reflective essay health and social care

• Research article
• Open access
• Published: 22 July 2021

Health professionals and students’ experiences of reflective writing in learning: A qualitative meta-synthesis

• Giovanna Artioli   ORCID: orcid.org/0000-0002-1810-0857 1 ,
• Laura Deiana 2 ,
• Francesco De Vincenzo 3 ,
• Margherita Raucci 1 ,
• Giovanna Amaducci 1 ,
• Maria Chiara Bassi 1 ,
• Silvia Di Leo 1 ,
• Mark Hayter 4 &
• Luca Ghirotto 1  

BMC Medical Education volume  21 , Article number:  394 ( 2021 ) Cite this article

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Reflective writing provides an opportunity for health professionals and students to learn from their mistakes, successes, anxieties, and worries that otherwise would remain disjointed and worthless. This systematic review addresses the following question: “What are the experiences of health professionals and students in applying reflective writing during their education and training?”

We performed a systematic review and meta-synthesis of qualitative studies. Our search comprised six electronic databases: MedLine, Embase, Cinahl, PsycINFO, Eric, and Scopus. Our initial search produced 1237 titles, excluding duplicates that we removed. After title and abstract screening, 17 articles met the inclusion criteria. We identified descriptive themes and the conceptual elements explaining the health professionals’ and students’ experience using reflective writing during their academic and in-service training by performing a meta-synthesis.

We identified four main categories (and related sub-categories) through the meta-synthesis: reflection and reflexivity, accomplishing learning potential, building a philosophical and empathic approach, and identifying reflective writing feasibility. We placed the main categories into an interpretative model which explains the users’ experiences of reflective writing during their education and training. Reflective writing triggered reflection and reflexivity that allows, on the one hand, skills development, professional growth, and the ability to act on change; on the other hand, the acquisition of empathic attitudes and sensitivity towards one’s own and others’ emotions. Perceived barriers and impeding factors and facilitating ones, like timing and strategies for using reflective writing, were also identified.

Conclusions

The use of this learning methodology is crucial today because of the recognition of the increasing complexity of healthcare contexts requiring professionals to learn advanced skills beyond their clinical ones. Implementing reflective writing-based courses and training in university curricula and clinical contexts can benefit human and professional development.

Peer Review reports

Education of healthcare professionals supportstheir transformation into becoming competent professionals [ 1 ] and improves their reasoning skills in clinical situations. In this context, reflective writing (RW) is encouraged by both universities, and healthcare training providersencourage reflective writing (RW) since its utility in helping health students and professionals nurture reflection [ 2 ], which is considered a core element of professionalism. Furthermore, the ability to reflect on one’s performance is now seen to be a crucial skill for personal and professional development [ 3 ]. Writing about experiences to develop learning and growth through reflection is called ‘reflective writing’ (RW). RW involves the process of reconsidering an experience, which is then analyzed in its various components [ 4 , 5 ]. The act of transforming thoughts into words may create new ideas: the recollection of the experience to allow a deeper understanding of it, modifying its original perception, and creating new insights [ 6 ]. RWis the focused and recurrent inspection of thoughts, feelings, and events emerging from practice as applied to healthcare practice [ 7 ].

Reflection may be intended as a form of mental processing or thinking used by learners to fulfill a purpose or achieve some anticipated outcome [ 2 ]. This definition recalls Boud and colleagues’ view of reflection as a purposive activity directed towards goals [ 8 ]. For those authors, reflection involves a three-stage process, including recollection of the experience, attending to own feelings, and re-evaluating the experience. This process can be facilitated by reflective practices, among which RW is one of the main tools [ 9 ].

Between reflection-on-action (leading to adjustments to future learning and actions) and reflection-in-action (where adjustments are made at the moment) [ 10 ], RW can be situated in the former. It involves theprofessional’s reflections and analysis of experiences in clinical practice [ 11 , 12 ]. Mainly,RWinvolves the recurrent introspection ofone’s thoughts, feelings, and events within a particular context [ 13 ]. Several studies highlight how RWinfluencespromoting critical thinking [ 14 ], self-consciousness [ 15 ], and favors the development of personal skills [ 16 ], communication and empathy skills [ 4 , 17 ], and self-knowledge [ 3 ]. Thanks to the writing process, individuals may analyze all the components of their experience and learn something new, giving new meanings [ 5 ]. Indeed, putting down thoughts into words enables the individual to reprocess the experience, build and empower new insights, new learnings, and new ways to conceive reality [ 6 , 18 , 19 , 20 ].

Furthermore, RW provides an opportunity to give concrete meaning to one’s inner processes, mistakes, successes, anxieties, and worries that otherwise would remain disjointed and worthless [ 21 , 22 ]. The reflective approach of RW allows oneself to enter the story, becoming aware of our professional path, with both an educational and therapeutic effect [ 23 ].

Reflection as practically sustained by RW commonly overlaps with the process of reflexivity. As noted elsewhere [ 24 ], reflection and reflexivity originate from different philosophical traditionsbut have shared similarities and meanings. In the context of this article, we adopt two different working definitions of reflection and reflexivity. Firstly, we draw from the work of Alexander [ 25 ]: who explains reflection as the deliberation, pondering, or rumination over ideas, circumstances, or experiences yet to be enacted, as well as those presently unfolding or already passed [ 25 ]. Reflexivity at a meta-cognitive level relates to finding strategies to challenge and questionpersonal attitudes, thought processes, values, assumptions, prejudices, and habitual actions to understand the relationships’ underpinning structure with experiences and events [ 26 ]. In other words, reflexivity can be defined as “the self-conscious co-ordination of the observed with existing cognitive structures of meaning” [ 27 ].

Given those definitions,a philosophical framework for helping health trainees and professionals conduct an exercise that can be helpful to them, their practice, and – ultimately – their patients can be identified. There is a growing body of qualitative literature on this topic – which is valuable – but the nature of qualitative research is that it creates transferrable and more generalizableknowledge cumulatively. As such, bodies of qualitative knowledge must besummarized and amalgamated to provide a sound understanding of the issues – to inform practice and generate the future qualitative research agenda. To date, this has not been done for the qualitative work on reflective writing: a gap in the knowledge base our synthesis study intends to address by highlighting what connects students and professionals while using RW.

This systematic review addresses the following question: “What are the experiences of health professionals and students in applyingRWduring their education and training?”

This systematic review and meta-synthesis followed the 4-step procedure outlined by Sandelowski and Barroso [ 28 , 29 ], foreseeing a comprehensive search, appraising reports of qualitative studies, classification of studies, synthesis of the findings. Systematic review and meta-synthesis referto the process of scientific inquiry aimed at systematically reviewing and formally integrating the findings in reports of completed qualitative studies [ 29 ].

