Abstract
Objective
Medical students’ reflective journals can be a rich source for understanding what students learn and think about during clinical rotations and can offer educators and mentors insight into students’ professional identity formation. The aim of this paper is to ascertain, from reflective accounts, students’ development and reactions to psychiatry following their psychiatry clerkship.
Method
The patterns, recurrent categories, and themes in 100 psychiatry clerks’ reflective journals were analyzed using grounded theory. Constant comparative method was employed to identify and quantify emergent themes and uncover relationships between these themes.
Results
The most common “unprompted” themes that students reported were the recognition of the complexity of the illness condition and the fact that the psychiatric patient does not exist in a vacuum (52 %); an acknowledgement of one’s respect for the struggle of patients with mental illness (49 %); an expressed or demonstrated empathy for patients (48 %); and a reduced skepticism of the biological basis of mental illness and efficacy of treatments (46 %).
Conclusion
Reflective exercises—along with quality mentorship—can be used to understand students’ experience with clinical encounters, facilitate change, refine assumptions among students, and promote critical self-assessment and personal growth.
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Appendix 1: Writing Prompts for Reflective Exercise
Appendix 1: Writing Prompts for Reflective Exercise
Regarding Psychiatry:
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The student will write about what he or she learned during the rotation and compares that to the anticipated learning from the first entry.
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The student will compare and contrast his or her predictions of what he or she would find most challenging about the rotation and what he or she would most enjoy about the rotation with the clinical experience.
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The student will assess if the patient encounters reinforced or diminished his or her preclinical notions about patients with mental illness. The student will reflect on his or her own views of what people with mental illness have lost or gained and if the student has hope for patients with this type of illness.
Regarding Personal Skills:
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The student will compare his or her predictions about his or her own strengths and weaknesses with the feedback received and self-assessment of his or her skills.
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The student will modify his or her own individual learning goals for the next clerkship based on this analysis, including what activities he or she will do to meet those goals.
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The student will reflect on how patient encounters reinforced or diminished his or her decision to come to medical school.
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The student will determine what they learned from and will take away from this rotation.
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Schatte, D.J., Piemonte, N. & Clark, M. “I Started to Feel Like a ‘Real Doctor’”: Medical Students’ Reflections on Their Psychiatry Clerkship. Acad Psychiatry 39, 267–274 (2015). https://doi.org/10.1007/s40596-014-0276-7
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DOI: https://doi.org/10.1007/s40596-014-0276-7