Purpose Medical schools are increasingly aware of the ways in which physician empathy can have a profound impact on patients’ lives and have developed humanities initiatives to address this concern. Reflective writing in particular is more commonly promoted in medical curricula, but there is limited research on the impact of reflective writing on medical student empathy levels. It aims to find the emotional effects of reflective writing interventions on medical and healthcare students by systemic review. Methods: Two investigators independently reviewed educational publications for critical analysis. This review focused systematically on quantitative papers that measure the impact of reflective writing on empathy. Results: Of the 1,032 studies found on Medline and CINAHL, only 8 used quantitative measures pre- and postwritten reflection to measure any impact on empathy outcomes. The outcomes measured included impact of reflective writing exercises on student wellness, aptitude, and/or clinical skills. Of these studies, a significant change in student empathy was observed in 100% of the studies, demonstrating a significant change in outcomes. Conclusion: Although the lack of homogeneity in outcome measurement in the literature limits possible conclusion from this review, the overwhelmingly positive reporting of outcomes suggests that reflective writing should be considered in any medical curriculum.
Citations
Citations to this article as recorded by
Impact of reflective writing skill on emotional quotient Swapnali S. Kadam, Shilpa K. Kolhe, Vrushali V. Kulkarni, Poorva A. Sule Medical Journal Armed Forces India.2024; 80(2): 205. CrossRef
Can storytelling of women’s lived experience enhance empathy in medical students? A pilot intervention study Parimala Kanagasabai, Judy Ormandy, Sara Filoche, Claire Henry, Sarah Te Whaiti, Robin Willink, Tehmina Gladman, Rebecca Grainger Medical Teacher.2024; 46(2): 219. CrossRef
A narrative analysis of clerkship reflections: Medical student identity development in a changing world Mahino A. Talib, Richard E. Greene, Abigail Ford Winkel The Clinical Teacher.2024;[Epub] CrossRef
Communication and empathy of nursing students in patient care through telenursing: A comparative cross-sectional study Lorena Gutiérrez-Puertas, Vanesa Gutiérrez-Puertas, Blanca Ortiz-Rodríguez, Gabriel Aguilera-Manrique, Verónica V. Márquez-Hernández Nurse Education Today.2024; 133: 106048. CrossRef
Promoting health education through collaborative writing sessions in the Dominican Republic Helena J Chapman, Bienvenido A Veras-Estévez Health Education Journal.2024; 83(1): 95. CrossRef
Exploring medical students’ perceptions of empathy after cinemeducation based on Vygotsky’s theory Mahla Salajegheh, Amir Ali Sohrabpour, Elaheh Mohammadi BMC Medical Education.2024;[Epub] CrossRef
Reflective capacity and context of reflections: qualitative study of second-year medical students’ learning diaries related to a general practice course Elina Paloniemi, Maria Hagnäs, Ilona Mikkola, Markku Timonen, Ritva Vatjus BMC Medical Education.2024;[Epub] CrossRef
Use and effectiveness of the arts for enhancing healthcare students' empathy skills: A mixed methods systematic review Tracy Levett-Jones, Elizabeth Brogan, Deborah Debono, Mark Goodhew, Natalie Govind, Jacqui Pich, Jo River, Judith Smith, Suzanne Sheppard-Law, Robyn Cant Nurse Education Today.2024; 138: 106185. CrossRef
Reflect to interact – fostering medical students’ communication through reflection-focused e-learning Laura Janssen, Kristina Schick, Tiziana Neurohr, Sylvia Irene Donata Pittroff, Sabine Reiser, Johannes Bauer, Pascal O. Berberat, Martin Gartmeier BMC Medical Education.2024;[Epub] CrossRef
