Article review: Self-reflection using blogs

Self-reflection is an unique metacognition learning tool. It is increasingly being used in medical education (another prior blog entry). Traditionally, reflection pieces are writing assignments which are shared amongst peers in faculty-facilitated, small-group discussions.

With the advent of new technologies, such as blogs (web-logs), how does blogging one's self-reflection pieces compare to the traditional method?

Some of the research questions included:

• How does the level of reflection evident in student writings compare between the two methods?
• How do reflective writing themes compare between the two methods?
• What are student perceptions of their respective assignments?

Methodology
Internal medicine clerkships at two different US medical schools over two consecutive blocks were quasi-randomized into the control (written essay) or the experimental (blog) group. Convenience sampling made it possible that each study arm enrolled relatively equal numbers of students between the two sites.

Control group: Wrote a single reflective essay, which were shared in 2-hour, faculty-facilitated, face-to-face, small-group discussion.

Study group: Wrote 2 blog posts and provided at least 1 comment on a peer's blog post. A faculty member provided online commentary and feedback.

The reflection pieces were thematically coded by 2 coders with 91% agreement.

Results
There were 95 total study participants (control group n=45; study group n=50).

Seven themes were found in the reflective writings for the 95 study participants.

• Being humanistic
• Professional behaviour
• Understanding caregiving relationships
• Being a student
• Clinical learning
• Dealing with death and dying
• The health care system, quality, safety and public health

Both study groups demonstrated similar distribution of themes and depths of reflection. Post-clerkship surveys showed that students who were in the control group favored written reflections with face-to-face discussions and the blogging group favored blogging. This means that both approaches are likely effective.

Bottom Line
Blogging technology provides educators another option where reflections can be shared and discussed.


Reference
Fischer MA, Haley HL, Saarinen CL, Chretien KC. Comparison of blogged and written reflections in two medicine clerkships. Medical Education. 2011; 45 (2), 166-75 PMID: 21208262
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