Given the beneficial consequences of reflection, medical educators have sought to explore a variety of methods for fostering and assessing reflection in learners, ranging from one-to-one mentoring to guided discussions, digital approaches like video cases and written methods like reflective portfolios, journal and essay writings. 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. Hence, it follows that reflection allows the development and integration of new knowledge into practice leading to the core experience of greater professional competence. 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. 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. This will enable raters to objectively grade reflective essays and provide informed feedback to residents and students. 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. 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. 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. 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. This study took place in a major tertiary academic medical center in Beirut, Lebanon. 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.
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