The article selection processwas summarized as a PRISMA flowchart [ 30 ]; the search strategy was based on PICo (Population, phenomenon of Interest, and Context),and the study results are reported in agreement with Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines [ 31 ].

Selection criteria

Inclusion criteria for the meta-synthesis were:

Primary qualitative studies published in peer-reviewed English journals.

With health professionals or health studentsas participants.

UsingRW in learning contexts (both pre-and in-service training).

Mixed methods where the qualitative part can be separated.

Articles should report the voice of participants (direct quotations).

Given the meta-synthesis indications, we excluded quantitative studies, non-primary research articles, meta-synthesis of qualitative studies, literature and systematic reviews, abstracts, unpublished reports, grey literature. In addition, we also excluded studies where participants were using RW in association with other learning tools and where the personal experience was not about using RW exclusively.

Data sources and searches

An experienced information specialist (MCB) performed the literature search on Medline, Embase, Cinahl, PsycInfo, Eric, and Scopus for research articles published from Jan 1st, 2008 to September 30th, 2019,to make sure we incorporated studies reflecting contemporary professional health care experience. Additional searchinginvolved reviewing the references or, and citations to, our included studies.

We filled an Excel file with all the titles and authors’ names. A filter for qualitative and mixed methods study was applied. Table  1 shows the general search strategy for all the databases based on PICo.

Four reviewers (GAr, MR, GAm, LD) independently screened titles and abstracts of all studies, then checked full-text articles based on the selection criteria. We also searched the reference lists of the full-text articles selected for additional potentially relevant studies. Any conflict was solved through discussion with three external reviewers (LG, MCB,SDL, and MH).

Quality appraisal

We used the Critical Appraisal Skills Programme (CASP): it provides ten simple guiding questions and examples to examine study validity, adequacy, and potential applicability of the results of qualitative studies. Guided by the work of Long and colleagues [ 32 ] and previously used in other meta-synthesis [ 33 ], we created 30 items from the 10 CASP questions on quality to ensure we could provide a detailed appraisal of the studies. FDV and LD independently assessed the quality of included studies with any conflicts solved by consulting a third reviewer (MCB and LG). Researchers scored primary studies weighingthe proposed items and ranking the quality of each included study [ 34 ] on high ( n  > 20 items positively assessed), moderate (10 <  n  < 20), or low quality ( n  < 10).

Analysis and synthesis

MCB created a data extraction table, GAr, GAm, and MRdescribed the included articles (Table  2 ). Quotations were extracted manually from the “results/findings” sections of the included studies by GAr, MCB, LDand inserted into adatabase. GAr, GAm, MR, and FDVperformed a thematic analysis of those sections, along with participants’ quotations. Then, they inductively derived sub-themes from the data, performing a first interpretative analysis of participants’ narratives (i.e., highlighting meanings participants interpreted about their experience). The sub-themes were compared and transferred across studies by adding the data into existing sub-themes or creating new sub-themes. Similar sub-themes were then grouped into themes, using taxonomic analysisto conceptually identify the sub-categories and the categories emerging from the participants’ narratives. This procedure allowed us to translate the themes identified from the original studies [ 28 ] into interpretative categories that could amalgamate and refine the experiences of health professionalsor health students on the use of RW [ 29 ]. The final categories are based on the consent of all the authors.

Literature search and studies’ characteristics

A total of 1488 articles were retrieved. Duplicates ( n  = 251) were removed. Then, articles ( n  = 1237) were identified and reviewed by title and abstract. We excluded n  = 1152 articles because they did not match the specified inclusion criteria, based on the title and abstract. Consequently, we assessed 85 full-text articles. Sixty-eight records did not meet the inclusion criteria. At the end of the selection process, 17 reportsof qualitative research were selected. Figure  1 illustrates the search process.

PRISMA flow diagram

Table 2 shows the characteristics of the included studies. Eleven studies involved healthcare students (58%, including nurses, midwives, physiotherapists, doctors, dentists, and oral health students), and six (32%, including doctors, occupational and radiation therapists) were referred to health professionals. In thirteen studies, participants were trained on RW before using it: this information could not be retrieved from the remaining articles.

Five articles reported studies conducted in the US, three in Australia, two in Canada, and two in Israel. The other studies were carried out in Italy, UK, Korea, Taiwan, and Sweden.

Critical appraisal results

We critically evaluatedall 17 studies to highlight the methodological strengthsand weaknesses of the selected studies. No article was removed on a quality assessment basis. Results of the quality appraisal are reported in Table 2 .

Meta-synthesis findings

Through the meta-synthesis, we identified four main categories (and related sub-categories): (i) reflection and reflexivity; (ii) accomplishing learning potential; (iii) building a philosophical and empathic approach; (iv) identifying reflective writing feasibility (for the complete dataset, please refer to supplemental material , where we have listed a selection of meaningful quotations of categories and sub-categories).

Given such categories, we developed an interpretative meta-synthesis model (Fig.  2 ) to illustrate the commonalities of the experience of using RW according to both students and professionals: RWas a vehicle for discovering reflection and allowing users to enter personal reflexivity to fulfillone’s learning potential, alongside the building of a philosophical and empathic approach. In their experience, reflection and reflexivity generate different skills and competencies: reflection matures skills such as professional skills and the ability to activate change and innovation. Reflexivity allows students and professionals to reach higher levels of competencyconcerning inner development and empathy reaching. Finally, from our analysis, participants, while recognizing the value of RW, also defined factors that could encourage or limit its use. Differences among participants’ groups are also outlined.

Meta-synthesis model: RW as experienced by health professionals and students

Reflection and reflexivity

Within this category, we collected the users’ narratives about the experience of applying RW and its disclosing capacity. By using RW, participants confronted themselves with both reflection and reflexivity. This category includes two sub-categories we named: discovering reflection and entering personal reflexivity.

Discovering reflection

The sub-category shows that experiencingRW deepened their reflection on experiences, practice, and profession. Thanks to RW, professionals, and students could explore previously unexplored topics and learn more about themselves.

“ Writing initiated me to think about my experiences … ” (professional) [ 46 ]. “ I think it’s good for physicians to reflect on what we’re doing ” (professional) [ 50 ]

The analysis showed that RW was considered reflective when it provided an opportunity for those who applied it to stop, reflect and conduct an inner discourse on topics never considered before [ 44 , 46 , 50 ]. Some students affirmed:

“ Helped (me) reflect on positive aspects ” (student) [ 40 ]. “ I don’t usually think too much about what happens to me, but through critical reflective journaling, I was able to think carefully about things happening around me. This activity helped me to look into my mind ” (student) [ 44 ]

This sub-category explains transversal meanings coming from uniformly professionals and students.

