise and focused thesis statement that encapsulates the main point or lesson learned from your reflection.
This statement will serve as a guiding principle for your essay, ensuring that your writing remains coherent and purposeful.
Create an outline that organizes your thoughts and provides a logical structure for your essay.
Divide your essay into sections including the introduction, body paragraphs, and conclusion. Outline the main ideas, experiences, and reflections you plan to include in each section.
Want to learn more about how to create an outline? Here is our comprehensive reflective essay outline guide for you.
Start your essay with an attention-grabbing opening that sets the tone and introduces the topic to the reader.
Engage your audience by sharing a captivating anecdote, posing a thought-provoking question, or presenting a compelling quote. Clearly state your thesis to provide a roadmap for your reflective journey.
In the body paragraphs, vividly describe the experiences or events that shaped your reflection. Use sensory details and specific examples to paint a clear picture for your readers.
After describing the experience, delve into the reflection and analysis phase. Explore the significance of the experience and its impact on your personal growth, beliefs, or worldview.
Analyze the reasons behind your thoughts, emotions, and reactions.
Wrap up your essay by summarizing your main points and reinforcing the significance of your reflection. Share the insights and lessons you gained from the reflection process.
For instance, what did you learn about yourself? How did this experience contribute to your personal development?
Be honest and authentic in your reflections, demonstrating vulnerability and self-awareness. Don't present new information here, but summarize everything that happened in the essay.
Once you have completed your first draft, revise and edit your essay for clarity, coherence, and grammar. Pay attention to the flow of your ideas, sentence structure, and word choice.
Seek feedback from peers or mentors to gain different perspectives and refine your essay further. This way, your final draft will turn out to be an interesting and valuable piece of work.
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Reflective Essay Structure
The structure of the reflective essay is the same as other types of essays. It contains an introduction, several body paragraphs, and a conclusion.
Here is the basic reflective essay format that you can use:
Paragraph 1 Paragraph 2 Paragraph 3 (Follow the same structure for as many body paragraphs as needed) |
Let's learn about the components of a reflective essay in depth:
A reflective essay also starts with an introduction, like all other essays. An essay introduction should be brief but relevant to the topic. In this part, you can give a general overview of the topic to the reader.
Start your essay with a strong hook statement . The hook statement is the first thing that the reader reads in the introduction part.
In the introduction part, state the thesis statement but don't give too much information in this statement.
Remember that in this part, only give a brief overview and don't write in-depth information.
Writing the body paragraphs is the hardest part of the reflective essay. Some writers spend a lot of time writing body paragraphs. If the outline is not created well, then writing the body paragraphs is a time-consuming process.
It is the most important part of the essay and follows the proper chronological order. Describe the main issues in order related to the described event.
The body paragraphs are well-focused, and it is not a summary of your experience. Each body paragraph end with a concluding sentence.
The conclusion is the last part of the essay. In this part, you should provide a summary of the entire essay. Moreover, do not repeat the same point again and again.
Make sure the conclusion of the essay is powerful and encourages the readers to do further research. In this concluding part, restate the thesis statement, and no need to add new ideas.
Here are some writing tips that can make your reflective essay even better, so try following these in your essay:
Two commonly used formatting styles for academic writing are the APA and the MLA styles. Each style has its unique guidelines for formatting, including structure, citations, and references.
Formatting your essay in APA requires the following:
The MLA style recommends the following formatting guidelines:
Check out some reflective essay samples that can give you a better understanding of the reflective essay.
Reflective Essay Example for High School
Personal Reflective Essay Example
Reflective Essay Outline
Example of Reflective Essay on Learning Experience
Reflective Essay Example About Life Experience
In a reflective essay, you write about your personal experience, thoughts, and significant moments of your life. Choosing the right topic for the essay sometimes becomes a challenging task, but here are some ideas that can help you out.
Need more topics to get your thoughts running? Here are more reflective essay topics to help you out!
Writing a reflective essay can be a transformative experience as you discover your own thoughts and feelings along the way. By following the writing steps and tips, you can enhance this experience by writing an essay that is interesting, informative, and engaging.
So don't hesitate to start writing a reflective paper today! You've got everything you need.
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How many paragraphs are in a reflective essay.
In a reflective essay, you should follow a 5-paragraph format. However, you can add more paragraphs, and it depends on your chosen topic.
Writing a reflective essay aims to explore how they have changed and learned from their experiences.
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Reflective thinking is essential for success in unpredictable and complex situations such as working in healthcare. Reflective thinking helps you to:
You will be asked to think reflectively when completing assignments that draw on your experience in the workplace, or when considering your own skills and experience and where you might need to develop. Being able to think reflectively is an important transferrable skill that will help you to showcase your learning to the programme team, but also provide the skill of being a reflective healthcare practitioner.
