Impact of reflection writing on the learning ability of Indian medical students.

Reflective writing develops meta-cognition among students. Therefore, it is of interest to compare effectiveness of post lecture reflective writing to didactic lecture between individual and group reflective writing. Hence, we included 124 first-year students from AIIMS Bhopal, India and divided them in two groups of 62 students. Both groups took a pre-test using a reflection questionnaire. Students were taught reflective writing. Both groups attended physiology lectures on two different topics. First lecture on body fluids where Group A wrote reflections individually and Group B did so in sub-groups (B1 to B6). After another lecture on Pathophysiology of oedema, Group A wrote reflections in groups and Group B wrote individually (A1 to A6). Both groups took a test in the form of MCQ about reflective writing on lectures. After intervention both groups took a post-test using a reflection questionnaire. Mean and standard deviation of Pre-test is 3.86 ± 0.86 and Post-test is 7.58 ± 1.01, respectively. The Mean and standard deviation of reflection who wrote individually is 38.05 ± 4.41 and in group is 27.45 ± 3.93, respectively with p-value < 0.05. Evaluation of students who wrote reflection in groups after second lecture the mean and standard deviation of reflection who wrote individually is 38.22 ± 4.64 and in group is 27.03 ± 2.87 respectively with p-value < 0.05. The performance of students who wrote reflection in groups is not satisfactory as compared to students who wrote their reflection individually.

Impact of general practice/family medicine training on Japanese junior residents:reflective writing analysis using text mining.

BACKGROUND: We previously reported the impact of general practice/family medicine training on postgraduate training in Japan using evaluation criteria standardized nationwide. However, there is a possibility that new insights may be gained by analyzing the reflective reports written by these residents. METHODS: Junior residents who participated in one-month general practice/family medicine training at one of five medical institutions with full-time family medicine specialists between 2019 and 2022 were enrolled in this study. They were assigned to submit a reflective report on their experiences and thoughts every day during the training. We analyzed these reflective writings using text mining and created a co-occurrence network map to see the relationship between the most frequently used words. RESULTS: Ninety junior residents participated in the study. The words that appeared most frequently in the sentences referring to clinical ability included "symptoms," "medical examination," "consultation," "treatment," and "examination." The words of "family" and "(patient) oneself" showed strong association in the co-occurrence network map. CONCLUSION: It was suggested that general practice/family medicine training greatly contributes to the acquisition of clinical abilities and deepens the learning of junior residents not only about patient care but also about family-oriented care.

Assessing the Impact of the Portfolio Workshop and the Use of the Rubric Matrix for Reflective Writing on Medical Faculty and Students.

Purpose The portfolio can be used as a crucial tool for self-reflection, which allows us not only to showcase achievements but also course correct on our personal and professional journey. However, there is a significant lack of awareness among medical professionals about portfolios. Arranging a workshop to impart this knowledge could be a potential mitigation approach. This study aims to assess the impact of workshops on portfolios on students' and faculty's knowledge. In addition, the study also analyzes the effect of using rubrics on reflective writing skills. Method A portfolio workshop was organized for the medical faculty and students in the Bundelkhand Government Medical College, Sagar, M.P. The Kirkpatrick model of training evaluation along with a rubric for the evaluation of reflective writing skills were used to measure the effectiveness of the workshop. Pre and post-tests for the workshop, pre and post-reflective writing skills, and workshop feedback were collected using questionnaires. The Shapiro-Wilk test and the Wilcoxon signed rank test were applied to the data collected. Results Out of 89 registrations for the workshop, only 81 people consented to the workshop and participated in the study. The total number of faculty was only 17 and the rest were students from all the phases. Both the Shapiro-Wilk test and the Wilcoxon signed rank test showed a significantly small p-value, stating that there was a significant positive impact on the knowledge, perception, and effectiveness of the workshop. Conclusion This study clearly outlines the positive impact of conducting a workshop on portfolios. A significant increase in participants' knowledge of portfolios is identified. Similarly, employing rubrics has a significant increase in the quality of reflective writing skills.

