title: Using reflection to influence practice: student perceptions of daily reflection in clinical education.
abstract: OBJECTIVE
  Reflection is a key element in learning from experience, but the impact of most programmes of reflection on daily practice remains unclear. We investigated students' perceptions of adding a daily written reflection assignment to a clinical rotation.
  
  
  METHODS
  Third-year medical students on a single two-week rotation completed daily reflections analyzing their performance. Programme evaluation used a 33-question anonymized survey. Quantitative data were summarized and qualitative responses coded for recurring themes.
  
  
  RESULTS
  Twenty-six students completed the survey (90 % response rate). Eighty-five percent of students felt that the daily reflections had a positive impact on their learning from clinical experience. Seventy-seven percent of students reported that the programme changed their awareness of their thoughts and actions, and 80 % felt that it improved their recall of experiences. A greater sense of mindfulness and focus on self-improvement were major themes that emerge from students' descriptions of the role of daily reflections in their learning.
  
  
  CONCLUSIONS
  Overall, daily reflections demonstrated a positive learning influence. This exploratory study suggests students may benefit from more frequent, short reflections as opposed to more typically spaced reflective assignments.
authors.affiliation: Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, USA. larsend@neuro.wustl.edu.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Larsen
authors.affiliation: Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: London
authors.affiliation: Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, USA.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Emke
keywords: Practice-based learning; Reflection; Reflection-in-action; Reflection-on-action