Dear Editor,

We read with interest the workshop described by Shahu and colleagues [1] of using self-reflection to tackle the challenges of medical student clerkship. Reflective writing is a requirement in the curricula of many medical schools around the world, and indeed, in UK medical schools, there is a great emphasis on medical students reflecting on their experiences during clinical placements. As students in our final years of medical school in the UK, we would like to suggest a few additions to the workshops described in order to maximise the benefit that medical students gain from these workshops.

As has been described before, reflection fatigue is something medical students often experience [2, 3]. Although we recognise that reflection is an important part of our future careers in medicine, we feel that its ubiquitous presence in student portfolios might lead to some medical students writing vacuous reflective pieces in order to ‘tick a box’. We therefore suggest that ways to tackle reflection fatigue are incorporated into these workshops. This could include exploring different models of reflection and using these to vary how medical students think about reflection. For example, the workshop could discuss how reflection is not necessarily just about patient interaction; medical students can also reflect on their clinical knowledge, interaction with clinical staff, and other similar aspects of their clerkship.

We would also like to see workshops such as these integrate some guidance on overcoming ‘writer’s block’. We have personally experienced writer’s block when sitting down to write reflective pieces for our portfolios. The writing prompts provided in the study are useful in stimulating reflective thinking, but we suggest that specific tips are included in these workshops for students to overcome writer’s block. These could include reducing distractions (an important point for tech-savvy medical students!), dictating one’s reflections into an audio recorder before writing them, writing one-line points before expounding on them, and other similar tips.

We suggest that the authors of this study consider incorporating our suggestions when further developing their workshops, and that future workshops such as these that are implemented in other medical schools consider reflection fatigue and writer’s block when discussing reflective writing.