Entering personal reflexivity

This sub-category includes data about RW enabling users’reflexivity. In this context, RW was considered training for reflexivity as it enabled participants to question themselves more often [ 48 ], reflect on their experiences [ 35 ], attitudes, actions [ 38 , 45 ], and also reconsider their actions and identify their strengths and weaknesses [ 40 , 44 ].

“ The questions in this study do make me stop and think about things – how I feel about what I’m doing in residency ”(professional) [ 46 ]. “ Helped me ID (identify) my strengths and weaknesses ” (student) [ 40 ] RW also helped eradicate the background noise that my mind does not yet know how to filter out [ 51 ] .

Interesting to note that this sub-category is more present in students’ narratives. While professionals referred to self-reflection practices (probably already acquired in other contexts), students often reported how RW helped them discover reflexivity.

Accomplishing learning potential

Our analysis showed how users RW used the technique to “Accomplish learning potential.”

According to the studies’ participants, RWcan enable a learning performancethat would be difficult to reach otherwise. In this context, participants addressed RW as a tool for“accomplishing learning potential.”Within this category, three sub-categories were highlighted: the improvement of skills, personal and professional growth, and assisting the change and development process.

Improvement of skills

Participants agreed that the development of skills and abilities through RWwas aimed at their clinical skills and –in relevant areas such as question asking – encouraged reflection and research [ 35 , 46 ]. Communication skills were also enhanced, as were their relationship with patients, family,colleagues, and friends [ 35 , 38 , 46 ].

Participants said:

“ Through reflective journal writing, my attitude towards learning has changed. I have been encouraged to be a proactive learner. (...) I have been able to identify necessary places for improvement and through research, question asking, goal-setting (...). I have improved my skills in relevant areas” (student) [ 35 ]. “I feel that it [participation in the study] has been a positive experience by motivating me to improve on my clinical, communication skills, and also my relationships with colleagues, patients, family, and friends ” (professional) [ 46 ]

Participants also reported that,in their experience, RWprovided an opportunity to assess and improve themselves and to enhance their self-confidence [ 38 , 40 ]. Cognitive skills, includinggaining more profoundknowledge and problem-solving, along withtime-management [ 35 , 40 , 46 , 49 ], were also enhanced: RW,therefore,represented a learning mode [ 45 ].

“ Without reflection, I absolutely believe these skills would be more unattainable for me ”(student) [ 35 ]

This sub-category applies more to students’ narratives. Health students mentioned the tools helping them most to develop their skills. Professionals focused principally on what RWcould improve (communication skills or organizational skills).

Personal and professional growth

Participantsidentifiedthat RWhad promoted personal [ 51 ] and professional growth [ 35 , 46 ]. RW meant for participants:an ameliorated attitude towards work [ 46 ]; a development path for one’s job potential [ 38 ]; an enhancement of their introspective knowledge [ 51 ]; an enrichment of their expressive capability [ 38 ];an improvement of their interpersonal relationships with patients and colleagues [ 50 ] and developed their use of critical and reflective thinking [ 38 ].

“ Reflecting introduces a new aspect to clinic that focuses on the individual’s learning experience ” (student) [ 35 ]. “I think that it does change the way that you think about the practice of medicine and your own personal tendencies and your interactions with your patients and colleagues. And I think it can be a really powerful driver of culture change ” (professional) [ 50 ]

This sub-category is more represented among students than professionals. Students are ‘surprised’ at how important RW was to their learning. Professionals still recognized how RW was an essential driver of change for their clinic activities.

Assisting the change and development process

We labeledthe third sub-category“assisting the change and development process.”The changeinvolvedintroducing modifications tothe way of working [ 48 ], assessing what needed to be changed to achieve a work-life balance [ 51 ], understanding elements that did not allow change, and how to act on them in the future, and also considering new and important issues [ 46 ], further information [ 51 ] and new ways of thinking. This sub-category equally explained the meaning given to RW by students and professionals.

“ I think writing answer to some of these questions has allowed me to reflect back on the year and think about specific important topics that I might not have thought about again.” (professional) [ 46 ]. (Reflective journaling encouraged) “Assessing and focusing on the changes that need to be done to achieve the balance in my life and being able to integrate that with my family and in my work as a nurse.” (Student 16/RJ2) [ 51 ]

However, thischange process could not be possible without witnessing change and becoming aware of it [ 38 , 46 ]. This allowedparticipants to ‘see one’slearning history and path of growth,‘have a picture of the problem, handle things differently, and broadening their vision of the problem [ 48 ].

Building a philosophical and empathic approach

The “Reflection and reflexivity” category is closely aligned with the “Building a philosophical and empathic approach” category. Participants defined RW as a means for nurturing an intimate and profound level of learning, i.e., a philosophical and empathic approach towards real-life professional issues. The third category consists of three sub-categories: the ability to find benefits in negativity/adversity, assuming an empathetic attitude, and the awareness of things, experiences,emotions.

Finding benefits in negativity/adversity

According to participants, RWexerted a therapeutic effect by encouraging professionals and students to focus on the present (43)strictly. It seemed that RWeventually reduced their emotional stress [ 44 , 51 ]. Likewise,in the contextofnegative experiences [ 49 ], its practice acted as a catharsis [ 46 ] that could even allow them tolook back at those experiencesafresh – enabling a change in perspective [ 39 ].

“While writing the journal entry, I felt like I was unloading something from inside myself and being set free. This process made me feel better ” (student) [ 44 ]. “It is always good to pause to reflect on my experiences. The most cathartic question was a few months back when I got to describe my really bad experience.” (professional) [ 46 ] “Very therapeutic. I wrote on a bad experience, but at the end, we were laughing at it.” (professional) [ 49 ]

This specific approach allowed the practitioner/trainee to improve their self-care and focus on work objectives [ 51 ]:

“Self-reflection and reflective journaling promote self-understanding and is another part of self-care.” (Student 5/RJ3) [ 51 ]

Even if more emerging from students’ voices, professionals appeared genuinely amazed at how learning can be generated out of negativity.

Assuming an empathetic attitude

Study participants stressed the fact that RWhelped them develop empathetic attitudes. It seems that RWemphasized the importance of sensitivity and empathy by trying ‘to be in someone else’sshoes,’ especially that of patients or colleagues [ 36 , 37 , 44 ].

“How reflecting on patient encounters through field notes allowed her to “take a walk in someone else’s shoes ” (student) [ 36 ]. “It helps you see the humanity... ” (professional) [ 50 ]

This approach also applied in contexts outside of work and helped the practitioner take off his/her‘white coat’ and understand that before being a professional,he/shewas a person and a human being [ 36 , 37 , 46 , 50 ].