Reflection will enable you to consider aspects of your practice in depth. By using a structured approach, you will be expected to describe and critically analyse an incident which is significant to your learning. Reflection is an important stage in effective learning and reflective practice is an integral part of continuing professional development (CPD) for health care professionals. Successful reflection enables self-awareness, personal and professional growth and it is important to develop these skills as a healthcare professional. A reflective account documents the way you have thought about and experienced a particular event or experience.
In all cases reflection is an active process that involves reviewing an experience of practice in order to describe, analyse, evaluate and so inform learning about practice. Reflective skills can include the ability to be:
In a clinical working environment, this process should be continuous or cyclical, i.e. actions continually reviewed in light of most recent developments but may also be sparked by a particular event or experience.
You will also have access to resources from your regulator (GPhC, HCPC or NMC) on the role of reflection and revalidation which will help you link reflective practice to your registration. If you are a member of your professional leadership body (e.g. RPS, RCN, CoP, CSP) they often have resources you can also access to support your development.
Be prepared to:
Reflective questions to ask yourself
Consider the following
Keep comparing theory to practice and exploring the relationship between the two
Assignments involving reflective thinking often ask you to refer to both relevant theories , evidence and your own experiences , but what does this mean? Academic theories and your professional observations are both evidence that you need to use to support your points, but they are different types of evidence:
Academic theories provide a generalised model or framework to help you understand what might be happening in a situation - the reflective model discussed in this section are examples of theoretical models - they gives you a structure to compare your own experiences to and language to help you explain what is happening
Evidence provides a means to compare your understanding of the situation to published evidence to analyse your real-life experiences. These might be papers, journals, books, guidelines or good practice recommendations - evidence is something you can reference to critique your experience against.
Your own experiences are what happens in practice; these may be more complex and richer than the evidence or theories, but it can be harder to see what is relevant. By analsying your experiences using a theory (i.e. a reflective model), you can develop some more insightful explanations for what happened. Also, use your own experiences to interrogate and question the evidence - does it fit what happened? If not, why? Does the evidence only explain part of the story? Does the evidence need to be adapted for different situations?
This video was developed by Cardiff University to help their students develop reflective skills (5 min 19 sec).
This short video (2 mins 42 sec) was produced by the Chartered Institute of Personnel and Development (CIPD) gives a brief introduction to reflective practice.
Reflective writing involves an exploration and explanation of an event. It may feel particularly difficult and more challenging than other forms of academic writing as it involves thinking and writing about anxieties and errors as well as successes in your interactions with an individual or when carrying out a practical task. Try to stand back from the situation and be as objective as possible. Although you are writing about your own experiences and feelings, you need to be as rigorous and thorough as you would be for any other assignment.
Reflective writing is a way of processing your practice-based experience to produce learning. It has two key features:
It is a common misconception that reflective writing is describing an event, it requires much more depth and largely focusses on the analysis of the event/experience/learning/topic. There are some tips in the box on the right about the questions you can ask yourself which encourage reflective thinking. Being about to reflect on your own practice is a key skill as a competent healthcare professional - analysing how you react to situations and the impact they have had on your learning and development are the key aims. When done well, reflective writing can help develop a better understanding of your strengths and weaknesses, challenge your own assumptions and biases to provide better patient care, deal with you own anxieties, support a learning plan and allow you to understand your own values and beliefs.
There are too many topics to list here, but almost any healthcare related experience can be used for reflective writing. Common examples include:
Reflective writing will take many forms throughout the PACE modules and programmes. You should refer to the assessment criteria for the piece of coursework to identify the expectations. Some coursework will be a specific reflective essay or you might need to reflect on a topic/event/experience as a much smaller part of a piece of coursework. Do not forget in professional exams you will also be required to reflect verbally on your learning, experiences and/or performance.
Follow the guidelines for your module. There is likely to be a word limit: you cannot write about everything, so select what will illustrate your discussion best. Remember that most of the marks awarded for your work are likely to be for the reflective insights and not for the description of events, so keep your descriptions brief and to the point.
This model was developed in the 1980's by Graham Gibbs and is widely used because of the clear framework and depth of reflection are well suited to coursework tasks. It has six stages:
However, this model has some disadvantages in that it is introspective and tends to focus on the writer. In some postgraduate study it it necessary to demonstrate critical analysis and reflexive skills in your reflective essay writing. You need to show how you are developing new perspectives and to do this you will need to refer to the available literature. So we have adapted Gibbs by using the work of Atkins and Murphy (1993) to ensure you take a robust academic approach:
Make sure that you read the assignment brief carefully and check with the course handbook to understand what is expected for each individual assignment. If you are unsure, please ask your tutor.
As a large proportion of your reflective account is based on your own experience, it is normally appropriate to use the first person ('I'). However, most assignments containing reflective writing will also include academic writing. You are therefore likely to need to write both in the first person ("I felt…") and in the third person ("Smith (2009) proposes that …"). Identify which parts of your experience you are being asked to reflect on and use this as a guide to when to use the first person.
