Enhancing Reflective Practice Using Prompts in Online Submission of Case Reports (OSCAR): An Exploratory Study Among Medical Students in Rural Longitudinal Integrated Clerkships.

INTRODUCTION

Medical students learn to reflect to gain new insights into self and practice; however, allowing for reflection within a busy curriculum is challenging. In this study we embedded reflective writing prompts (RWP) into an existing assessment item, Online Submission of Case Reports (OSCAR), to investigate whether this minimalistic scaffolding intervention could develop students' reflective capacity and increase their exposure to rural social determinants of health.

METHODS

This study is framed by ontological realism and informed by an interpretivist stance. Focus group transcripts (medical students and educators) were inductively analysed using thematic analysis. Written OSCAR reflections were analysed in a deductive top-down method to provide a contrasting perspective and triangulation.

RESULTS

Focus groups included 27 students, 10 educators, and 52 OSCAR reflections. Inductive analysis generated three themes: Scaffolded Learning, Affording Diverse Responses, and Maximising Learning Opportunities. Deductive analysis indicated that most students (87%) demonstrated lower-order thinking.

DISCUSSION

Most participants valued the impact of RWP on students' learning. Though the RWP did not assist students to demonstrate higher-order thinking, they did increase the breadth of rural social determinants of health topics reflected upon by students, thereby increasing student knowledge of the impact of rural context on patient care.