Grading reflective essays: the reliability of a newly developed tool- GRE-9
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Grading reflective essays: the reliability of a newly developed tool- GRE-9 Nisrine N. Makarem1, Basem R. Saab1*, Grace Maalouf1, Umayya Musharafieh1, Fadila Naji1, Diana Rahme1 and Dayana Brome2
Abstract Background: The main objective of this study is the development of a short reliable easy-to-use assessment tool in the aim of providing feedback to the reflective writings of medical students and residents. Methods: This study took place in a major tertiary academic medical center in Beirut, Lebanon. Seventy-seven reflective essays written by 18 residents in the department of Family Medicine at the American University of Beirut Medical Center (AUBMC) were graded by 3 raters using the newly developed scale to assess the scale reliability. Following a comprehensive search and analysis of the literature, and based on their experience in reflective grading, the authors developed a concise 9-item scale to grade reflective essays through repeated cycles of development and analysis as well as the determination of the inter-rater reliability (IRR) using intra-class correlation coefficients (ICC) and Krippendorff’s Alpha. Results: The inter-rater reliability of the new scale ranges from moderate to substantial with ICC of 0.78, 95% CI 0.64–0.86, p < 0.01 and Krippendorff’s Alpha was 0.49. Conclusions: The newly developed scale, GRE-9, is a short, concise, easy-to-use reliable grading tool for reflective essays that has demonstrated moderate to substantial inter-rater reliability. This will enable raters to objectively grade reflective essays and provide informed feedback to residents and students. Keywords: Reflective writing, Reflective articles, Grading tools, Reflection
Background Reflective practice within medical education is considered an essential aspect of lifelong self-directed learning becoming a crucial element of the medical program at all its levels aiming towards a competence-based curriculum [1]. The idea of reflective practice was first established by Schon in 1987 and characterized by three stages: awareness of thoughts and feelings, critical analysis of a condition, and development of a new viewpoint of the situation [2]. Hence, it follows that reflection allows the development and integration of new knowledge into practice leading to * Correspondence: [email protected] 1 Department of Family Medicine, American University of Beirut-Medical Center, Riad El-Solh, P. O Box 11-0236, Beirut 1107 2020, Lebanon Full list of author information is available at the end of the article
the core experience of greater professional competence [3]. A growing body of research with regard to reflection in the medical education literature highlighted the relationship between reflective capacity and the enhancement of physician competence [4–7]. Given the beneficial consequences of reflection [8], medical educators have sought to explore a variety of methods for fostering and assessing reflection in learners, ranging from one-to-one mentoring [9] to guided discussions [10], digital approach
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