You will produce a balance by weaving together sections of 'I thought… 'I felt,…' and the relevant evidence in the same section or paragraph. This is more effective than having a section which deals with the evidence and a separate section dealing with your experiences.
Try to avoid emotive or subjective terms. Even though you are drawing on your experiences (and they may well have been emotional), you are trying to communicate these to your reader in an academic style. This means using descriptions that everyone would understand in the same way. So rather than writing, "The patient was very unhappy at the start of the session", it might be better to write, "The patient was visibly distressed", or "The patient reported that he was very unhappy". This shows that you are aware that the patient's understanding of 'unhappiness' may be quite different from yours or your reader's.
When writing about your reflections use the past tense as you are referring to a particular moment (I felt…). When referring to theory use the present tense as the ideas are still current (Smith proposes that...).
Try to move beyond being critical and think about being analytical - use your feelings to ask questions and challenge assumptions, where you can then draw in evidence from the module this will move towards excellence in reflection
Read the example statements below and think about how they demonstrate moving from descriptive to analytical to self-reflective:
Example 1: I identified a prescribing error and asked the doctor to re-prescribe it. They stated I was wrong and the prescription was correct. I checked the BNF and they were right as the BNF I had was out of date. The literature states that 50% of these errors are due to incorrect resources (source).
Example 2: I identified a prescribing error but when I asked the doctor to re-prescribe the medicine, it transpired I was wrong and the original prescription was correct. I was embarrassed that I had not correctly reviewed the prescription and need to remember to use the most up to date reference sources in my practice. I have looked at the literature on prescribing errors and was surprised that 50% of errors are due to incorrect resources (source)
Example 3 : I identified a prescribing error but when I asked the doctor to re-prescribe the medicine, it transpired I was wrong and the original prescription was correct. I was embarrassed that I had made such an error and the doctor appeared frustrated that I had wasted their time. It is important that all prescriptions are checked before administration and it is key in my role to do so thoroughly. I have spent a lot of time building a relationship with the multi-disciplinary team to show my advancing knowledge and I feel this has set back their confidence in me. It is my responsibility to ensure I have the correct resources to do my job well and on this occasion I felt under pressure to give a quick answer. This made me reflect on how external factors can influence the quality of patient care. In analysing prescribing errors I was surprised that 50% of errors were due to incorrect references but following this experience, I understand how they occur and I must safeguard my practice to prevent it recurring (source).
Example 4 : I identified a prescribing error but when I asked the doctor to re-prescribe the medicine, it transpired I was wrong and the original prescription was correct. I was embarrassed that I had made such an error and the doctor appeared frustrated that I had wasted their time. It is important that all prescriptions are checked before administration and it is key in my role to do so thoroughly. I have spent a lot of time building a relationship with the multi-disciplinary team to show my advancing knowledge and I feel this has set back their confidence in me. This made me think about prescribing errors and how 50% of errors are due to incorrect or out of date information sources (source). However, although I recognise that it was part of my role responsibility to ensure I use up to date resources (source), I began to reflect on team relationships and how they impact team function and support. Author (source) explored the hierarchy of MDT membership and discovered that certain professions tend to regard their positions as more senior to others within any MDT. This impacted the ability of team members to questions the actions of other team members. This positional hierarchy seemed to be based on perceived value of qualification; medical qualification being most often seen as the most valuable. The concept of professional value is seen in the work of Author (source) who found that historical professional power had a significant impact on decision making within MDTs, with particular regard to accepting questions on clinical decisions from other team members. I realised that my own position within the team could be perceived, by some, as being less valuable in a prescribing setting. I have decided to speak to my manager and ask her to consider two things: firstly how we can make sure all the team have access to the most up to date information and secondly, how we offer and react to constructive criticism in the clinical setting (source).
NB (source) would be an in-text citation for the relevant reference and a full reference would be given at the end in the Vancouver or Harvard style.
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1 School of Health Sciences, University of Dundee, Dundee, Scotland, DD1 4HN, UK
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Discovery: Extended data for Teaching of reflection in higher education: a narrative review 38
http://doi.org/10.15132/10000254
This project contains the following extended data:
Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).
Healthcare professional students (HCPs) are encouraged to utilise reflection during and after their study programmes as a part of their life-long learning skill and professional competencies. However, the way in which the concept of reflection is taught and its’ influence students’ capacity to reflect have not been fully explored. This narrative review aimed to explore how the concept of reflection is taught in higher education and how the teaching of reflection influences HCP students’ capacity to reflect.
Articles that were published during 2014–2024 within three databases, PubMed, CINAHL and ERIC were searched. 1929 articles were eligible for screening. 93 articles were further assessed for eligibility.
18 articles were included. The included articles were geographically well-distributed in both the Global North and Global South countries, indicating universal interest in the topic. Eight articles had qualitative study designs; six had quantitative designs and four had mixed-method designs.
