Implementing Reflective Writing at a Newly Established Health Science Academy of Nepal: Exploring a Novel Practice, Overcoming Obstacles and Recommendations

Abstract

Establishing new institutions for health professions provides the opportunity to implement innovative approaches catering to the current health needs and also allows to address the inadequacies of well-established institutions. Grabbing this opportunity, we initiated the implementation of reflective practices at Madan Bhandari Academy of Health Sciences, a new provincial university in Nepal. Though literature shows that reflection is a helpful tool to reflect on choices, experiences, and failures and obtain knowledge for the students, the adoption of reflective writing in health professions education in Nepal is limited. Therefore, we looked into the practices from other countries to adopt them in our settings and integrated them into our curriculum. But, we came across many impediments during the process-particularly those related to limited resources. We found innovative solutions like using technology and peer mentoring to overcome these challenges and integrated these practices to initiate reflective writing at the institution. The introspective "talking to oneself" has been a valuable strategy for implementing the reflective practices at our institution. Based on our experiences, we highly recommend educators in Nepal or similar settings embrace team-based writing practices that are contextually appropriate. But, we also recognize the benefits of team-based reflective writing that considers the cultural context. We hope this review will inspire educators, particularly those who lack the resources to initiate such practices at their institution. Our firsthand experience is detailed in this perspective article.

Keywords: curriculum; health professions education; perspective; reflective journal; reflective writing.

Figure 1.

Framework of work-based dialogue on reflective writing adapted from Bjerlöv et al. By the framework of team reflective writing in Figure 1, an individual differentiates different perspectives, which allows the person to decenter oneself and recognize diverse perspectives allowing an individual to resolve issues and generate a new perspective. Incorporating a broader context of immediate importance leads to a formulation of new knowledge and experience. Alteration in understanding may lead to resolution.