"I will never forget": what we learned from medical student reflections on a palliative care experience.

Purpose: To use reflective writing to evaluate a new required palliative care experience for third year medical students.

Method: The authors used a constant comparison method based on grounded theory to conduct a thematic analysis of reflective writings produced by third-year medical students completing a mandatory week-long clinical rotation in palliative care during academic year 2010 at the University of Louisville.

Results: Two broad thematic categories were identified: what the students learned and what the students experienced. Student writings revealed learning about palliative care (pain management, family meetings, goals of care, patient-family centered care, timing of palliative care, and delivering bad news); being a doctor (knowledge, communication, presence, empathy, not giving false hope, and person-focused care); the patient (importance of family, the experience of dying, and the uniqueness of each patient); and themselves (need to be non-judgmental, ability to do palliative care, self-limitations, becoming a better physician, and dealing with death). Student reflections centered on encounters with patients and families, internal emotional responses, and self-transformation.

Conclusions: Systematic analysis of reflective writing provides educators with valuable data about students' learning experiences. These results may inform the design and modification of the curriculum.