Reflective writing and its impact on empathy in medical education: systematic review

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. 

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. 

Of the 1032 studies found on MEDLINE and CINAHL, only 8 used quantitative measures pre- and post-written 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. Conclusions: 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.

Isabel Chen