Reflect to interact - fostering medical students' communication through reflection-focused e-learning.

BACKGROUND: Previous research indicates that reflection can foster medical communication competence. However, best practices for embedding reflection in online medical education are missing. This study examined how reflection processes can be promoted and embedded in an e-learning course on physician-patient communication to foster learning. METHODS: We investigated three differently designed e-learning conditions featuring different proportions of reflection triggers and compared their effects on students' reflections. We had 114 medical students in their first clinical year complete one of the variants: video modelling (VM, n = 39), video reflection (VR, n = 39), or a variant merging both approaches (VMR, n = 36). Each student wrote a total of nine reflections based on the same guiding questions at three time points embedded in the course. The students' levels of reflection were measured using an adapted version of the REFLECT rubric (scale 0-18). RESULTS: Students of all course variants achieved good levels of reflection beyond the descriptive level at all three time points, with no significant differences between the variants. The mean reflection scores at the end of the course were M = 14.22 for VM (SD = 2.23), M = 13.56 for VR (SD = 2.48), and M = 13.24 for VMR (SD = 2.21). Students who completed VM showed significantly improved levels of reflection over the course, whereas we found no statistically significant development for those in VR or VMR. The reflection scores correlated significantly positively with each other, as did the text lengths of the written reflections. Reflection scores also correlated significantly positively with text length. CONCLUSIONS: Our study offers a teaching strategy that can foster good levels of reflection, as demonstrated in the three e-learning variants. The developed reflection prompts can be easily embedded in various e-learning environments and enable reflections of good quality, even in settings with limited available teaching time.

Twelve tips for maximizing the potential of reflective writing in medical education.

Reflective writing (RW) is a popular tool in medical education, but it is being used in ways that fail to maximize its potential. Literature in the field focuses on why RW is used - that is to develop, assess, and remediate learner competencies - but less so on how to use it effectively. The emerging literature on how to integrate RW in medical education is haphazard, scattered and, at times, reductionist. We need a synthesis to translate this literature into cohesive strategies for medical educators using RW in a variety of contexts. These 12 tips offer guidelines for the principles and practices of using RW in medical education. This synthesis aims to support more strategic and meaningful integration of RW in medical education.

Impact of reflective writing skill on emotional quotient.

Background: The skill of reflective writing and emotional drivers of behavior is enhanced by boosting the awareness of one's feelings and emotions. Individuals having characteristic activity of reflection have more emotional quotient (EQ). EQ has more significance than intelligence quotient in personal and professional life. This study is conducted to analyze the impact of reflective writing skills on components of EQ among first-year MBBS students and to find out the impact of reflective writing between components of EQ and different levels of reflective writing skills among first-year MBBS students. Methods: An observational-analytical study was carried out for EQ self-assessment and reflections of first-year MBBS students. A paired t-test was used to check the difference between different segments of EQ. Analysis of reflections was done by modifying the REFLECT rubric method. Results: There was a significant difference in the motivation component between pre and post-test (p-value = 0.013), whereas no significant difference was observed in other components, viz. self-awareness, empathy, self-control, self-confidence, and social competency. The average total scores among EQ domains compared were more at the level of reflection than habitual and introspection levels. Conclusion: Along with intelligence quotient, EQ is critical for students' overall development. The average total scores of EQ were higher among the students who had a higher level of reflection. Developing reflective writing skills had an impact on the motivation component of the EQ of the students within a short duration.

Transforming self-experienced vulnerability into professional strength: a dialogical narrative analysis of medical students' reflective writing.

