Medicine has become a profession with increasing accountability to the needs of society. To meet this need, real-world, community-located experiences and reflection are frequently used to promote students' learning and personal growth. This article reports first-year medical students' reflective writing after visiting a primary healthcare clinic. A construct including affective, cognitive and behavioural components was used to analyse the data. Powerful observations were made on students' experience of the health care services available to a sector of the public who are state dependent for healthcare. The study shows that experience-based learning helps students to 'see' in ways they have never seen before, and that guided reflection promotes critical reflection and thus transformative learning.
IntroductionEncouraging students to use reflection to enhance self-awareness is currently considered an interesting and worthwhile challenge. This is so because higher learning of good quality no longer embraces only knowing, but also acting and being (Illeris, 2004). The latter component falls into the affective domain of learning and refers to a range of qualities and dispositions such as emotions, opinions, feelings, motivations, attitudes, beliefs and values. These qualities include the concept of self-awareness and self-understanding.Reflection points to a thinking process that allows for the integration of practical experience with an understanding of that experience, in order to enhance future choices or actions and to improve a person's overall effectiveness (Rogers, 2001). As such, reflection is at the heart of preparing graduates emerging from institutions of higher education as holistically prepared, civically minded human beings, capable of reflecting on experiences in order to transform the world into a better place for all.This article gives an account of an ongoing enquiry into the reflective writing of first-year medical students enrolled for the Bachelor of Medicine and Bachelor of Surgery degrees (MBChB) at the University of the Free State. A qualitative interpretive study was done to ascertain the degree to which the intended outcomes of a reflective writing assignment had been achieved.