Date of Award

January 2017

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Anna Reisman

Abstract

NEAR-PEER REFLECTIVE WRITING WORKSHOPS: SAFE SPACE, SOLIDARITY, CONVERSATION, AND DEBRIEFING.

Kayleigh Herrick-Reynolds (Sponsored by Anna Reisman). Section of General Medicine, Department of Internal Medicine, Yale University, School of Medicine, New Haven, CT.

Medical students experience challenging situations during the clerkship year, but often lack opportunities to debrief. The near-peer reflective writing workshop at Yale School of Medicine (YSM) is a student-led session that is integrated into the didactic portion of the clerkships. We hypothesized that near-peers can create a safe environment for honest reflection, that this experience can create a rigorous perception of reflection, and that the mixed peer groups in these workshops can increase the sense of community.

Data was collected over one year from students in their clinical clerkships. Facilitators were trained near-peer volunteers who led students through a series of progressively more challenging writing prompts in a 1 hour and fifteen minute session. Open-ended evaluations were distributed after each session, and a final more detailed questionnaire was distributed at the end of the year. Facilitators also completed an end-of-year questionnaire. Open-ended answers were analyzed through an inductive, randomized, and iterative consensus process within a phenomenological framework.

Most students (62%) indicated that they would choose to attend the workshop even if they were not mandatory. Participants and facilitators alike agreed that they should become a standardized part of medical education. Facilitators and participants reported an increased sense of community from these workshops, and they provided a safe space for reflection. Students were surprised by how willing peers were to share their experiences, and they valued having protected time for reflection. The structure of the workshop helped facilitate recall and reflection. The workshops helped students process experiences, and encouraged them to focus more on empathy and emotions in clinical care. Students indicated that they would be more likely to share various challenging topics in a group led by a near-peer rather than a faculty member. Many indicated that this workshop would encourage them to increase reflective practice moving forward.

The YSM near-peer reflective writing workshop had an overwhelmingly positive reception by medical students, and has the potential to mitigate isolation and stress during the clerkship year. It may encourage medical students to change their perception of reflection, and continue to practice it throughout their careers.

Comments

This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.

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