Medical students' efforts to learn person-centered thinking and behavior can fall short due to the dissonance between person-centered clinical ideals and the prevailing epistemological stereotypes of medicine, where physicians' life events, relations, and emotions seem irrelevant to their professional competence. This paper explores how reflecting on personal life experiences and considering the relevance for one's future professional practice can inform first-year medical students' initial explorations of professional identities. In this narrative inquiry, we undertook a dialogical narrative analysis of 68 essays in which first-year medical students reflected on how personal experiences from before medical school may influence them as future doctors. Students wrote the texts at the end of a 6-month course involving 20 patient encounters, introduction to person-centered theory, peer group discussions, and reflective writing. The analysis targeted medical students' processes of interweaving and delineating personal and professional identities. The analysis yielded four categories. (1) How medical students told their stories of illness, suffering, and relational struggles in an interplay with context that provided them with new perspectives on their own experiences. Students formed identities with a person-centered orientation to medical work by: (2) recognizing and identifying with patients' vulnerability, (3) experiencing the healing function of sharing stories, and (4) transforming personal experiences into professional strength. Innovative approaches to medical education that encourage and support medical students to revisit, reflect on, and reinterpret their emotionally charged life experiences have the potential to shape professional identities in ways that support person-centered orientations to medical work.

Implementing Reflective Writing at a Newly Established Health Science Academy of Nepal: Exploring a Novel Practice, Overcoming Obstacles and Recommendations.

Establishing new institutions for health professions provides the opportunity to implement innovative approaches catering to the current health needs and also allows to address the inadequacies of well-established institutions. Grabbing this opportunity, we initiated the implementation of reflective practices at Madan Bhandari Academy of Health Sciences, a new provincial university in Nepal. Though literature shows that reflection is a helpful tool to reflect on choices, experiences, and failures and obtain knowledge for the students, the adoption of reflective writing in health professions education in Nepal is limited. Therefore, we looked into the practices from other countries to adopt them in our settings and integrated them into our curriculum. But, we came across many impediments during the process-particularly those related to limited resources. We found innovative solutions like using technology and peer mentoring to overcome these challenges and integrated these practices to initiate reflective writing at the institution. The introspective "talking to oneself" has been a valuable strategy for implementing the reflective practices at our institution. Based on our experiences, we highly recommend educators in Nepal or similar settings embrace team-based writing practices that are contextually appropriate. But, we also recognize the benefits of team-based reflective writing that considers the cultural context. We hope this review will inspire educators, particularly those who lack the resources to initiate such practices at their institution. Our firsthand experience is detailed in this perspective article.

Promoting Self-Care in Palliative Care: Through the Wisdom of My Grandmother.

In the post COVID-19 pandemic period, targeted efforts are needed more than ever to improve frontline nurses' well-being. In the field of palliative care, there is recognition of the importance of self-care, but the concept itself remains nebulous, and proactive implementation of self-care is lacking. Reflective writing has been noted to have positive impacts on health care providers' well-being. This piece brings to light the author's interest and work in reflective writing, sharing a personal account that provides a source of happiness and an opportunity to better understand her palliative care practice. Beyond the individual level, organizations are also encouraged to invest in their nurses' overall well-being.

Narrative Empowerment for Medical Students in Narrative Medicine Education in Public Health Crises / 中国医学伦理学

Narrative competence is one of the factors to reflect humanistic literacy of doctors and nurses. According to the advice of many experts, the narrative competence should be improved from the stage of medical students through the two major tools including close reading of text and reflective writing. Based on the background of prevention and control of COVID-19 outbreak, this paper aimed to clarify the focus and methodology of close reading and reflective writing, that was, close reading was supposed to focus on the analysis of disease metaphors in classic literature and narrative function in clinical works and realism works, and writing tended to focus on the the differentiation of writing purpose and the writing guidance in different texts. The proper guidance plus solid training in close reading and writing will definitely lay a strong foundation for medical students in achieving humanistic quality.

Narrative Medicine in Hospice and Palliative Care: A Longitudinal Fellowship Curriculum Pilot.

