Do writing and storytelling skill influence assessment of reflective ability in medical students' written reflections?

BACKGROUND Increasingly, students are asked to write reflections as part of their medical education, but some question the influence of other factors on the evaluation of these reflections. In this pilot study, the investigators determined whether scores from a validated rubric to measure reflective ability were affected by irrelevant variance resulting from writing or storytelling ability. METHOD Students in clerkships wrote reflections on professionalism. All were given identical prompts, with half receiving additional structured guidelines on reflection. Sixty reflections, 30 from each group, were randomly chosen and scored for reflection, writing, and storytelling by trained raters using validated rubrics. RESULTS There was no correlation between reflection and either writing (r = 0.049, P = .35) or storytelling (r = 0.14, P = .13). The guidelines increased reflection, but not writing or storytelling scores. CONCLUSIONS Reflection is a distinct construct unaffected by learners' writing or storytelling skills. These findings support reflective ability as a distinct skill.