Conceptually, the teaching of reflection could be categorised as a spectrum, ranging from: i) structured format (reflective templates or debriefing); ii) semi-structured format (physical/virtual small group discussions, video recordings, AI generative arts, in-verse reflection and concept mapping) and iii) flexible and creative (art-based pedagogy or narratives).
All included articles indicated students actual and perceived better understanding of reflection. This claim is supported both quantitatively and qualitatively via either validated instruments or narratives and themes based on students’ textual outputs.
This review identified several teaching methods that help facilitating students’ capacity to reflect. Findings are unable to recommend the most efficient way to teach reflection since it depends on students’ progress in their programmes. However, a more relational approach to teaching of reflection is recommended. Students might begin their reflective journey with a structured format of teaching of reflection then gradually move to less-rigid format of the teaching to empower students’ autonomy.
Reflection is one of the metacognition skills that enhances lifelong learning capacity as well as professional competencies 1 – 3 . As such, any practice to enhance capacity to reflect is highly encouraged, particularly in healthcare professions education since it relates to better learning outcomes and long-term professional performances 2 , 4 – 7 . In the UK, reflective practice (RP) is encouraged by several professional bodies such as the General Medical Council and the Nursing and Midwifery Council (NMC) as a strategy to foster healthcare professionals (HCPs)’ competencies 8 , 9 .
Still, the concept of reflection is relatively abstract hence it is challenging to frame the appropriate way to teach the concept to students, particularly those who are new to the concept 6 , 10 – 12 . Furthermore, reflection could occur in various contexts and activities such as during small group discussions, online learning environment, writing or art-based activities 12 – 15 thus making it harder to capture.
Additionally, students in higher education - particularly in the UK - have become increasingly diverse 16 . This includes students from non-traditional background, international students or students who disclosed as disabled hence may need additional support for their learning 17 . Consequently, the notion of Equality, Diversity and Inclusivity (EDI) in the teaching of reflection warrants further exploration to scrutinise if the existing teaching methods sufficiently address such diversity or not.
There is a need to systematically understands the way in which the concept of reflection is taught in higher education and how it influences students’ capacity to reflect hence, a narrative review was conducted. This narrative review aimed to:
A narrative review was undertaken as a part of the author’s study for UKPSF’s fellowship title. The justification was to balance between the time constraints within the module (four months) and the robustness of the searching process. Although some researchers argue that a narrative review may be prone to bias, subjectivity and is not replicable 18 , this argument is less relevant to this review and strategies have been applied to mitigate these limitations. Given that this review aims to explore a conceptual and broader understanding of how reflection is taught in higher education as well as its influence on students, a more focused approach such as a systematic review is not appropriate; instead, a broad approach such as a narrative review is deemed more appropriate. Next, the notion of ‘bias’ is not relevant to this review since the phrase is deeply rooted with post-positivist research paradigm that considers knowledge to be quantifiable, measurable and repeatable 19 ; all of which do not relate to aims of this review.
The search terms and strategies, developed with support from an academic librarian, are described below to ensure that the search process is transparent and replicable.
The PCC framework (Population, Concept, and Context) were used to frame the scope of the review 20 :
P opulation: undergraduate healthcare professionals students
C oncept: teaching of reflection or reflective practice
C ontext: Higher education institutes and their associated clinical placements or hospitals, colleges, global context
The inclusion criteria were any peer-reviewed empirical studies that were published between 2014–2024 and were published in English that discussed the influence of reflection teaching methods with students. The focus was any undergraduate HCPs students in the context of higher education settings, including any associated clinical placements.
Articles were excluded if they were reviews, grey literature or focused on any theoretical discussions, debates or opinion pieces as well as dissertations and theses. Articles that did not focus on reflection teaching methods, higher education settings, were published before 2014 or were published in non-English were excluded (see Table 1 ).
Inclusion criteria | Exclusion criteria |
---|---|
-Peer-reviewed empirical studies (quantitative, qualitative or mixed-method designs) that discussed the influence or effectiveness of reflection teaching methods | -Reviews -Grey literature, policies, opinion piece, debate, theoretical discussion -reflection of certain experiences which did not include the influence of effectiveness of reflection teaching methods |
-Articles that focussed on undergraduate healthcare professional students | -Articles that did not focus on undergraduate HCPs students |
-Higher education settings -Clinical placements associated with higher education institutes | -Any contexts beyond higher education |
-Articles published in English | -Non-English Articles |
-Articles published between 2014–2024 | -Articles published before 2014 |
From December 2023 to March 2024, three databases were searched: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Educational Resources Information Center (ERIC). Eight duplicated articles were removed (see Table 2 ). One article was retracted by the journal due to systematic manipulation of the publication process and was subsequently removed from the screening process. Five articles were not accessible, leaving 1929 articles for title and abstract screening. 93 articles were further assessed for eligibility with the full-text reading.