INTRODUCTION: Growing evidence suggests that clinician exposure to narrative medicine (NM) may help bolster resilience and mitigate burnout. The value of formal longitudinal training in NM for hospice and palliative medicine (HPM) trainees remains understudied. METHODS: A 1-year longitudinal NM curriculum for HPM fellows was pilot-tested for feasibility, acceptability, and exploratory impact. Six monthly 45-minute sessions included reading literature, reflective writing, and sharing creative work. Quantitative and qualitative data were collected through a pre-intervention survey and post-intervention survey administered immediately upon completion of the curriculum. Longitudinal impact was assessed with a post-intervention survey administered three months after completion of the curriculum. RESULTS: All HPM fellows (n = 6) attended at least 5/6 sessions during the 1-year pilot, suggesting intervention feasibility. Participant engagement and self-reported comfort with NM exercises supported intervention acceptability. Post-intervention, participants described the positive influence of NM practice on their clinical practice and stated an intention to integrate NM skills in their future HPM careers. Three months following the intervention, participants had a sustained increase in their comfort level with NM. All participants felt that the NM sessions had been relevant to their life as HPM fellows and anticipated using NM moving forward in their practice of HPM. DISCUSSION: This novel NM curriculum was feasible and acceptable to implement in a 1-year HPM fellowship. Longitudinal impact showed sustained increase in trainee comfort and interest in using NM in their future clinical practice.

Exploring the impact of mindfulness-based training on the well-being of physical therapists.

Introduction: Experimental evidence is needed to evaluate interventions that curtail burnout for physical therapists. The goal of this research was to assess the impact of mindfulness-based training (MBT) on the well-being of physical therapists. We hypothesized physical therapists would demonstrate greater work engagement, empathy, and job satisfaction, and lower depression, anxiety, stress, and moral distress following MBT. Methods: Thirteen physical therapists (10 female/3 male; 35.38 ± 9.32 years old) completed this two-arm embedded mixed-methods pilot study. The control group (n = 4) was followed while the intervention group (n = 9) completed six MBT sessions over 3 months. Sessions were assigned a representative topic area (meaning in physical therapy, situational- and self-awareness, compassion fatigue/burnout, implicit biases, establishing boundaries and managing conflict, self-care) with relevant reflective writing, small group discussions, and mindfulness strategies. Non-parametric statistics compared quantitative outcomes across and within groups, and a thematic framework matrix was established by way of qualitative description for data analysis. Results: Physical therapists in the intervention group had improved pre- to post-scores for work engagement, mental health, and moral distress (p ≤ 0.043). Inability to effect change contributed to compassion fatigue/burnout, whereas difficulty prioritizing self/limited personal time impeded self-care. "I realized how easy it is to get caught up in life and in helping out those around you, you completely forget to take time to check in with how you are doing (Physical Therapist 3)." Conclusion: Implementing an MBT program demonstrates promise and may benefit the well-being of physical therapists while simultaneously enhancing employee retention and improving patient care.

An Innovative Workshop Embedding Pathology Service Users into the Undergraduate Biomedical Science Curriculum.

The integration of pathology service users into the biomedical science curriculum has been driven by the refinement of the Health and Care Professions Council (HCPC) Standards of Proficiency. This study aimed to design and implement a novel and innovative service user event with a reflective assessment to enhance students' knowledge and understanding of the impact of pathology laboratory results on the patient pathway. The 4-h workshop consisted of a series of service users. Patients discussed how pathology services had contributed to their diagnosis and treatment, while service providers-a Microbiology Consultant, a director of primary care, and the patient referral optimisation officer-discussed their roles and their interactions with pathology services. Post-event, students completed a 750-word reflective assessment, highlighting challenges experienced by service users and providing suggestions for improving the delivery of pathology services. In total, 57.5% of respondents (57/99) completed a post-reflection survey, which included open- and closed-ended questions. Quantitative analysis of the survey data revealed that over 87.7% of respondents had increased knowledge and understanding of the revised HCPC standards. Following the assessment, students reported a significant increase in their confidence with respect to reflective writing (p < 0.001), with over 90% of respondents agreeing that the reflective assessment had increased their knowledge and understanding of the limitations that may negatively impact service users and patient care. Moreover, respondents highlighted how advancements in point-of-care testing (POCT) and improvements in communication can improve patient experiences. Thematic analysis revealed that respondents agreed that embedding patients into the curriculum reinforced the importance of there being a patient behind every sample. Respondents reported that reflecting upon service user experiences enabled them to identify improvements to the delivery of pathology services while recognising the essential role that Biomedical Scientists play in the patient pathway. This successful workshop has created a platform encompassing a range of pathology service users in the undergraduate curriculum. We recommend that other accredited biomedical science programmes adopt and embed this innovative workshop and reflective assessment into their programmes to help them meet these standards relating to service users while fostering important transferable skills in their students.

