Influence of community experiences on first-year medical students' reflective writing.

The purpose of this research was to investigate the usefulness of providing students with community-located experiences as a basis for reflection by observing the degree to which community-located experiences influenced the quality of a reflective writing exercise. Students were prepared for reflection by means of a lecture and a handout on the meaning, function and process of reflection. One hundred and twenty-eight students (66 Afrikaans-speaking, and 62 English-speaking) took part in the study. Initially, most students (71%) who revealed affect prior to the visit reported negative emotional states. For 54% of the students who revealed emotions upon arrival, positive emotional states replaced the negative and this increased to 67% as the visit continued. This represented the most important stage of the personal growth continuum, signifying awareness of perspective 'distortions'. The majority (94.3%) regarded the visit as being important prior to immersing themselves in the theory of primary healthcare. In the questionnaire survey, students were asked for their opinions on the value of reflective writing as a tool for promoting deep learning, as students' attitudes were considered an important determinant of increased uptake of this kind of activity. Reflective writing can be promoted through using a real-world experience as stimulus, and a framework for guiding students' thoughts.