P3.Q336: Developing reflective practitioners- A qualitative analysis of reflective writing after a four-week rotation in community pediatrics

Background: Reflective writing is increasingly becoming a part of the medical education curriculum. While traditional assessment measures usually cognitive intelligence, reflection is an important strategy for understanding the learner as a person and the impact a rotation or an experience can make on their professional development. Through the assessment of reflective essays, this study aims to understand residents learning of community resources and the impact on their patient care, rotating through community pediatrics rotation in the Michigan State –Sparrow Hospital pediatric residency program.

Methods: Residents (n=8) rotate through the community pediatrics curriculum for four weeks. They are expected to experience community resources (early childhood services, Center for grieving children, WIC, Social worker, nutrition, etc.) apart from rotating in outpatient clinics. At the end of the rotation, residents write a reflective essay on their community experiences. The research team reviewed 40 essays from 2019-2024. An inductive qualitative analysis using the grounded theory model was used to identify codes using the constant comparative method. MSU-IRB deemed the study exempt.

Results: Coding these reflective essays reveals that residents value learning about community resources through the rotation and intend to utilize these resources for their own patient panel. Their understanding of social determinants of health increased, as evidenced by an understanding of resources available for patients with Medicaid/Medicaid plans compared to private insurance. The common themes were cultural sensitivity when dealing with mental health and weight issues, individualized care, the impact of preventive care on societal health, and the impact of collaborative health care between various resources.

Conclusion: Reflective writing complements traditional assessment with a more rounded approach to a resident's experience. It helps to understand their self-growth, understanding of the objectives of the rotation, and engagement combined with a traditional assessment. The reflective essay can also be used to assess resident understanding and meeting the system-based practice competency.