“ Which has made me more open to other’s ideas and thoughts ” (professional) [ 46 ]

As previously mentioned, according to the participants’ statements, awareness was the cornerstone to effective personal and professional growth [ 40 , 51 ].

This sub-category is equivalently present among the participants’ groups. Nonetheless, different meaningscould also be highlighted. Students appreciated RWby stressing its value of allowing them to enter deeply ‘into the other’ inner world (mainly patients). Professionals claimed they could recognize the profession’s human and relational aspects, whichcould also be helpful for their extra-professional relationships (family members, friends).

Awareness of things, experiences, emotions

Impartially balanced among professionals and students, awareness was cited in terms of ‘how things have affected me rather than simply continuing to work in a robotic manner’ [ 46 ], the awareness of who one was and who one has become thanks to the process of change [ 51 ]. This professional and relational awareness made it possible to think clearly about one’s practice and the health resources present in the context of belonging [ 50 ].

“Just being aware of what I know now and what I’ll know by the end of the semester … is a great way to learn who I am and what I can change about me for the better.” (Student 9/RJ1) [ 51 ]

The process of awareness that was facilitated by how their RW allowedthem to transform shapeless and straightforward ideasinto words and givethem a specific value and emotional charge [ 36 , 47 , 51 ]: it wasan authentic opportunity to turn emotions and feelings into something tangible –a journey of discovery and personal acceptance [ 43 ].

“ After two years or so, when you look back, it’s like, oh,that’s how I was feeling at the time, and right now, I feel differently. There is also this level of satisfaction. Like you have matured out of this thinking ” (professional) [ 47 ]

Identifying RW feasibility

The fourth category consists of three sub-categories: perceived barriers/impeding factors, facilitating factors, and when and how to use RW. Students and healthcare professionals who had the experience of practicing the RW in their work identified both limitations and facilitating factors and indications about when and how to use RW.

Perceived barriers/impeding factors

Some study participants (almost entirely students) identified several barriers to their activity. Some students could not see the benefits and thought RW was a waste of time [ 35 , 38 , 51 ]. However, others, who did see the potential benefits still felt that they lacked the time needed to devote to RW [ 42 ] or, sufficient mental space to report and describe a work situation, an excessive similarity of this activity to the regular working practice and, consequently, a lack ofmotivation to write [ 47 , 51 ]. In addition, some described the strainthey felt in writing down personal/professional experiences [ 47 ]. A lack of privacy was another problem, both for the concern about sharing the reflection and for the respect of confidentialityin writing itself [ 51 ]. Taken together,it appeared that some study participants did not recognizeRW as an effective means of help [ 39 , 50 ]. Althoughrealizing the potential of RW,others felt that their tutors did not provide noticeably clearexplanations of the aim of RW– which they would have found useful and motivating [ 45 ].

“ To be honest, not a great deal ( … ) it wasn’t really some revelation ” (professional) [ 50 ]. “ I got a hard time referring it [my experience] to citations … I could have sat and cried yesterday when I did my essay … when I actually read it [my essay] I thought, oh I don’t know what it means, myself ” (Female 2 - student) [ 42 ]

Facilitating factors

This sub-category was exclusively interpreted from students’ narratives. They valued the perspectives to use RWin their practice seeing it as a valuable tool to be applied throughout their career [ 35 , 45 ],with many students reporting that they would continue with this technique [ 38 ]. Studentssaw RW as a valuable means of staying focused on their own goals and needs [ 40 , 51 ]. They remarked that it helped them reduce stress, gain clarity in one’s life and practice [ 41 ], and spiritually connect with themselves [ 45 , 51 ]. Furthermore, RW enabled studentsto discover more information about their health and well-being, ‘it also helped me tie in ideas and beliefs from different sources and relate it to my own’ [ 51 ]. RWhelped maintain awareness and recall the medical being/human being dichotomy [ 37 ]. It remindedstudentsof the difference between studying literature and refining manual skills and the ability to learn from experience and mistakes [ 35 ].

“ During the interview, I felt an element of being more like a ‘normal person’ having a ‘normal conversation’ with another human being. This was a strange realization because it reminded me of the dichotomy that physicians may experience, being doctor versus human ” (student) [ 37 ]

When and how to use RW

Health professionals (a few) and many students finally mentioned the time considered most appropriate to use RW, underlining its usefulness primarilywas during hardship rather than daily practice [ 47 ].Moreover,RWshould not be forced onto someone in any given moment but instead left to individual choice based on one’s spirit of the moment [ 40 , 46 ].

“. .. like if you had a patient die; that would be the only time you might write it down ” (professional) [ 47 ]

Otherparticipantsconsidered instructions on RW to be too forceful and notapplicable to their own experience of reflection [ 40 ]. ‘Reflection wasn’t just signing on the line.’ It allowed constructive feedback for the trainee or the professional. Constructive feedback could be positive or negative, but it was a powerful tool for thinking and examining things [ 45 ].

In this meta-synthesis of qualitative studies, we have interpreted the experiences of health professionals and students who used RWduring their education and training. Given the number of studies included, RW users’ experience was predominately investigated in students. This result, although not surprising, raises the question of whether RW in professional training is being used. RW is not used in professional training as often as it is in the academic training of healthcare students.

As to this review’s aim, we could highlight continuities and differences from study participants’ narratives. Our findings offer a conceptualization of usingRW in health care settings. According to the experience of both students (from different disciplines) and health professionals, RW allows its exponents to discover and practice reflectionas a form of cognitive processing [ 2 ] and enablethem to develop a better understanding of their lived situation. We also interpreted that RW allows users to make a ‘reflexive journey’ that involves them practicing meta-cognitive skills to challengetheir attitudes, pre-assumptions, prejudices, and habitual actions [ 24 , 26 ]. This was particularly true for students: “entering personal reflexivity” appears to be newer for them than for the professionals who are likely to acquire reflexivity during academic training. Students seemed more focused on tools than RW-related results. This consideration makes us affirm that reflective capacity is in progress for them.

Challenging pre-assumptions and entering reflexivityenabledRWusers to realize how RW may develop their learning potential to improve skills and personal/professional growth. Skills to be enhanced are quoted mainly by students. Conversely, professionals could comprehend the final purpose of learning, achievable through RW, in terms of communication or organizational abilities. Professionals interpreted skills from RW as abilities to apply in the clinical activities to find new solutions to problems.