Empathy and shame through critical phenomenology: The limits and possibilities of affective work and the case of COVID‐19 vaccinations Maryam Golafshani Journal of Evaluation in Clinical Practice.2023; 29(7): 1143. CrossRef
Mind The Gap: A Philosophical Analysis of Reflection’s Many Benefits Sven Peter Charlotte Schaepkens, Thijs Lijster Teaching and Learning in Medicine.2023; 35(3): 368. CrossRef
Reflection in the training of general practitioners in clinical practice settings: a scoping review protocol Linda Schumann Scheel, Niels Kristian Kjaer, Casey Marnie, Micah D.J. Peters JBI Evidence Synthesis.2023; 21(7): 1501. CrossRef
Narrative medicine as a teaching strategy for nursing students to developing professionalism, empathy and humanistic caring ability: a randomized controlled trial Mengxin Xue, Huiping Sun, Jin Xue, Jingxin Zhou, Junchao Qu, Siqi Ji, Yuan Bu, Yongbing Liu BMC Medical Education.2023;[Epub] CrossRef
Influence of Emotional Skills on Attitudes towards Communication: Nursing Students vs. Nurses María del Carmen Giménez-Espert, Sandra Maldonado, Vicente Prado-Gascó International Journal of Environmental Research and Public Health.2023; 20(6): 4798. CrossRef
A penny for your thoughts: promoting compassionate medical practice through reflection Kirsty Brownlie Reflective Practice.2023; 24(3): 389. CrossRef
Educational opportunities about ethics and professionalism in the clinical environment: surveys of 3rd year medical students to understand and address elements of the hidden curriculum Wayne Shelton, Sara Silberstein, Lisa Campo-Engelstein, Henry Pohl, James Desemone, Liva H. Jacoby International Journal of Ethics Education.2023; 8(2): 351. CrossRef
Empathy, emotional intelligence and interprofessional skills in healthcare education Jonathan P. McNulty, Yurgos Politis Journal of Medical Imaging and Radiation Sciences.2023; 54(2): 238. CrossRef
An undergraduate course on pain: Its impact on students' empathy Adriana H. van Houwelingen, Ilayda Özaydin, Theo Wubbels Currents in Pharmacy Teaching and Learning.2023; 15(6): 559. CrossRef
Activities to promote empathy for patients among pharmacy learners: A scoping review Kimberly B. Garza, Adelia Grabowsky, Lindsey E. Moseley, Bradley M. Wright, Brandy R. Davis, Channing R. Ford Currents in Pharmacy Teaching and Learning.2023; 15(10): 911. CrossRef
Medical Humanities in Undergraduate Psychiatry Teaching: Learner Assessment and Mediators of Better Learning Outcomes Arvind Rajagopalan, Qian Hui Chew, Kang Sim Journal of Medical Education and Curricular Development.2023;[Epub] CrossRef
The integrated curriculum and student empathy: a longitudinal multi-cohort analysis Christiane R. Herber-Valdez, Julie A. Blow, Tammy T. Salazar, Kathryn V. Horn, Dyanne G. Herrera, Naomi L. Lacy, Lisa Beinhoff, J. Manuel de la Rosa Advances in Health Sciences Education.2023;[Epub] CrossRef
Assessment tools for reflection in healthcare learners: A scoping review Cassandra Préfontaine, Isabelle Gaboury, Hélène Corriveau, Jacinthe Beauchamp, Chantal Lemire, Marie-Josée April Medical Teacher.2022; 44(4): 394. CrossRef
Is reflection like soap? a critical narrative umbrella review of approaches to reflection in medical education research Sven P. C. Schaepkens, M. Veen, A. de la Croix Advances in Health Sciences Education.2022; 27(2): 537. CrossRef
Impact of social pediatrics rotation on residents’ understanding of social determinants of health Kimberly Connors, Marghalara Rashid, Mercedes Chan, Jennifer Walton, Bonnieca Islam Medical Education Online.2022;[Epub] CrossRef