Database | Search terms | No. of articles found |
---|---|---|
PubMed | | 1255 |
| 337 | |
| 1143 | |
CINAHL Plus | (reflection or reflective or reflective practice) AND (medical students or nursing students or healthcare professional students) AND (university or college or higher education) | 1126 |
(reflection or reflective or reflective practice) AND (medical students or nursing students or healthcare professional students) AND (university or college or higher education) Limiters - Publication Year: 2014–2024; English Language Expanders - Apply equivalent subjects Search modes - Boolean/Phrase | 588 | |
ERIC | (reflection or reflective or reflective practice) AND (medical students or nursing students or healthcare professional students) AND (university or college or higher education) Limiters - Published Date: 20140101-20241231 Expanders - Apply equivalent subjects Narrow by Language: - english Search modes - Boolean/Phrase | 212 |
(reflection or reflective or reflective practice) AND (medical students or nursing students or healthcare professional students) AND (university or college or higher education) | 393 |
The Inclusion and exclusion criteria were applied and 76 articles were excluded:
Six articles also were manually searched from the reference lists; five articles were excluded and one was included for the final analysis 2 . Together, the final numbers of the included articles were eighteen (see Figure 1 ) 21 .
Data from the included articles were extracted into Microsoft Excel. The extraction process was iterative and the focus of the extracted data was revised to ensure that they were relevant to the aims of the review. The final data extraction file included:
Title, Author’s name, Year, Country, Type of study, Aims, Teaching methods employed, Data collected/generated, Data analysis techniques, Underlying theory/pedagogy, Participants, How the teaching methods influence reflection, Themes and Limitations of the study.
Narratives were used to describe the findings. The author read and reread the included articles to see the patterns, similarities and differences within them. The focus related to the aims of the review. Given that there were diverse types of study from several countries within different groups of students, the underlying theory and pedagogical approach was examined to conceptually capture the findings in a more meaningful way. The included articles were not critically appraised since this review did not intend to determine the quality of each article and intended to explore a broad range of existing practices.
The included 18 articles were published from 2014 to 2024. There was a well-distributed geographical distribution of the included studies. The majority of the included articles (5) were conducted in the United States 5 , 22 – 25 , followed by the UK (3) 26 – 28 . Two articles were conducted in Australia 10 , 29 . One article each originated from The Netherlands 30 , New Zealand 15 , Norway 31 , Singapore 32 , Spain 33 , South Korea 34 , Taiwan 35 and Thailand 2 .
Eight articles had qualitative study designs. Six articles had quantitative designs and four had the mixed-method designs. The HCPs students in these articles were also diverse. Almost all of the articles predominantly focused on students from one field which were medical students (8), nursing students (8) and healthcare assistants (1). Only one study focused on the first-year students from various fields 35 , indicating a universal interest of reflection from the educator’s standpoint from various disciplines.
The most frequently used underlying theory employed in these articles was Constructivism (4) followed by social constructionism (2), Sociocultural learning theory (1), Social cognitive theory (1) and Sociocritical paradigm (1). Kolb’s experiential learning theory were mentioned in two articles. Seven articles did not explicitly mention their underlying learning theory utilised; two were implied to utilise positivism research paradigm and five were implied to base on constructivism (see Extended data 1).
This section respectively discusses the findings and relates them back to the aims of this review.
Based on the included articles, the teaching of reflection could be categorised as a spectrum, ranging from:
The structured format of reflection approach usually involves any teaching with reflective templates or reflective models that students could use to enhance and demonstrate their reflection. The reflective models used were Gibb’s reflective model 2 and Bain’s reflective framework 10 . Often, structured tools such as a reflective journaling 34 , or post-activities debrief were offered to students to facilitate on how they could express their reflection. In such instances, reflection was often not the main focus of the activities but students could demonstrate their increased capacity to reflect as well. This mainly occurred in high fidelity simulations with debriefing 5 , 10 , 32 which suggested multiple benefits of the learning activities.
This approach, whilst perceived as useful, was paradoxically seen by students as rigid. Students from several articles expressed a dislike of this approach since it was perceived as inauthentic and repetitious 15 , 22 , 30 . Pedagogically, students could even become a reflective zombie 36 ; that is, they might emulate the reflective process but did not actually reflect thus making it more challenging to ascertain the authenticity of their reflection 1 .
Alternatively, the semi-structured format of reflection provides more flexibility to students to express their thoughts but still offers scaffolding of their reflection. This approach includes Balint student support group 28 , Schwartz round 27 , video recording of students’ performance 31 and AI generative arts 25 , problem-based learning group discussions 22 , virtual classrooms 23 and concept mapping 30 and in-verse reflection workshops 29 .