The category “Accomplishing learning potential”confirms what many authors highlight: putting thoughts into words not only permits a deeper understanding of events [ 6 ], enhances professionalism [ 52 ] but also improves personal [ 16 ], communication, and empathy skills [ 4 , 17 ]. In this context, RW fulfills its mandate by letting human sciences [ 53 ] and evidence-based health disciplines affect clinical practice. As noted [ 54 ], students and health professionals’RW training allowed integrating scientific knowledge with behavioral and sociological sciences to supporttheir learning [ 55 ].

Users understood that RWcould be a powerful means of developing empathy and developing their philosophy of care: this consideration is in line with a recent study from Ng and colleagues [ 24 ]. Additionally, some authors [ 4 , 17 ] stressed these empathetic skills and “humanistic”competencies as essential to care for patients effectively [ 56 ]. Professionals were amazed how negativity could generate learning through RW. On the other hand, by recognizingand writing experienced negative situations, students could free themselves from feelings impeding empathy.

By employing RW, users reported factors that could encourage or limit its use. These findings further illustrate that RW is not always a tool that is easy to use without adequate training [ 57 ]. Almost exclusively, students reported hindering factors (limited time, difficulty in writing and understanding assignments, privacy issues, feeling bored or forced). As to professionals, few describedRW as a very stressful activity. Although students could identify impeding factors, they also recognized many positive ones. For professionals, RW was not to be used every day but in ‘extreme’ situations, requiring reflection and reflexivity to be applied. In general, enhancing motivation to write reflectively [ 58 ] should be the first goal of any training to make the process acceptable and profitable for trainees. If this first stage is not accomplished, it will reduce RW’sapparent professional and personal effectiveness among health professionals and students substantially.

Strengths, limitations, and research relaunches

This review may enrich our knowledge about providing RW as an educative tool for health students and professionals. However, the findings must be applied,taking into account some limitations. We focused our attention only on recent, primary, peer-reviewed studies within the time and publication limits. Qualitative studies often are available as grey literature: considering it may result in a different interpretation of students’ and professionals’ experience in using RW. Therefore, our conceptualization should be read bearing in mind a publication bias and the need to expand the literature search to other sources. Besides limiting the risk of missing published qualitative studies, we reviewed the reference listsof included studies for additional items. Our meta-synthesis is coherent to the interpretation of the included studies’ findings.

At least two reviewers have conducted each step of this systematic review. We purposely did not exclude studies based on a quality assessment to maintain a robust qualitative study sample size and valuable insights.

During analysis, all possible interpretations were screened by authors, and an agreement was reached. Nonetheless, we did not cover all the possible ways to interpret the voices of students and professionals.

Since RW is not used in professional training as often as it is in the academic training of healthcare students, a research relaunch could be investigatingwhether and to what extent RW is being used in in-service training programs. Moreover, the studies included in this review were conducted within Western countries. Students’ and professionals’ perspectives from Africa and Asia are underrepresented within the qualitative literature about experiences of using RW. Therefore, geographicalgeneralizations from the present meta-synthesis should be avoided, and our paper reveals the necessity for RW research in other cultures and settings. Nonetheless, authors of primary studies have paid little attention to cultural and regionaldiversity. Therefore, we recommend furtherinvestigations exploring the differences between cultural backgrounds and howRW is recognized within training programs in different countries. Finally, additional qualitative and quantitative research is required to deepen our understanding of RW’s clinical and psycho-social outcomes in high complexity health practice contexts.

Our analysis confirms the crucial role of RW in fostering reasoning skills [ 59 ] and awareness in clinical situations. While its utility in helping health students and professionals to nurture reflection [ 2 ] has been widely theorized, this meta-synthesis provide empirical evidence to support and illustrate this theoretical viewpoint. Finally, we argue that RWis even more critical given the increasing complexity of modern healthcare, requiringprofessionals to develop advanced skills beyond their clinical ones.

Practical implications

Two important implications can be highlighted:

students and professionals can recognize the potential of RW in learning advanced professional skills. ImplementingRW in academic training as well as continuing professional education is desirable.

Despite recognizing the effectiveness of RW in healthcare learning, students and professionals may face difficulties in writing reflectively. Trainers should acknowledge and address this.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

Critical appraisal skills programme

Enhancing transparency in reporting the synthesis of qualitative research

Population, phenomena of interest and context

Preferred reporting items for systematic reviews and meta-analyses

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We thank Dr. Silvia Tanzi for her insightful feedback about this work and Manuella Walker for assisting in the final editing of the paper.

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GArwas responsible for the original concept. MCB performed the literature search on databases. MCB, GAr, GAm, LD, MR were responsible of data curation. GAr, MR, GAm, and LD screened titles and abstracts of all studies. LG, MCB, SDL, and MH served as external auditors. FDV and LD assessed the quality of included studies. MCB and LG gave a third opinion in case of disagreement. GAr, GAm, MR, and FDV derived sub-categories from the data. GAr, LG, MH drafted the first version of the manuscript. FDV, LD composed tables, and figures. All authors read and approved the final manuscript.

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Meta-synthesis framework with participants’ narratives.

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Artioli, G., Deiana, L., De Vincenzo, F. et al. Health professionals and students’ experiences of reflective writing in learning: A qualitative meta-synthesis. BMC Med Educ 21 , 394 (2021). https://doi.org/10.1186/s12909-021-02831-4

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Reflective Practice (Key Themes in Health and Social Care)

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David Wilkins, Reflective Practice (Key Themes in Health and Social Care), The British Journal of Social Work , Volume 44, Issue 3, April 2014, Pages 787–788, https://doi.org/10.1093/bjsw/bcu026

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Reflective practice, as noted by the authors of this book, is generally accepted as being a ‘good thing’, certainly in social work, but also in other areas of health and social care more generally as well. However, somewhat refreshingly for a book on the topic, the authors also make a case for the relative paucity of evidence we have as to why reflective practice is a good thing and how reflective practice might make a difference, either in terms of the professional engaging in reflective practice or, more importantly, in terms of outcome for the ‘service user’. One potential problem with this contention is that, via Google Scholar, it is relatively easy to find over half a million results for the search phrase ‘reflective practice social work’, which suggests that it is hardly a topic that has gone unnoticed.

Nevertheless, it does appear to be the case that much of this work, if not all, is written with the starting premise that reflective practice is a good thing rather than examining whether it is, why and how. Understandably, the authors of this book do tentatively conclude that, despite the absence of a strong evidence base either way, reflective practice is a skill-set worth developing for social workers and they also highlight the necessity of reflective practice being demonstrated ‘through doing’ rather than perhaps being seen as a mindset or ‘only’ as a way of thinking to be used in particular settings or contexts, such as supervision.

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Health & Social Care Workforce:

Welcome to the blog of the nihr policy research unit in health and social care workforce at king's college london, toolkit for reflection on human rights in the context of social care.