Introspective self-narrative modulates the neuronal response during the emphatic process: an event-related potentials (ERPs) study Daniela Altavilla, Ines Adornetti, Alessandra Chiera, Valentina Deriu, Alessandro Acciai, Francesco Ferretti Experimental Brain Research.2022;[Epub] CrossRef
Supporting resident wellness through reflection on professional identity: A novel curriculum Diana Toubassi, Milena Forte, Lindsay Herzog, Michael Roberts, Carly Schenker, Ian Waters, Erin Bearss Education in the Health Professions.2022; 5(3): 85. CrossRef
Can doctors be taught virtue? Ariel Lefkowitz, Dafna Meitar, Ayelet Kuper Journal of Evaluation in Clinical Practice.2021; 27(3): 543. CrossRef
Sustainable Engaged Accountable Learners Michael A. Gisondi, Jeremy Branzetti, Laura R. Hopson, Linda Regan, Wendy C. Coates AEM Education and Training.2021;[Epub] CrossRef
Reflective Writing on the Cadaveric Dissection Experience: An Effective Tool to Assess the Impact of Dissection on Learning of Anatomy, Humanism, Empathy, Well‐Being, and Professional Identity Formation in Medical Students Matthew P. Abrams, Tabitha Eckert, Daniel Topping, Katherine D. Daly Anatomical Sciences Education.2021; 14(5): 658. CrossRef
Bringing narratives from physicians, patients and caregivers together: a scoping review of published research Tracy Moniz, John Costella, Maryam Golafshani, Chris Watling, Lorelei Lingard Medical Humanities.2021; 47(1): 27. CrossRef
Effectiveness of simulation-based interventions at improving empathy among healthcare students: A systematic review and meta-analysis Joelle Yan Xin Chua, Emily Ang, Siew Tiang Lydia Lau, Shefaly Shorey Nurse Education Today.2021; 104: 105000. CrossRef
Medical Students’ Creation of Original Poetry, Comics, and Masks to Explore Professional Identity Formation Johanna Shapiro, Juliet McMullin, Gabriella Miotto, Tan Nguyen, Anju Hurria, Minh Anh Nguyen Journal of Medical Humanities.2021; 42(4): 603. CrossRef
Incorporating reflective writing into criminal justice courses Amie R. Scheidegger Reflective Practice.2020; 21(1): 122. CrossRef
Why Write? Laura Weiss Roberts, John Coverdale Academic Medicine.2020; 95(2): 169. CrossRef
A Comparison of Guided Video Reflection versus Self-Regulated Learning to Teach Knot Tying to Medical Students: A Pilot Randomized Controlled Trial Peter Zhan Tao Wang, Wen Yan Xie, Shiva Nair, Sumit Dave, John Shatzer, Saad Chahine Journal of Surgical Education.2020; 77(4): 805. CrossRef
Empathy training in health sciences: A systematic review Pilar Bas-Sarmiento, Martina Fernández-Gutiérrez, María Baena-Baños, Alba Correro-Bermejo, Pablo Sergio Soler-Martins, Sonia de la Torre-Moyano Nurse Education in Practice.2020; 44: 102739. CrossRef
Reflections of an Integrated Maternal-Child Health Medical Student Assignment Christopher J. McCauley, J. Alex Miles, Benjamin W. Frush, Gary L. Beck Dallaghan, Sofia Aliaga, Maria Ferris, Richard Hobbs Maternal and Child Health Journal.2020; 24(6): 679. CrossRef
Content and outcomes of narrative medicine programmes: a systematic review of the literature through 2019 Christy DiFrances Remein, Ellen Childs, John Carlo Pasco, Ludovic Trinquart, David B Flynn, Sarah L Wingerter, Robina M Bhasin, Lindsay B Demers, Emelia J Benjamin BMJ Open.2020; 10(1): e031568. CrossRef
Interpersonal communication, empathy, and stress perceived by nursing students who use social networks Lorena Gutiérrez‐Puertas, Verónica V. Márquez‐Hernández, Vanesa Gutiérrez‐Puertas, Genoveva Granados‐Gámez, Gabriel Aguilera‐Manrique Journal of Advanced Nursing.2020; 76(10): 2610. CrossRef