Clinical records after asynchronous and synchronous e-learning courses: a multi-method randomised controlled trial on students' performance and experience.

BACKGROUND: Clinical Record (CR) writing is a fundamental skill for healthcare professionals, but the best e-learning methods for teaching it remain unstudied. Therefore, we investigated speech therapy students' differences in the quality production of CR at the placement and their experience after following asynchronous or synchronous e-learning courses. METHODS: A multi-method randomised controlled trial. Fifty speech therapist students were equally and randomly divided into two groups attending asynchronous or synchronous e-learning classes to learn how to write a CR. The quality of the CR was tested through an ad hoc checklist (score 0-32) and the groups' scores were compared. The assessors and the statistician were blinded to students' group assignment. Students' experience was assessed through semi-structured interviews analysed with a reflexive thematic analysis. RESULTS: No score differences between the two groups were found (Cohen's d = 0.1; 95% Confidence Interval [-0.6; 0.7]). Four themes were generated: (1) 'Different Forms of Learning Interaction', as the synchronous group reported a positive experience with being fed back immediately by the lecturer, whereas the asynchronous group reported that pushing back the question time allows for reflecting more on the learning experience; (2) 'Different Ways to Manage the Time', as the synchronous group had to stick to the lecturer's schedule and the asynchronous group felt the possibility to manage its time; (3) 'To Be or Not To Be (Present)?' due to the different experiences of having (or not) the lecturer in front of them; (4) 'Inspiring Relationships With The Peers', where both groups preferred a peer-to-peer discussion instead of contacting the lecturer. DISCUSSION: Asynchronous and synchronous e-learning courses appeared equally effective in teaching CR writing. However, students perceive and experience these methods differently. The choice or blend of these methods should be based on students' needs and preferences, teacher input, as well as organisational requirements rather than solely on students' attended performance.

"An invitation to think differently": a narrative medicine intervention using books and films to stimulate medical students' reflection and patient-centeredness.

BACKGROUND: Narrative medicine purports to improve medical students' communication skills, self-reflection, empathy and professional development. These interpersonal skills and attitudes can facilitate more patient-centered care and positively impact patients' treatment outcomes. However, current studies report mainly on small study populations, leaving the efficacy of narrative medicine in larger study groups unknown. Therefore, this study aimed to evaluate a mandatory narrative medicine lesson in a large sample of medical students. We assessed if this narrative medicine lesson stimulated meaningful self-reflection on patient-centeredness in medical students. METHODS: All fourth-year medical students of a Dutch medical school participated in this mandatory narrative medicine lesson. The four-step activity consisted of an introductory lecture, close reading and watching of a book and film, a discussion group and a short reflective writing exercise. Students were divided over three thematic pairings (or book and film combinations): 'The doctor as a patient,' 'The mysterious brain,' and 'Until death do us part.' A mixed-methods design was used. First, we qualitatively analyzed the content of 203 essays from the reflective writing exercise. A quantitative analysis of the reflective quality was conducted using a scoring-system based on the REFLECT rubric. RESULTS: Students demonstrated reflection on a professional level and connected this to future intentions as medical practitioners, for example to use specific communication strategies or to deliver healthcare in a broader sense. They also reflected on a personal level by questioning their own worldview or beliefs. Furthermore, they stressed the importance of individual patient stories to gain understaning of patients' perspectives. Approximately half of the students showed an in-depth and authentic reflection, according to the REFLECT rubric. Additionally, reflection levels differed between book and film pairings. CONCLUSIONS: This study supports the value of narrative medicine in the medical curriculum by validating its outcomes in a larger study population and in a mandatory course. Students reflected on themes related to the principles of patient-centeredness, namely personal attitudes towards patients and the uniqueness of patient stories. In additon, the majority of students demonstrated higher levels of reflection, which suggests that this exercise contributes to self-awareness and self-reflection, important qualities for delivering patient-centered healthcare.