The teaching methods under this approach tend to include group learning experience, utilise social constructionism and offer several methods for students to express their reflections e.g., either verbally or in writing. The process almost always includes an extensive preparation for the students before during and after the sessions and is mainly dependent on facilitator’s skill to lead the sessions. For instance, Reed et al. (2023) piloted a novel approach to integrate the use of generative AI to facilitate nursing students’ reflection. The learning process included students, who are also the coauthors of the article, creating AI prompts to create photos that were related to nursing. They were subsequently encouraged to write and reflect on the photos and subsequently joined a small group discussion.
As the description attest, the process is rather laborious and comprised of several preparations, making this approach relatively time and resource extensive. This limitation is similar to what Gleeson et al. (2020) acknowledged. That is, they agreed with the usefulness of the medical Schwartz round to enhance students’ capacity to reflect yet found it financially and logistically challenging to facilitate the sessions thus may not be applicable to scale within their institution or beyond.
Finally, the flexible and creative format of reflection almost always relates to art-based pedagogy. This approach leverages the use of art forms to empower students to creatively express their reflections without any constraints. The studies included an offer to use various creative outlets namely poetry, visual arts, narrative prose, photography, sculpture, music, needlework 15 . Or, one alternative approach over the formal reflection form of writing was offered such as poetry 26 or narrative writing 24 , 33 , 35 . Still, despite the creativity freedom within this approach that empower student’ agency, some expressed concern over their learning process since they found it harder to express themselves or could not fully relate its relevance to a more ‘formal’ reflective assessment which tends to be dominated by a written format 15 , 26 . This was compounded from the educators’ standpoint; that is, it is impossible – and even inappropriate – to assess the quality of students’ reflection with this approach due to their subjectivity. As such, the flexible and creative format may be suitable for learning activities that do not involve any assessment.
All of the included articles reported that students had either an improved understanding of reflection or improved reflective capacity. This claim was usually asserted by validated instruments to demonstrate students’ improved capacity to reflect before and after the class such as the Groningen Reflection Ability Scale (GRAS) 22 , 23 , 32 , or the Reflective Thinking Level 34 . Zhang et al. (2020) conducted a study to assess 63 third year nursing students GRAS post-class and one week after the class after their high-fidelity simulations with the use of video-assisted debrief. Results showed that participants had significantly improved their debriefing reflective abilities (p<0.01) after the video-assisted debrief intervention from the median of 84 to 87 pre- and post-class; this trend is also similar to other included studies, indicating the usefulness of the teaching methods employed.
For qualitative or mix-method studies, students’ textual outputs or interview transcripts were often used to support the claim that they have a better understanding of reflection. McBain et al. (2015) offered 14 fourth year medical students to freely choose their medium to reflect which could be either a traditional reflective essay or more creative options such as poetry, visual arts, or sculpture; their textual commentaries that accompany their works were used for the analysis. Participants universally expressed that creative outputs were more effective for them to express emotion or ideas that are difficult to articulate. This is particularly important since these students were doing a clinical rotation in a palliative care department which may be rather emotionally demanding, indicating that it might be useful to have certain tools to ease the cognitive load of participants when they were reflecting 24 , 31 , 33 . Students also stated that the arts created were helpful since they could reflect in a different way that was not as repetitious or perceived as just another reflective essays 15 . Still, most of the studies tend to capture participants’ self-perceived of enhanced reflection. Or it could come from educators’ perception that these students had a better capacity to reflect which might be challenging to verify.
Findings from this review indicate that there are several approaches to enhance student’ capacity to reflect. This could be achieved either via a more structured approach which could be perceived as repetitious and inauthentic 15 , 30 . Or, students could be offered a semi-structured approach or even more creative and flexible form of reflection to empower their autonomy 24 , 26 .
Despite the various approaches to teach reflection, both the educators and students suggested that there is a need to balance between being directive and being flexible 28 , 30 . That is, for students who are relatively new to the concept e.g., those who are in the first year of their programme or have limited exposure to clinical experience, it might be more appropriate to have a structured guidance to scaffold their learning process 29 , 32 . Conversely, those who are in their later years or are more experienced reflective practitioners may find the structured reflective format repetitive or even restrictive to their reflection. Consequently, a more flexible and creative expression might be an alternative option for students to demonstrate their reflection.
To the author’s knowledge, this is the first review that has explored the way in which the concept of reflection is taught in higher education for HCPs students. The review demonstrates a comprehensive view of the teaching methods available that educators could consider and apply the most appropriate ones to their contexts. The review process was also thoroughly described hence making it transparent and replicable.
Still, this review poses few limitations:
First, despite the attempt to outline the screening process, this review was conducted by one person. As such, there might be certain articles that the author has overlooked. Second, the review only included articles that were published in English. This further perpetuating the dominant Western-centric scholarship, restricting the latest call for citational justice and may not be fully transferable to wider contexts 37 . Still, this review was conducted with a limited time and resource hence the author could not include more diverse scholarly outputs that were not in English.
