title: A review of creative and expressive writing as a pedagogical tool in medical education.
abstract: BACKGROUND
  The act of writing offers an opportunity to foster self-expression and organisational abilities, along with observation and descriptive skills. These soft skills are relevant to clinical thinking and medical practice. Medical school curricula employ pedagogical approaches suitable for assessing medical and clinical knowledge, but teaching methods for soft skills in critical thinking, listening and verbal expression, which are important in patient communication and engagement, may be less formal. Creative and expressive writing that is incorporated into medical school courses or clerkships offers a vehicle for medical students to develop soft skills. The aim of this review was to explore creative and expressive writing as a pedagogical tool in medical schools in relation to outcomes of medical education.
  
  
  METHODS
  This project employed a scoping review approach to gather, evaluate and synthesise reports on the use of creative and expressive writing in US medical education. Ten databases were searched for scholarly articles reporting on creative or expressive writing during medical school. Limitation of the results to activities associated with US medical schools, produced 91 articles. A thematic analysis of the articles was conducted to identify how writing was incorporated into the curriculum.
  
  
  RESULTS
  Enthusiasm for writing as a pedagogical tool was identified in 28 editorials and overviews. Quasi-experimental, mixed methods and qualitative studies, primarily writing activities, were aimed at helping students cognitively or emotionally process difficult challenges in medical education, develop a personal identity or reflect on interpersonal skills. The programmes and interventions using creative or expressive writing were largely associated with elective courses or clerkships, and not required courses.
  
  
  CONCLUSIONS
  Writing was identified as a potentially relevant pedagogical tool, but not included as an essential component of medical school curricula.
authors.affiliation: Rutgers University School of Health Related Professions, Institute for Complementary and Alternative Medicine, Newark, NJ, USA.
authors.forename: Virginia S
authors.initials: VS
authors.lastname: Cowen
authors.affiliation: New Jersey Medical School, University Behavioral Healthcare, Rutgers University, Newark, NJ, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Kaufman
authors.affiliation: Department of Preventive Medicine and Community Health, New Jersey Medical School, Rutgers University, Newark, NJ, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Schoenherr
mesh_terms: D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D006801:Humans; D013850:Thinking; D014956:Writing