During the COVID-19 pandemic, the importance of human rights for people needing care and support in care homes or at home, their carers, families and friends became evident. Care home residents, especially people with dementia, were one of the groups who were and still are most severely affected by the virus, with thousands of deaths from a COVID-19 infection not only in England but many countries around the world. The need to protect people requiring care and support and to balance infection control – thus the basic rights to health and life – with the right to a private and family life and to social participation was but one of many examples of a human rights issue that we as a society had to face during this pandemic. Conversations around these topics are often difficult.

Human rights as enshrined in international and national law, notably the Human Rights Act, are directly relevant to people requiring care and support, service providers and care workers. Not only is every human being entitled to have his or her rights respected, protected and implemented but the English legal and regulatory system for care providers also makes them directly relevant in care settings. However, human rights are more than a legal concept. They are also a moral concept, which can help to build a social care system and determine the way care is provided. Human rights in social care is therefore a broad topic, with many different ways of approaching it in conversations, training and research.

In order to help you start or pick up your own reflective journey on human rights in conversation or learning by yourself or with others, we are making available a toolkit comprising a personality test, a pocket card game and a creative page to be downloaded or ordered as physical copies.

In each case, the tools below are available as a pdf and online.

These exercises can be used prior to any training, meeting or workshop to start a conversation on the topic of human rights in social care and/or care homes. They can also be completed privately, for example before embarking on research.

The tools were co-produced by ARC South London’s social care Post-doctoral fellow Dr Caroline Green together with Dr Edel Roddy at My Home Life Scotland, Dr Belinda Dewar at Wee Culture, Carlyn Miller at the British Institute of Human Rights and Dr Kritika Samsi of ARC South London. The tools are based on the findings of Caroline’s PhD study on human rights in care homes for older people and particularly her findings that there are many ways of approaching the topic ( the PhD study is available to read here ).

The co-production was funded by the ESRC Impact Acceleration slingshot fund. They are available for anyone working with, teaching or talking about human rights in social care and beyond to download and use.

Get in touch with Caroline at [email protected] if you would like further information. We would also highly appreciate your feedback on the tools, which are still a work in progress. Please note the tools are subject to copyright and may not be reproduced without acknowledgement.

Green, C. (2020) ‘The potential role of human rights and the right to privacy in the context of English care homes for older people’ , King’s College London, London.

Models of reflection

Models and stages of reflection.

There are many different models of reflection – you will find some examples in this guide. Although the structure and format of these models may vary, they share many common features.

Reflection usually begins with a description of what has happened . It is important at this stage to identify exactly what the key elements are – what makes this an incident worthy of reflection? This starting point relates to a low or superficial level of reflection .

Very often a negative or uncomfortable situation (a ‘critical incident’) prompts reflection. 'We learn from our mistakes' is certainly true! However, positive experiences can also provoke reflection. It can be very powerful to reflect on what worked, in order to reproduce that again.

The next stages of reflection require you to relate what you already know to the situation – how is theory relevant? Awareness of your own feelings, assumptions and lack of knowledge should also be recognised and challenged – what did you bring to the situation that had an impact? What didn’t you bring (knowledge, openness) that may have made the situation different? Making sense of all of these factors allows you to recognise what has been learnt and what changes you should make for future situations.

The final stage of reflection is one of change – for example, of how you see yourself, how you see others, your beliefs, your values, your views and/or opinions. It is the deepest level of reflection .

• Atkins and Murphy
• Other models

Atkins, S. and Murphy, K. (1994). Reflective Practice. Nursing Standard, 8 (39) 49-56.

Gibbs, G. (1988) . Learning by Doing: A guide to teaching and learning methods. London: Further Education Unit.

The following cues are offered to help practitioners to access, make sense of, and learn through experience.

Description

• Write a description of the experience
• What are the key issues within this description that I need to pay attention to?
• What was I trying to achieve?
• Why did I act as I did?
• What are the consequences of my actions?
• For the patient and family
• For people I work with
• How did I feel about this experience when it was happening?
• How did the patient feel about it?
• How do I know how the patient felt about it?

Influencing factors

• What internal factors influenced my decision-making and actions?
• What external factors influenced my decision-making and actions?
• What sources of knowledge did or should have influenced my decision making and actions?
• Alternative strategies
• Could I have dealt better with the situation?
• What other choices did I have?
• What would be the consequences of these other choices?
• How can I make sense of this experience in light of past experience and future practice?
• How do I NOW feel about this experience?
• Have I taken effective action to support myself and others as a result of this experience?
• How has this experience changed my way of knowing in practice?
• Johns, C. (1994). Nuances of reflection. Journal of Clinical Nursing 3 71-75

Adapted from: Pfeiffer, J. W. & Ballow, A. C. (1988). Using structured experiences in human resource development. (UATT Series, vol. 1). San Diego, CA: University Associates.

Further reading

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• Next: Reflective writing style >>

‘Being’ person-centred: a reflection from a personal and professional experience

In this week’s Evidence Based Nursing Blog, Andrew Cassidy (@mrandycassidy) brings his own personal lived experiences and professional thoughts from his years working in the NHS and other sectors on what being person-centred looks like. 

I’ve worked in the healthcare for nearly fifteen years, in the NHS, the third sector, and for a social enterprise. In spite of the differences in these roles, a main focus of each of them has been on the provision of person-centred care. But what is person-centred care, and how can one person be expected to say what is and what isn’t person centred for someone else? This question was brought into sharp relief in the early days of the pandemic. I have Crohn’s Disease, and take immunosuppressant medication to keep it under control. This placed me in the shielding group, and led to one of the most challenging conversations that I have ever had with my healthcare team. Early in the morning of March 23rd, my GP called to ask me how I would feel about having a DNR placed on my medical records. I have a good relationship with my GP, and her manner was sensitive and, I felt, pitched at a level I would respond to. We’ve always been candid in our conversations, and I appreciated this candour in our conversation, but it made me think. My conversation with my GP was structured around my level of understanding and my “expertise” of my own condition. However, I appreciate how difficult that conversation would have been for my GP to instigate, and I began to wonder how the conversations she had with other patients in my position were positioned. Were they all as “person-centred” as the conversation I had?

