title: Reflective writing and its impact on empathy in medical education: systematic review.
abstract: OBJECTIVE
  Medical schools are increasingly aware of the ways in which physician empathy can have a profound impact on patients' lives and have developed humanities initiatives to address this concern. Reflective writing in particular is more commonly promoted in medical curricula, but there is limited research on the impact of reflective writing on medical student empathy levels. It aims to find the emotional effects of reflective writing interventions on medical and healthcare students by systemic review.
  
  
  METHODS
  Two investigators independently reviewed educational publications for critical analysis. This review focused systematically on quantitative papers that measure the impact of reflective writing on empathy.
  
  
  RESULTS
  Of the 1,032 studies found on Medline and CINAHL, only 8 used quantitative measures pre- and postwritten reflection to measure any impact on empathy outcomes. The outcomes measured included impact of reflective writing exercises on student wellness, aptitude, and/or clinical skills. Of these studies, a significant change in student empathy was observed in 100% of the studies, demonstrating a significant change in outcomes.
  
  
  CONCLUSIONS
  Although the lack of homogeneity in outcome measurement in the literature limits possible conclusion from this review, the overwhelmingly positive reporting of outcomes suggests that reflective writing should be considered in any medical curriculum.
authors.affiliation: University of British Columbia Faculty of Medicine, Vancouver, Canada ; Yale University, New Haven, CT, USA.
authors.forename: Isabel
authors.identifier: 0000-0001-8982-445X
authors.initials: I
authors.lastname: Chen
authors.affiliation: University of British Columbia Faculty of Medicine, Vancouver, Canada.
authors.forename: Connor
authors.identifier: 0000-0002-8541-3909
authors.initials: C
authors.lastname: Forbes
keywords: Aptitude; Clinical competence; Empathy; Medical students; Writing
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