title: Changes in themes over time from medical student journaling.
abstract: BACKGROUND
  There has been little exploration of journaling in medical student education.
  
  
  OBJECTIVE
  To document the themes on which medical students reflect during training.
  
  
  METHODS
  We evaluated journals kept by primary care medical students to identify prominent themes and determine change or constancy in themes over time. We looked at third-year medical students participating in a required primary care clerkship in a university-affiliated, community-based family medicine residency program with a rural catchment area.
  
  
  METHODS
  During 1994-1996 and 2001-2003, students were asked to keep weekly journals reflecting on their thoughts and feelings regarding "topical content, course processes and methods, and personal reflections on becoming a doctor." Faculty evaluated journals to identify change or constancy in themes over time.
  
  
  RESULTS
  Prominent themes included gender issues, professional identity emergence, career choice, and rural practice, the experience of learning, the experience of relating to patients, and the nature of medical practice.
  
  
  CONCLUSIONS
  We found both constancy and change in student journal themes over time. Changes in journal themes appeared to correlate with outside events and educational trends, including increased attention to reflective practice, changing demographics in medicine and the increasing acceptance of female physicians, and personal life events.
authors.affiliation: University of Wisconsin Department of Family Medicine at the Eau Claire Family Medicine Residency, USA. bcayley@yahoo.com
authors.forename: William
authors.initials: W
authors.lastname: Cayley
authors.forename: Rae
authors.initials: R
authors.lastname: Schilling
authors.forename: Ralph
authors.initials: R
authors.lastname: Suechting
mesh_terms: D000328:Adult; D002982:Clinical Clerkship; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D013337:Students, Medical; D014956:Writing