This made me think about my professional life, and the roles of my clinical colleagues. As nurses, they are expected to provide person-centred care in all circumstances. But how can “person-centred-ness” be quantified? Two people could look at the same interaction, and arrive at two polar opinions as to whether or not it was person-centred. Is there a universal definition, or is it nebulous and does that definition differ from person to person? Further, if there is no definitive definition – and, if the notion of what is and is not “person-centred” varies from person to person, then surely there cannot be? – how can we reasonably expect professionals themselves to determine whether their interactions are person-centred or not?  I decided to examine my own experiences of care, and to try to determine what factors were important in my appraisal of whether or not they were person-centred. My first thoughts ran to health literacy. For me, the first step of a person-centred approach is communicating at a level people are comfortable with. I’ve had Crohn’s for over twenty years, and conversations about antiemetics, 5-ASA’s, and terminal ilea do not faze me, but I can imagine the confusion these conversations would give rise to someone who has been newly diagnosed. But here’s the rub; that’s precisely what makes it person-centred for me. The very aspect that makes it person-centred to me could have completely the opposite effect on someone else. This leaves a very obvious question; can we truly expect professionals to know at first glance or interaction the approach that would suit every patient and pitch their interactions accordingly? And, if so, how can policies be made at Trust / Health Board / National levels when we have a virtual smorgasbord of opinions on what person-centred is and isn’t. For me, the essence of person-centred care comes down to ascertaining what is important to the person themselves. Recent initiatives have led the way on this, notably the Scottish Government’s What Matters to You , have shone a light on a way forward.  A system simply cannot decide what being person-centred looks like, but getting to the heart of what is important to the person can provide a starting point. What matters to the person should influence everything in a healthcare environment, from communications to potential treatment options and long-term support and care. Only once what matters to someone is identified and valued can systems begin to design a package of care that truly puts people at the centre.

Comment and Opinion | Open Debate

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Impact of Foundation Degree in Health and Social Care Essay

Introduction, description, action plan.

This reflective essay is based on my progression in the past two months, where I have been undertaking a Foundation Degree in Health and Social Care. In this essay, I intend to cover many issues relating to this course. The discussion includes frequent assessments, the importance of coming together in groups, and talking about what I need to work on to improve my personal growth and development professionally. The reflection will also enable me to be a better practitioner by learning from my previous mistakes and bettering myself as a person. I will implement a consistent act in developing and growing efficiency and effectiveness within the context of what is considered a desirable practice. The concepts I have grasped will make me easily use the abilities I learned and implement the skills effectively related to my learning and training.

Gibb’s Reflective Cycle has enabled me to break down the reflection with ease because of its systematic flow, which is easy to understand. The model is effective because it ensures every detail in the reflective essay is covered effectively (Adeani, Febriani, and yafryadin, 2020). Some of the areas I will reflect on include time management, assignment writing, referencing, critical thinking presentation, and module evaluation. More details on my development in specific areas are elaborated on in the sections below, as per Gibb’s Reflective Cycle throughout the paper.

When the semester started, and I had my first module, I was buzzing and ready for the course. The introductory part was interesting, as everything seemed to be easy and encouraged me to set my mind ready for completing the next semester. This part was a great introduction to the course, as I learned that I would be handling more topics than I had expected. The professor was brilliant in all aspects. It was easy to note that he had simplified the work to enable everyone to understand the course concepts and ways of handling various topics. At some point, the professor taught about literature management, and that is when I learned the value of taking short notes as the lecture continued. I discovered that short notes are easy to go through and remember during any revisions. The lecturers/tutors provided various assignments during the course, including group work, which were very insightful. The different learning styles that the tutors have introduced are helpful, and I find them useful. Based on this knowledge, I can now choose the best approaches to studying per my learning style. Having specific learning styles is that it assists with proper time management. It is necessary to involve proper timing as I participate in group discussions and project management, and it will be proper to save time for the other aspects of my studies.

The individual assignment was a bit easier than what I did to do for the group work; however, I enjoyed the group tasks even more. The group assignment made me ha acquire good presentation skills. Once one has enough knowledge on a topic, presenting it becomes easy. The first major group project enabled me to learn and get to know some of my classmates better; though most were younger than me, they were extremely brilliant in their assignment input. We divided the workload so that everyone would be able to handle a specific topic and present it effectively. However, there was confusion whereby three people picked e same topic, so we had to quickly gather and do the pending work in the shortest period possible. That was when I realized how smart my group mates were and could critically think and analyze a question to give the best assignment’s answers. I have to admit that the first group assignment that was theoretical made me better in every aspect. Most significantly, it honed my critical and analytical skills in various assignments. When the results came for the written group assignment, we had passed. Nevertheless, the sections we scored even more highly are the areas we handled together as a group; one of the benefits of group work.

As one of the older students in the class, the entire period’s experience has enabled me to uplift my confidence. Engaging with younger learners in the class brings out some level of confidence (Ford et al., 2015). However, as Edwards and Best (2020) observe, personal growth and improvement build on awareness. Of late am always alert and updated on a variety of issues with regards to what I learn and how I do it. Close association with my tutor outside and inside the class has been essential to understanding specific topics and having diverse opinions n certain topics. That is among the reasons until today, my results have been top-notch, always striving to do more and become a better learner. The entire faculty is very friendly, so it is easy to seek assistance in any matter. I have acquired more knowledge and skill in Health and Social Care in the past two months than I ever had anticipated.

At the beginning of the module, I did not know what to make of some situations while in class. I was a bit nervous and silent and did not participate much. In the past month, I was able to illustrate a different presentation by myself brilliantly. The attitude has grown from then, and I feel more rejuvenated and ready to work on any assignment or presentation. People often overlook the importance of professors and tutors (Veine et al., 2018). The way I can break down information now shows pure growth and development, all thanks to my professors (Dhaliwal, Singh, and Singh, 2017).

During the first major group work, where we had assigned portions for everyone to handle, I was a bit mad and frustrated when some group members had not done part of their assignment and instead did what was assigned to others. Everything was in shambles and the fact that I could not previously work well under pressure. The three who had messed up were also nervous and full of guilt. What made me change my view on my group members’ is the unity and work rate they put in to ensure that the project was done efficiently using the least possible time. That group project created a bond that made us closer even when out of school.

This module has been beneficial to my growth, and I am already buzzing about what awaits in the next module. The good and bad things about a situation always create ripple effects depending on the circumstances. As I evaluated the results with my group members today, I realized that we made a mistake in assigning different projects to the group members. We could have done the best thing to join our minds and do all the assignments from start to finish together. However, the upside of the situation is that even though the deadline was approaching fast, we managed to work on the assignments effectively. There was a revelation that the people in that group had an intense work rate. On realizing that everyone was focused and intended to work hard, it was clear that we would pass the project and beat the deadline.

I believe everything is currently on the right track for me because of the work rate and dedication that I am putting in so that I can be among the best in the field. It is not easy to be ranked as one of the best in a field without major dedication. That is what I have my eyes focused on, being the best in my field so that I may be able to work with other greats. The reason why things were hard for me, in the beginning, was my naivety. But now, with all the confidence in me, I can achieve anything. Even with the group, things did not previously go well as planned because there was no common ground at first. Since everyone was new, everyone opted to handle their work section, which caused significant confusion. What drove the group members in producing their best is the joint effort that brought out the work rate and discipline from everyone.