Response to: an exploratory cross-sectional study on the relationship between dispositional mindfulness and empathy in undergraduate medical students Sithhipratha Arulrajan, Nazifa Ullah, Pranavan Pavanerathan Medical Education Online.2020;[Epub] CrossRef
The Impact of Meeting Patients with Neurological Disorders on Medical Student Empathy Catherine Eve Tisdale, Asa C. Black, Sandip Jain, Ervin Lowther, Lee Madeline, Chris Troup, Thomas Nathaniel, L. A. Fowler Medical Science Educator.2020; 30(4): 1561. CrossRef
Added value of assessing medical students’ reflective writings in communication skills training: a longitudinal study in four academic centres Camila Ament Giuliani Franco, Renato Soleiman Franco, Dario Cecilio-Fernandes, Milton Severo, Maria Amélia Ferreira, Marco Antonio de Carvalho-Filho BMJ Open.2020; 10(11): e038898. CrossRef
Reflective writing: Implementation and learning perception from students and teachers of French nursing schools Tony Timizar-Le Pen, Claire Marchand, Marie Léocadie, Monique Rothan-Tondeur Nurse Education in Practice.2020; 49: 102921. CrossRef
Innovative Communication Learning: Combining TED Talks and Reflective Writing for Nursing Students Maureen Hillier, Donna Luff, Elaine C. Meyer Creative Nursing.2020; 26(3): 182. CrossRef
A Four-Week Reflective Writing Program in the Psychiatry Clerkship: Testing Effects on Reflective Capacity Charles A. Whitmore, Joseph Sakai, Susan K. Mikulich-Gilbertson, Robert D. Davies Academic Psychiatry.2019; 43(2): 171. CrossRef
Reflective Practices Among Global Health Fellows in the HEAL Initiative: a Qualitative Study Zachary G. Jacobs, Robin Tittle, Joseph Scarpelli, Karen Cortez, Samuel D. Aptekar, Sriram Shamasunder Journal of General Internal Medicine.2019; 34(4): 521. CrossRef
Empathy assessment in healthcare students is highly heterogeneous: A systematic review and meta-analysis (2012-2016) Konstantinos C Fragkos, Ioannis Sotiropoulos, Christos C Frangos World Journal of Meta-Analysis.2019; 7(1): 1. CrossRef
Practical Tips for Implementing a Student-Led Reflective Writing Workshop Series Andi Shahu, Alyssa R. Thomas, Eli Neustadter, Anna Reisman Medical Science Educator.2019; 29(3): 863. CrossRef
Teaching empathy to nursing students: A randomised controlled trial Pilar Bas-Sarmiento, Martina Fernández-Gutiérrez, Mercedes Díaz-Rodríguez, Concepción Carnicer-Fuentes, Cristina Castro-Yuste, María José García-Cabanillas, Cristina Gavira-Fernández, María de los Ángeles Martelo-Baro, Olga Paloma-Castro, María del Carmen Nurse Education Today.2019; 80: 40. CrossRef
Do Sociology Courses Make More Empathetic Students? A Mixed-Methods Study of Empathy Change in Undergraduates Ashley Rockwell, Chris M. Vidmar, Penny Harvey, Leanna Greenwood Teaching Sociology.2019; 47(4): 284. CrossRef
How does medical education affect empathy and compassion in medical students? A meta-ethnography: BEME Guide No. 57 Charmaine Krishnasamy, Sik Yin Ong, May Eng Loo, Jill Thistlethwaite Medical Teacher.2019; 41(11): 1220. CrossRef
Developing EFL students’ digital empathy through video production Cheryl Wei-yu Chen System.2018; 77: 50. CrossRef
Use of mixed-methods approach to assess the impact of a pre-professional health humanities honors course on developing interpersonal skills Haley N. Ilcewicz, Therese I. Poirier, Junvie Pailden Currents in Pharmacy Teaching and Learning.2018; 10(11): 1456. CrossRef
Narrative Praxis: Erzählungen als Vermittler zwischen Erfahrungswelten im Gesundheitswesen Vera Kalitzkus Leidfaden.2018; 7(4): 37. CrossRef
