Enhancing Professionalism Through Reflections in Obstetrics and Gynecology [5]

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Professional identity formation is a critical competency for medical students. The study objective was to determine the effectiveness of using a reflective assignment in the obstetrics and gynecology clerkship to enhance medical student professional development.


Over a 2 year period, medical students completed a reflective assignment of their experiences in obstetrics and gynecology and received feedback to guide reflective capacity. A validated analytic rubric with high inter-rater agreement was used to assess levels of critical reflection including respect for the patient, understanding of physician's limitations, analysis of personal emotions, and professional growth. Outcomes were measured by comparing the analytic rubric score from the reflective assignment and standardized patient empathy ratings during an objective-structured clinical exam. Student surveys rated the effectiveness of the reflective assignment in promoting empathy, professional growth and reflective abilities. Paired t tests were used for data analysis.


Eighty-two students participated in the reflective assignment. Common themes included the labor and delivery experience (63.4%), women's health (12.2%), cultural sensitivity (12.2%), fetal demise (7.3%), and gynecologic cancer (4.9%). Standardized patient empathy rating scores were significantly higher in those students with high reflective scores (1.04 vs 2.33, 1=high, 3=low, P<.01). Survey results indicated that the reflective assignment promoted empathy (83.3%), understanding of limitations (91.1%), analysis of emotions (80.0%) and professional growth (85.6%). Feedback on the assignment was the most significant factor in promoting reflective abilities (96.6%).


Fostering professional identity formation in medical students lends itself well to the obstetrics and gynecology experience. Guided reflective capacity improves empathy and promotes professional growth.

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