What makes a good reflective paper?

BACKGROUND AND OBJECTIVES Reflective papers are increasingly recognized as potentially important contributors to clinical education and practice; however, few quality guidelines are available for potential authors or reviewers. We sought to identify key characteristics of effective reflective papers and to clarify factors that increased or reduced the probability of acceptance for publication. METHODS A 10-item survey addressing the definition, purpose, and quality characteristics of reflective papers was developed based on a literature review and analysis of the author instructions of 14 journals that regularly publish reflective papers and are likely to be read by primary care physicians. The survey was sent electronically to the editor or associate editor responsible for reflective papers at each journal. RESULTS Seven completed surveys were returned. The essential element defining a reflective paper was identified as narration of a specific professional experience that resonated with readers and conveyed deeper meaning. All respondents rated emotional engagement as very important, followed by stimulating reflection in the reader, providing a lesson applicable to patient care, and stimulating discussion with colleagues and/or learners. Reasons for acceptance or rejection of reflective submissions to journals were identified in issues related to writing style, topic selection, and reader reaction. CONCLUSIONS Writing and reviewing reflective papers is strongly dependent on context, personal values, experience, and emotional reaction; nevertheless, core quality features can be identified to guide both writers and editors/reviewers without destroying the unique nature of these papers.