Third, although this review did not intend to appraise the quality of the included articles, some articles indicated either poor study designs or superficial level of analysis that lack criticality. Also, almost all of the included studies except two were conducted with a relatively small sample size from a single institute thus makes it even more challenging to transfer the findings to other contexts.
This narrative review has identified several teaching methods that help facilitating HCPs students’ capacity to reflect. Even though findings are unable to recommend the most efficient way to teach reflection, it might be more appropriate to consider students’ learning needs and adjustments the teaching method accordingly. This could be achieved via a more relational approach to teaching that might begin with a structured format of reflection which gradually increases students’ autonomy to express their reflection throughout. Given that there is no one-size-fits-all to teaching due to different leaning contexts, the focus should be how educators could scaffold the students’ learning process to empower them to become a lifelong reflective practitioner.
[version 1; peer review: 2 approved]
The author(s) declared that no grants were involved in supporting this work.
Tanisha jowsey.
1 Bond University, Robina, Queensland, Australia
Hi there, thanks for undertaking this work, which I read with interest.
Here are recommendations to make this solid paper even better:
The title and introduction suggest your review is of the entire higher education field; we need clarity on the scope of your study throughout. I suggest you reword the title from higher education to 'undergraduate health professions students' and hone the focus of your introduction to match that focus.
methods suggest replacing this sentence: "Articles that were published during 2014–2024 within three databases, PubMed, CINAHL and ERIC were searched. 1929 articles were eligible for screening. 93 articles were further assessed for eligibility." I suggest this instead: "I searched three databases (PubMed, CINAHL and ERIC) for articles published between 2014–2024 using the following search terms and their derivatives: XXXX 1929 articles were eligible for title and abstract screening. 93 articles were further assessed (full text screening) for eligibility."
Methods is fine. I found it unusual and insightful that you've applied a narrative focus to the included studies but I didnt see a evidence of this unique method in the way the results are presented. Did I miss something?
Results - Ah yes, the reflective zombie - a constant frustration for teachers (!) I found Reed's approach to this - the Gen AI image reflection - a great example of one possible avenue to engage students and get them out of zombie mode.
The paragraph about "creative format of reflection almost always relates to art-based pedagogy" - I was surprised that creative outputs as evidence of reflection were deemed impossible to assess. There are whole schools of practice that do exactly that. For example, critical arts therapy. I myself published a book called Medicine Reflections (2017 1 ) where we showcased how creative elements in the reflective portfolios of our undergrad medical students were assessed. I would suggest that it can be done. The question of whether this is appropriate or not is another matter. Perhaps you could rework those last two sentences of the paragraph to split out whether you can assess from whether you should assess?
The remaining sections read well. Thanks.
Is the review written in accessible language?
Are all factual statements correct and adequately supported by citations?
Are the conclusions drawn appropriate in the context of the current research literature?
Is the topic of the review discussed comprehensively in the context of the current literature?
Reviewer Expertise:
I have used critical reflection in assessment in medicine for the past 12 years and currently supervise a doctoral student who is researching the role of critical reflection in paediatric surgery training. We have a published literature review in this space called 'Reflecting on insight and insights into reflection: a systematic review of insight and reflection in post graduate medical education.' I have also published a book called Medicine Reflections.
I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.
1 Walailak University, Thai Buri, Nakhon Si Thammarat, Thailand
Well-written article. Your insights into this interesting topic are enlightening and comprehensively supported by citations. The use of easily understandable language makes the content accessible, and the conclusions drawn are appropriate in the context of the current research literature. The comprehensiveness and clarity of your article make it a valuable resource.
Some suggestions:
1. The title may be edited to reflect the specific issue on healthcare professional students/learners.
2. The methodology is well-written, constructed, and valid.
3. In the discussion section, the author may provide a subsection about further considerations or gaps in studies that need to be explored.
COMMENTS
1 Choose a tone. Before you begin to write your reflective essay, choose a tone. Because a reflective essay is more personal than an academic essay, you don't need to use a strict, formal tone. You can also use personal pronouns like I and me in your essay because this essay is about your personal experiences.
A reflection is an essay, so provide full, thoughtful responses to the questions in your instructor's prompt. The style and tone of your reflective essay should match the purpose of the overall assignment. This is a personal essay meant to showcase what you learned from the text, event, or experience that you are writing about.
The language of reflective writing. Reflective academic writing is: almost always written in the first person. evaluative - you are judging something. partly personal, partly based on criteria. analytical - you are usually categorising actions and events. formal - it is for an academic audience. carefully constructed.
Reflective writing is a personal exploration of experiences, analyzing thoughts, feelings, and learnings to gain insights. It involves critical thinking, deep analysis, and focuses on personal growth through structured reflection on past events. In this guide, you'll learn everything you need to know about reflective writing — with lots of ...
Reflective essays are academic essays; what makes an essay "good" will work for a reflective essay. What is different about a reflective essay is that the essay is about you and your thinking. However, you will need evidence from your course to back up your reflections. You should structure a reflective essay as an essay, that is write to ...
