Beyond the Written Reflection: A Systematic Review and Qualitative Synthesis of Creative Approaches to Reflective Learning Amongst Medical Students

Introduction: In medical curricula, reflective learning (RL) mostly consists of writing and small-group discussion, yet accommodating diverse learning preferences is a key factor in developing lifelong reflective practitioners. Medical education uses a number of creative approaches to RL which cater to more diverse learning preferences; however, the overarching benefits of creative RL to students' development is unknown. To understand how creative RL approaches contribute to students' holistic development we performed a qualitative systematic review and synthesis. Methods: Systematic searches of PubMed, PsycINFO, and EMBASE databases identified 4986 unique records, with 15 studies meeting inclusion criteria. Included studies specifically assessed the impact of RL on medical students and utilized creative approaches to RL. Creative approaches were defined as those not predominantly focused on reflective writing or group discussion. Studies were appraised using the Critical Appraisal Skills Programme and the Checklist for Quasi-Experimental Studies. Results: We identified five distinctive RL methods: viewing, performing, creating, imagining, and mind-body. Thematic analysis generated three themes: building and maintaining relationships, personal development, and sense of belonging. These themes incorporated eight sub-themes: recognizing multiple perspectives, empathizing with others, two-way communication skills, patient centered care, processing thoughts and emotions, self-care, interacting positively with peers, and developing trust and commonality. Discussion: Creative RL approaches may foster students' sense of belonging and support interpersonal skills and personal development. In addition, creative RL activities may contribute to medical graduate's holistic development, while providing opportunities to address diverse student needs using innovative, non-conventional methods.