Mohan Nitesh, Ba Mackaleigh Levine, Yan Chen, Wilson Robert G
Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH, USA.
Cleveland Clinic, Neurological Institute, Cleveland, OH, USA.
J Med Educ Curric Dev. 2025 Sep 8;12:23821205251374897. doi: 10.1177/23821205251374897. eCollection 2025 Jan-Dec.
Medical students frequently observe social, ethical, and systemic challenges during clinical rotations but often lack formal avenues for reflection. Structured reflective writing can promote critical thinking, empathy, and professional identity formation.
To characterize the content and depth of student reflections on social elements of care during a neurology clerkship and assess the educational impact of a required reflective writing exercise.
This retrospective qualitative study analyzed 46 reflective logs submitted by third-year medical students during their neurology rotation at the Cleveland Clinic (June 2023-May 2024). Logs focused on bias, social determinants of health, healthcare inequities, system challenges, or quality improvement. Logs and corresponding faculty responses were analyzed to identify themes, emotional tone, and professional development insights.
Most logs (77.3%) described bias, often related to gender or race. Students also noted communication barriers, access issues, and health inequities. Emotional tones included frustration (69.6%) and empathy (21.7%). Reflections often conveyed professional identity development (55%) and ethical reasoning (47.5%). Clerkship director responses were supportive, with frequent teaching points and validation.
Students regularly encounter and meaningfully reflect on complex social issues during clinical training. Structured reflection offers critical insight into students' evolving perceptions of equitable care and often fosters professional growth. Integrating such exercises into clinical curricula may enhance students' ability to recognize and respond to bias and inequity in real-world practice.
医学生在临床轮转期间经常会观察到社会、伦理和系统性挑战，但往往缺乏正式的反思途径。结构化反思写作可以促进批判性思维、同理心和职业身份的形成。
描述医学生在神经科实习期间对护理社会因素反思的内容和深度，并评估必修反思写作练习的教育影响。
这项回顾性定性研究分析了三年级医学生在克利夫兰诊所神经科轮转期间（2023年6月至2024年5月）提交的46篇反思日志。日志聚焦于偏见、健康的社会决定因素、医疗保健不平等、系统挑战或质量改进。对日志及相应的教师回复进行分析，以确定主题、情感基调以及职业发展见解。
大多数日志（77.3%）描述了偏见，通常与性别或种族有关。学生们还指出了沟通障碍、获取问题和健康不平等。情感基调包括沮丧（69.6%）和同理心（21.7%）。反思通常传达了职业身份发展（55%）和伦理推理（47.5%）。实习主任的回复具有支持性，经常有教学要点和认可。
学生在临床培训期间经常遇到并对复杂的社会问题进行有意义的反思。结构化反思为洞察学生对公平护理不断演变的认知提供了关键视角，并且常常促进职业成长。将此类练习纳入临床课程可能会提高学生在实际临床实践中识别和应对偏见及不平等的能力。