Indicators of the dimensions of trust (and mistrust) in early primary care practice: a qualitative study.

BACKGROUND: Trust occurs when persons feel they can be vulnerable to others because of the sincerity, benevolence, truthfulness and sometimes the competence they perceive. This project examines the various types of trust expressed in written reflections of developing healthcare clinicians. Our goal is to understand the roles trust plays in residents' self-examination and to offer insight from relationship science to inform the teaching and clinical work for better trust in healthcare. METHODS: We analyzed 767 reflective writings of 33 residents submitted anonymously, to identify explicit or implicit indicators attention to trust or relationship development. Two authors independently coded the entries based on inductively identified dimensions. Three authors developed a final coding structure that was checked against the entries. These codes were sorted into final dimensions. RESULTS: We identified 114 written reflections that contained one or more indicators of trust. These codes were compiled into five code categories: Trust of self/trust as the basis for confidence in decision making; Trust of others in the medical community; Trust of the patient and its effect on clinician; Assessment of the trust of them exhibited by the patient; and Assessment of the effect of the patient's trust on the patient's behavior. DISCUSSION: Broadly, trust is both relationship-centered and institutionally situated. Trust is a process, built on reciprocity. There is tacit acknowledgement of the interplay among what the residents do is good for the patient, good for themselves, and good for the medical institution. An exclusive focus on moments in which trust is experienced or missed, as well as only on selected types of trust, misses this complexity. CONCLUSION: A greater awareness of how trust is present or absent could lead to a greater understanding and healthcare education for beneficial effects on clinicians' performance, personal and professional satisfaction, and improved quality in patients' interactions.

Attitudes and Perception of the REFLECT Communication Curriculum for Clinical Oncology Graduate Medical Education.

Communication and interpersonal skills are essential components of oncology patient care. The REFLECT (Respect, Empathy, Facilitate Effective Communication, Listen, Elicit Information, Compassion, and Teach Others) curriculum is a novel framework to improve and refine physician/patient interactions for oncology graduate medical trainees. We seek to evaluate the attitudes and perceptions of the REFLECT communication curriculum among oncology trainees. Seven-question and 8-question Likert scale surveys (1 = not beneficial and 5 = beneficial) were distributed to resident/fellow participants and faculty mentors, respectively. Questions asked trainees and faculty about their perceptions of improvement in communication, handling of stressful situations, the value of the curriculum, and overall impression of the curriculum. Descriptive statistics determined the survey's baseline characteristics and response rates. Kruskal-Wallis rank sum tests were used to compare the distribution of continuous variables. Thirteen resident/fellow participants completed the participant survey. Six (43.6%) Radiation Oncology trainees and 7 (58.3%) Hematology/Oncology fellows completed the trainee survey. Eight (88.9%) Radiation Oncologists and 1 (11.1%) Medical Oncologist completed the observer survey. Faculty and trainees generally felt that the curriculum increased communication skills. Faculty responded more favorably to the program's impact on communication skills (median 5.0 vs. 4.0, p = 0.008). Faculty were more assertive about the curriculum's capabilities to improve a learner's ability to handle stressful situations (median 5.0 vs. 4.0, p = 0.003). Additionally, faculty had a more favorable overall impression of the REFLECT curriculum than the residents/fellows (median 5.0 vs. 4.0, p < 0.001). Radiation Oncology residents felt more strongly that the curriculum enhanced their ability to handle stressful topics, compared to Heme/Onc fellows (median 4.5 vs. 3.0, range 1-5, p = 0.379). Radiation Oncology trainees felt more consistently that the workshops improved their communication skills, compared to Heme/Onc fellows (median 4.5 vs. 3.5, range 1-5, p = 0.410). The overall impression between Rad Onc resident and Heme/Onc fellows was similar (median 4.0, p = 0.586). Conclusions: Overall, the REFLECT curriculum enhanced communication skills of trainees. Oncology trainees and faculty physicians feel that the curriculum was beneficial. As interactive skills and communication is critical to build positive interactions, further work is needed to improve the REFLECT curriculum.

