Health professionals and students' experiences of reflective writing in learning: A qualitative meta-synthesis.
BACKGROUND
Reflective writing provides an opportunity for health professionals and students to learn from their mistakes, successes, anxieties, and worries that otherwise would remain disjointed and worthless. This systematic review addresses the following question: "What are the experiences of health professionals and students in applying reflective writing during their education and training?"


METHODS
We performed a systematic review and meta-synthesis of qualitative studies. Our search comprised six electronic databases: MedLine, Embase, Cinahl, PsycINFO, Eric, and Scopus. Our initial search produced 1237 titles, excluding duplicates that we removed. After title and abstract screening, 17 articles met the inclusion criteria. We identified descriptive themes and the conceptual elements explaining the health professionals' and students' experience using reflective writing during their academic and in-service training by performing a meta-synthesis.


RESULTS
We identified four main categories (and related sub-categories) through the meta-synthesis: reflection and reflexivity, accomplishing learning potential, building a philosophical and empathic approach, and identifying reflective writing feasibility. We placed the main categories into an interpretative model which explains the users' experiences of reflective writing during their education and training. Reflective writing triggered reflection and reflexivity that allows, on the one hand, skills development, professional growth, and the ability to act on change; on the other hand, the acquisition of empathic attitudes and sensitivity towards one's own and others' emotions. Perceived barriers and impeding factors and facilitating ones, like timing and strategies for using reflective writing, were also identified.


CONCLUSIONS
The use of this learning methodology is crucial today because of the recognition of the increasing complexity of healthcare contexts requiring professionals to learn advanced skills beyond their clinical ones. Implementing reflective writing-based courses and training in university curricula and clinical contexts can benefit human and professional development.
['Artioli|Giovanna|G|http://orcid.org/0000-0002-1810-0857', 'Deiana|Laura|L|', 'De Vincenzo|Francesco|F|', 'Raucci|Margherita|M|', 'Amaducci|Giovanna|G|', 'Bassi|Maria Chiara|MC|', 'Di Leo|Silvia|S|', 'Hayter|Mark|M|', 'Ghirotto|Luca|L|']
D002983:Clinical Competence D003479:Curriculum D006282:Health Personnel D006801:Humans D013334:Students D014956:Writing
Health professionals reflective writing qualitative meta-synthesis Health care education Health students