Reflection vs. rumination: Is medical education harming students?

Reflection has become one of the core virtues of contemporary health professional education. From journaling assignments to mindfulness prompts to competency-based portfolios, students are repeatedly asked to look inward. Reflection is framed as the doorway to insight, empathy, and professional identity formation. But an uncomfortable question is beginning to surface in hallway conversations and faculty retreats: Can too much reflection, or reflection done poorly, actually harm our learners?

At first glance, …

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Reflection vs. rumination: Is medical education harming students?