There was also no groupthink element, whereby the most dominant answer was not contested (Bassot, 2020). This never happened in our group, and a matter of fact is that everyone fairly gave their ideas, and if it was convincing enough, then it is what we used.

On reflection, I believe that I have overachieved what was initially in my work schedule. Knowing clinical practices is a breakthrough as I ready myself for my career. It is essential to have basic knowledge of all career requirements. (Husebø, O’Regan and Nestel, 2015). I have surpassed the expected standards that I had initially planned. This is a hallmark, and it shows just how much dedication I have put in working on my major. The progress I have in just the two months has enabled me to acquire various health-related skills, get more knowledge on clinical practices, and acquire new insights and ideas regarding my major. Frequent reflection of what I have accomplished is essential as it will necessitate professional and personal development, as Wain (2017) emphasizes. When I look back at the group assignments and workshop, I smile a bit because they are not only exciting but there are lots of new information that I get to know during the workshops.

The two months have been very fruitful, and I have gained valuable skills and knowledge from the modules. By reflecting, we develop reflective skills such as self-awareness, ability to describe, critically analyze, synthesize, and evaluate (Béres and Fook, 2020). This reflection is important for any scholar as it helps identify strengths and areas which need improvement.

I want to do more in order to keep growing in the field of health and social care practice. All this is achievable if I continue with the work ethic I am currently putting in. Slowing down will make me lose focus on the end goal. By following my professors’ advice, frequently practising through placements, and implementing all that I have learned and keep learning, I will undoubtedly reach my targets. Through my evaluation and analysis, it is evident that my learning curve is on a steady rise. Because I am still in my learning process, I must acquire substantial knowledge to fit my professional portfolio and assist during job hunting in the future. The referencing skills acquired will push me to be a better researcher.

In all honesty, despite everything going on well currently, if I had an opportunity to change anything, the only thing I would change is how I first present myself as a timid person. I now believe that there was nothing to be nervous about, and all that counted was me being able to express myself. Thankfully to those involved with the school, right from the faculty, the professors, and fellow learners, who have made me more confident and courageous when undertaking an array of activities. The next time I am in the same situation, I will act accordingly and make my presence felt right from the beginning. Regarding the group situation, with the little experience from my first group rodeo, I will be able to take charge and assist the group member in making appropriate decisions regarding the different projects we are handling. I will also ensure that every member is awarded the appropriate time to express themselves without any form of prejudice. By following my action plan, I believe I will supersede all my set goals and be an excellent example to everyone out there.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2022, February 23). Impact of Foundation Degree in Health and Social Care. https://ivypanda.com/essays/impact-of-foundation-degree-in-health-and-social-care/

"Impact of Foundation Degree in Health and Social Care." IvyPanda , 23 Feb. 2022, ivypanda.com/essays/impact-of-foundation-degree-in-health-and-social-care/.

IvyPanda . (2022) 'Impact of Foundation Degree in Health and Social Care'. 23 February.

IvyPanda . 2022. "Impact of Foundation Degree in Health and Social Care." February 23, 2022. https://ivypanda.com/essays/impact-of-foundation-degree-in-health-and-social-care/.

1. IvyPanda . "Impact of Foundation Degree in Health and Social Care." February 23, 2022. https://ivypanda.com/essays/impact-of-foundation-degree-in-health-and-social-care/.

Bibliography

IvyPanda . "Impact of Foundation Degree in Health and Social Care." February 23, 2022. https://ivypanda.com/essays/impact-of-foundation-degree-in-health-and-social-care/.

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Healthcare in Moscow

This guide was written prior to Russia's 2022 invasion of Ukraine and is therefore not reflective of the current situation. Travel to Russia is currently not advisable due to the area's volatile political situation.

Healthcare in Moscow is organised by the Moscow Health Department. While public healthcare facilities are available, most expats seek out private healthcare at international medical centres. Expats are advised to take out private medical insurance if it is not provided to them by their company.

Subsidised healthcare is provided to everyone living in the country, paid for by the state and the mandatory health insurance system. That said, professionals in the state system are likely to speak little to no English. 

There are several private medical centres in Moscow where English is spoken and where the healthcare is on par with expat standards. These clinics are generally very expensive, so it is highly recommended that expats take out private medical insurance to cover medical costs in Moscow. Most insurance coverage plans will also include evacuation cover for emergencies or life-threatening situations. 

Recommended hospitals in Moscow

Alliance medicale.

www.alliancemedicale.ru Address: Kutuzovsky Ave, 1/7

Intermed Center American Clinic

www.en.intac.ru Address:  4 Monetchikovsky Lane, 1/6, Building 3

International Clinic MEDSI

www.medsi.ru Address:  26 Prospekt Mira, Building 6

European Medical Center

www.emcmos.ru Address:   5 Spiridon'yevskiy Pereulok, Building 1

Further reading

►For more on the Russian healthcare system see our Healthcare in Russia page.

Expat Interviews " The standard is high, but health insurance is essential − both international and local cover tend to be adequate and similar for routine things." Read more about Stephen, a British expat, and his  experience living in Moscow . 

Are you an expat living in Moscow?

Expat Arrivals is looking for locals to contribute to this guide, and answer forum questions from others planning their move to Moscow. Please contact us if you'd like to contribute.

Expat Health Insurance

Cigna Global Health Insurance. Medical insurance specifically designed for expats. With Cigna, you won't have to rely on foreign public health care systems, which may not meet your needs. Cigna allows you to speak to a doctor on demand, for consultations or instant advice, wherever you are in the world. They also offer full cancer care across all levels of cover, and settle the cost of treatments directly with the provider. Get a quote from Cigna Global - 20% off

Aetna Aetna International, offering comprehensive global medical coverage, has a network of 1.3 million medical providers worldwide. You will have the flexibility to choose from six areas of coverage, including worldwide, multiple levels of benefits to choose from, plus various optional benefits to meet your needs. Get your free no-obligation quotes now!

Moving Internationally?

International Movers. Get Quotes. Compare Prices. Sirelo has a network of more than 500 international removal companies that can move your furniture and possessions to your new home. By filling in a form, you’ll get up to 5 quotes from recommended movers. This service is free of charge and will help you select an international moving company that suits your needs and budget. Get your free no-obligation quotes from select removal companies now!

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Home — Essay Samples — Geography & Travel — Travel and Tourism Industry — The History of Moscow City

The History of Moscow City

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Published: Feb 12, 2019

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