Reflective essays are essays in which the writer looks back on, or reflects upon, his or her experiences and how they caused personal change. Reflective essays involve self-reflection. Reflective ...
Reflective Writing. "Reflection is a mode of inquiry: a deliberate way of systematically recalling writing experiences to reframe the current writing situation. It allows writers to recognize what they are doing in that particular moment (cognition), as well as to consider why they made the rhetorical choices they did (metacognition).
A reflective essay is a personal perspective on an issue or topic. This article will look at how to write an excellent reflexive account of your experience, provide you with reflexive essay framework to help you plan and organize your essay and give you a good grounding of what good reflective writing looks like.
Structuring a Reflective Essay. While reflective essays vary depending upon topic and subject area, most share a basic overall structure. Unless you are told otherwise, then, your essay should include the following: Introduction - A brief outline of what your essay is about. Main Body - The main part of your essay will be a description of ...
1. Choose Your Topic Carefully. If you are given the freedom to choose a topic and don't have any idea regarding it, the best way is to brainstorm and research some trending and good topic ideas. Unfortunately, a common mistake when writing a reflective essay is to choose a topic that is too broad or too narrow. 2.
1. Keep it short and sweet. A typical reflection paper is between 300 and 700 words long. Verify whether or not your instructor specified a word count for the paper instead of merely following this average. If your instructor demands a word count outside of this range, meet your instructor's requirements. 2.
The essay can be considered an exemplary reflective essay. Example 2 breakdown: The second reflection paper begins with a perfect introduction, containing an impressive vocabulary and describing the experience of majoring in English.
Reflective writing helps students to develop a better understanding of their goals. Reflective writing is regularly used in academic settings, as it helps students think about how they think and allows students to think beyond the scope of the literal meaning of their writing or thinking. [ 8] In other words, it is a form of metacognition.
What Is a Reflective Essay: Definition. A good question to start with is, "What is a reflective essay?" A reflective essay is a type of academic writing, in which the student has to test personal life experience/position towards a particular topic. Unlike in argumentative writing, the student does not have to defend the personal position.
A reflective essay is a relatively broad category of academic essay writing. There is no one correct type of reflective essay. In fact, you could be asked to write a reflective essay that is written in the first person or the third person.. Most reflective essays will be thesis-driven.
1. Job applications. Both preparing for and writing job applications contain elements of reflective writing. You need to think about the experience that makes you suitable for a role and this means reflection on the skills you have developed and how they might relate to the specification.
In a reflective essay, you may use your conclusion to give closure to the experience you're writing about. Add any insights to explain your reasons for your impression. Finally, remember that a reflection is a way to write about the past from the perspective of the present. Make a clear connection from the past to the present.
Johns' Model Of Reflection. Step 1: Determine The Goal. Step 2: Establish The Context. Step 3: Select An Issue. Step 4: Develop A Plan. Step 5: Conduct Interviews. Step 6: Write Your Reflection. Kolb's Reflective Learning Cycle. The Structure Of A Reflective Essay.
1. Brainstorm life experiences that can help you answer the prompt. As you start planning your reflective essay, the writing process will flow much like any other academic essay. You'll start with a brain dump to generate as many ideas as possible about the topic you want to cover.
A reflective essay is similar to other essays in that it needs to be easily understood and well structured, but the content is more akin to something personal like a diary entry. In this guide, we explore in detail how to write a great reflective essay , including what makes a good structure and some advice on the writing process.
A reflective essay typically follows the familiar organisational pattern: Introduction - Body Paragraphs - Conclusion. In the body paragraphs, reflective writing involves a number of formats, and this guide will sugguest a DIEP approach, that is, to describe, interpret, evaluate and plan (Boud et al., 1985). · Introduction.
Reflection is focused on producing useful outcomes from the future. It can help you becoming more self-aware and can make you a better learner, researcher, practitioner or employee. 5) Make decisions or resolve uncertainty. Thinking about previous experiences can help you make decisions about new ones. Note: While all of these reasons for ...
A reflective essay is a type of essay where the writer describes a personal experience or event that they observed or examined. Reflective writing involves thinking or pondering about a specific topic and writing your thoughts. The content of a reflective essay is subjective. This means, the writer discusses the topic from their own personal ...
In some postgraduate study it it necessary to demonstrate critical analysis and reflexive skills in your reflective essay writing. You need to show how you are developing new perspectives and to do this you will need to refer to the available literature. So we have adapted Gibbs by using the work of Atkins and Murphy (1993) to ensure you take a ...
McBain et al. (2015) offered 14 fourth year medical students to freely choose their medium to reflect which could be either a traditional reflective essay or more creative options such as poetry, visual arts, or sculpture; their textual commentaries that accompany their works were used for the analysis. Participants universally expressed that ...