Narrative medicine educational project to improve the care of patients with chronic obstructive pulmonary disease Antonietta Cappuccio, Alessandro Sanduzzi Zamparelli, Massimo Verga, Stefano Nardini, Alessandro Policreti, Pasquale Alberto Porpiglia, Silvia Napolitano, Maria Giulia Marini ERJ Open Research.2018; 4(2): 00155-2017. CrossRef
Goals of care conversation teaching in residency – a cross-sectional survey of postgraduate program directors Amanda Roze des Ordons, Aliya Kassam, Jessica Simon BMC Medical Education.2017;[Epub] CrossRef
What Do Pediatric Residents Gain From an Experience in Juvenile Justice? A Qualitative Analysis of Community-Based Learning Elizabeth R. Hanson, Erin P. Finley, Jean A. Petershack Academic Pediatrics.2017; 17(3): 296. CrossRef
Exploring the Facets of Empathy and Pain in Clinical Practice: A Review Jenny Roche, Dominic Harmon Pain Practice.2017; 17(8): 1089. CrossRef
Student perceptions of the impact and value of incorporation of reflective writing across a pharmacy curriculum Amber E. King, Andrea S. Joseph, Elena M. Umland Currents in Pharmacy Teaching and Learning.2017; 9(5): 770. CrossRef
Efficacy of empathy training in nursing students: A quasi-experimental study Pilar Bas-Sarmiento, Martina Fernández-Gutiérrez, María Baena-Baños, Jose Manuel Romero-Sánchez Nurse Education Today.2017; 59: 59. CrossRef
Medical Students’ Empathy for Vulnerable Groups: Results From a Survey and Reflective Writing Assignment Caroline Wellbery, Pamela A. Saunders, Sarah Kureshi, Adam Visconti Academic Medicine.2017; 92(12): 1709. CrossRef
Meeting the Challenge of a More Person-Centered Future for us Healthcare Bonnie R. Sakallaris, William L. Miller, Robert Saper, Mary Jo Kreitzer, Wayne Jonas Global Advances in Health and Medicine.2016; 5(1): 51. CrossRef
Medical students’ creative projects on a third year pediatrics clerkship: a qualitative analysis of patient-centeredness and emotional connection Johanna Shapiro, Diane Ortiz, You Ye Ree, Minha Sarwar BMC Medical Education.2016;[Epub] CrossRef
The Emerging Issue of Digital Empathy Christopher Terry, Jeff Cain American Journal of Pharmaceutical Education.2016; 80(4): 58. CrossRef
Reflective Practice in Healthcare Education: An Umbrella Review Konstantinos Fragkos Education Sciences.2016; 6(4): 27. CrossRef
La formazione alle soft skills nel Corso di laurea in Medicina: uno studio qualitativo sulle scritture riflessive di un campione di studenti Lucia Zannini, Maria Benedetta Gambacorti-Passerini, Pier Maria Battezzati EDUCATIONAL REFLECTIVE PRACTICES.2016; (2): 9. CrossRef
Reflective Writing David M. Naeger, Ethan W. Hua, Bren Ahearn, Emily M. Webb Academic Radiology.2015; 22(10): 1221. CrossRef
Considerations in the use of reflective writing for student assessment: issues of reliability and validity Tracy Moniz, Shannon Arntfield, Kristina Miller, Lorelei Lingard, Chris Watling, Glenn Regehr Medical Education.2015; 49(9): 901. CrossRef
Professional Identity Formation in Medical Education for Humanistic, Resilient Physicians Hedy S. Wald, David Anthony, Tom A. Hutchinson, Stephen Liben, Mark Smilovitch, Anthony A. Donato Academic Medicine.2015; 90(6): 753. CrossRef
Learning from Primary Health Care Centers in Nepal: reflective writings on experiential learning of third year Nepalese medical students Rolina Dhital, Madhusudan Subedi, Neeti Prasai, Karun Shrestha, Milan Malla, Shambhu Upadhyay BMC Research Notes.2015;[Epub] CrossRef
One-Year Progress in Ophthalmic Education Eduardo Mayorga, Karl Golnik, Gabriela Palis Asia-Pacific Journal of Ophthalmology.2015; 4(6): 388. CrossRef