Analysis of Student Reflections on "What Matters Most" to Palliative Care Patients: A Narrative Medicine Exercise.

Background: Effective communication with ill patients requires practice, yet, the traditional history overlooks patients' personal stories. This information is vital to determining goals of care and facilitates partnership by building trust. Objective: We implemented a narrative medicine exercise for students during their palliative medicine rotation to highlight humanism. Impact was determined through thematic analysis of students' reflections. Design: Students elicited "what matters most" to patients, transcribing this plus a personal reflection. Using an inductive and iterative approach, 100 reflections were analyzed, developing codes then broader themes. Results: Four main themes (Getting to know the patient, Student Reaction, Building-blocks of patient-physician relationship, Student Personal Insights) were identified, with 15 subthemes. Conclusion: The power of uncovering patients' backgrounds and values was demonstrated, reinforcing a palliative medicine approach. Analysis showed a positive impact and the possibility of change to future practice. The intervention was feasible, well received, and encouraged reflection on the physician-patient relationship beyond the medical domain.

The use of artificial intelligence to detect students' sentiments and emotions in gross anatomy reflections.

Students' reflective writings in gross anatomy provide a rich source of complex emotions experienced by learners. However, qualitative approaches to evaluating student writings are resource heavy and timely. To overcome this, natural language processing, a nascent field of artificial intelligence that uses computational techniques for the analysis and synthesis of text, was used to compare health professional students' reflections on the importance of various regions of the body to their own lives and those of the anatomical donor dissected. A total of 1365 anonymous writings (677 about a donor, 688 about self) were collected from 132 students. Binary and trinary sentiment analysis was performed, as well as emotion detection using the National Research Council Emotion Lexicon which classified text into eight emotions: anger, fear, sadness, disgust, surprise, anticipation, trust, and joy. The most commonly written about body regions were the hands, heart, and brain. The reflections had an overwhelming positive sentiment with major contributing words "love" and "loved." Predominant words such as "pain" contributed to the negative sentiments and reflected various ailments experienced by students and revealed through dissections of the donors. The top three emotions were trust, joy, and anticipation. Each body region evoked a unique combination of emotions. Similarities between student self-reflections and reflections about their donor were evident suggesting a shared view of humanization and person centeredness. Given the pervasiveness of reflections in anatomy, adopting a natural language processing approach to analysis could provide a rich source of new information related to students' previously undiscovered experiences and competencies.

Master of nursing specialist experiences of an internship through the use of written reflections: A qualitative research study.

Background: Reflective practice is an educational strategy and an essential part of the professional development of nurses. However, there are few reflective journals in the master of nursing specialist program or clinical nursing education. Objectives: Based on Gibbs' reflective cycle theory, masters of nursing specialists (MNS) will use a diary to record their reflections on a particular clinical event. The purpose of this study was to identify reflective practice as tool to help MNS improve their professional and personal development. Design: A descriptive qualitative study. Methods: The purposive sampling method was used in the qualitative study. The data were derived from the master of nursing specialist who interned at the hospital from June to December 2021. After completing the job rotation and relevant course training within 6 months, a clinical experience was selected as a reflection. The traditional qualitative content analysis method was applied to analyze the collected data in the research. Results: A total of 10 reflective diaries completed by ten students were analyzed. This qualitative study demonstrated that the Gibbs' reflective cycle is valuable and helpful in the clinical practice of master of nursing specialists. This program helps master of nursing specialists reflect on their clinical practice and translate real-life experiences into valuable learning experiences for developing their professional development and personal skills. Conclusions: By writing reflection diaries, master of nursing specialists can reflect on the problems encountered during clinical rotations and take action following that reflection, which can assist them in improving their professional development and personal skills to handle clinical nursing aspects in the future, as well as improve their full participation in clinical practice.