International Helath Humanities Network: Humanities Subject Area Reports

Fostering Reflective Capacity with Interactive Reflective Writing in Health Professions Education

Short Description

Reflective capacity, i.e. the critical analysis of knowledge and experience – connecting with affective experience - to achieve deeper meaning and understanding, guiding future behavior is integral to core health care professional practice competencies. The use of reflection can foster empathy and humanistic practice and help guide health care practitioners as they encounter the complexity that is inherent to clinical practice.

Full Impact Narrative

“Interactive” reflective writing with integration of written feedback from faculty can foster learners’ development of more sophisticated reflection skills within health professions education (Wald et al, 2009). Formal analytic frameworks have been developed, ie. the “BEGAN” tool (Reis et al, 2010; Wald et al, 2010) and “REFLECT” rubric (Wald et al, 2012) to assess reflective writing and to guide faculty with crafting quality formative written feedback to learners’ narratives to enhance depth and breadth of reflection. These frameworks (and guidance on facilitating collaborative reflection- with narratives as springboard- within small group process) have recently been introduced within interprofessional faculty development workshops (medicine, nursing, dentistry, physical and occupational therapy, eg. Wald, 2012) including faculty development workshops for palliative care teams (medical, nursing, social work, and divinity students) to help enhance narrative reflective practice and ideally optimize patient-centered care.    


Wald, H. 2012,

Wald HS, Davis SW, Reis SP, Monroe AD, Borkan JM. Reflecting on reflections: medical education curriculum enhancement with structured field notes and guided feedback. Acad Med., 2009; 84(7):830–7.

Reis SP, Wald HS,Monroe AD, Borkan JM. Begin the BEGAN (The Brown Educational Guide to the Analysis of Narrative)- A framework for enhancing educational impact of faculty feedback to students’ reflective writing. Pt Educ Counsel., 2010; 80(2): 253-9.

Wald HS, Reis SP, Monroe AD, Borkan JM. “The Loss of My Elderly Patient”: Interactive reflective writing to support medical students’ rites of passage. Med. Teacher, 2010; 32(4): e178-84.

Wald HS, Borkan JM, Taylor JS, Anthony D, Reis SP. Fostering and evaluating reflective capacity in medical education: Developing the REFLECT rubric for assessing reflective writing. Acad Med. 2012; 87:41–50.

Contact Information

Hedy S. Wald, PhD

Clinical Associate Professor of Family Medicine, Warren Alpert Medical School of Brown University

Humanities Subjects

Health Care Areas


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