{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:03:01Z","timestamp":1789448581134,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Reflection is fundamental to medical education, supporting clinical reasoning, professional identity formation, and lifelong learning. Although generative artificial intelligence (AI) chatbots have emerged as tools to facilitate reflection, little is known about how AI-supported reflection differs from independent reflective writing. This study compared the characteristics and educational contributions of independent reflective writing and AI-supported reflection among medical interns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comparative qualitative quasi-experimental study was conducted with medical interns during an emergency medicine rotation. The control group was instructed to perform reflective writing independently, while the intervention group was tasked to use AI-supported reflections using a purpose-built chatbot to complete reflective writing. Data were analyzed using qualitative content analysis and compared in terms of themes, reflective depth, clinical reasoning, emotional awareness, and professional learning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one interns completed independent reflective writing, while eighteen engaged in AI-supported reflection using a chatbot. Although both approaches supported reflective learning, they facilitated distinct dimensions of the reflective process. Independent reflective writing was characterized by greater autonomous meaning-making, critical reflection, ethical reasoning, and systems-level thinking. In contrast, AI-supported reflection was characterized by greater emotional articulation, structured reflective dialogue, and future learning planning, but showed more limited exploration of contextual, ethical, and systems-level issues. Participants\u2019 comments embedded within the chatbot interactions suggested that some found the interaction supportive, while repetitive prompting and limited critical exploration emerged as limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Independent reflective writing and AI-supported reflections represent complementary rather than interchangeable educational approaches. While independent reflective writing fosters deeper critical reflection, AI primarily functions as a reflective scaffold that supports emotional engagement and structures reflective learning. Integrating AI-assisted reflections with independent writing and faculty-guided debriefing may optimize reflective learning in medical education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1942949","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:27:15Z","timestamp":1789446435000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A qualitative thematic comparative analysis of independent and AI-supported clinical reflections among medical interns"],"prefix":"10.3389","volume":"13","author":[{"given":"Sel\u00e7uk","family":"Akturan","sequence":"first","affiliation":[{"name":"Department of Medical Education, Karadeniz Technical University Faculty of Medicine","place":["Trabzon, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Pasl\u0131","sequence":"additional","affiliation":[{"name":"Department of Emergancy Medicine, Karadeniz Technical University Faculty of Medicine","place":["Trabzon, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salman Yousuf","family":"Guraya","sequence":"additional","affiliation":[{"name":"Collage of Medicine, Gulf Medical University","place":["Ajman, United Arab Emirates"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"B1","volume-title":"The Reflective Practitioner: How Professionals Think in Action","author":"Sch\u00f6n","year":"1983"},{"key":"B2","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1007\/s10459-007-9090-2","article-title":"Reflection and reflective practice in health professions education: a systematic review","volume":"14","author":"Mann","year":"2009","journal-title":"Adv Health Sci Educ"},{"key":"B3","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1080\/01421590903050374","article-title":"The use of reflection in medical education: AMEE guide No. 44","volume":"31","author":"Sandars","year":"2009","journal-title":"Med Teach"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e72664","DOI":"10.7759\/cureus.72664","article-title":"Teaching self-regulated learning through reflective writing: experiences of first-year medical students with the master adaptive learner model","volume":"16","author":"Koh","year":"2024","journal-title":"Cureus"},{"key":"B5","doi-asserted-by":"publisher","first-page":"91","DOI":"10.36834\/cmej.77172","article-title":"Using reflective writing to enhance empathy among medical students","volume":"15","author":"Hashim","year":"2024","journal-title":"Can Med Educ J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1186\/s12909-025-07199-3","article-title":"Investigating the status and influencing factors of professional identity formation among Chinese medical interns: a mixed methods study","volume":"25","author":"Jia","year":"2025","journal-title":"BMC Med Educ"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1671520","DOI":"10.3389\/fmed.2025.1671520","article-title":"Mechanism of career resilience formation during the role transition of medical interns: a grounded theory study","volume":"12","author":"Zhou","year":"2025","journal-title":"Front Med (Lausanne)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1007\/s11606-026-10217-9","article-title":"Making reflective practice by interns visible through digital storytelling","volume":"41","author":"Forrest","year":"2026","journal-title":"J Gen Intern Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1097\/ACM.0b013e31823b55fa","article-title":"Fostering and evaluating reflective capacity in medical education: developing the REFLECT rubric for assessing reflective writing","volume":"87","author":"Wald","year":"2012","journal-title":"Acad Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"875","DOI":"10.3109\/0142159X.2011.595434","article-title":"Self-regulation theory: applications to medical education. AMEE guide No. 58","volume":"33","author":"Sandars","year":"2011","journal-title":"Med Teach"},{"key":"B11","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1152\/advan.00241.2024","article-title":"Reflective writing assignments in the era of GenAI: student behavior and attitudes suggest utility, not futility","volume":"49","author":"Stranges","year":"2025","journal-title":"Adv Physiol Educ"},{"key":"B12","doi-asserted-by":"publisher","first-page":"465","DOI":"10.31662\/jmaj.2024-0390","article-title":"Rapidly rising preference among new-entry medical students for using generative artificial intelligence in reflective reports","volume":"8","author":"Kawakami","year":"2025","journal-title":"JMA Journal"},{"key":"B13","doi-asserted-by":"publisher","first-page":"e13930","DOI":"10.2196\/13930","article-title":"Applications and challenges of implementing artificial intelligence in medical education: integrative review","volume":"5","author":"Chan","year":"2019","journal-title":"JMIR Med Educ"},{"key":"B14","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1111\/medu.14116","article-title":"Is there a plan B? Clinical educators supporting medical students in uncertainty","volume":"54","author":"Bearman","year":"2020","journal-title":"Med Educ"},{"key":"B15","volume-title":"Deep Medicine: How Artificial Intelligence can Make Healthcare Human Again","author":"Topol","year":"2019"},{"key":"B16","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1111\/j.1553-2712.2012.01407.x","article-title":"The use of reflection in emergency medicine education","volume":"19","author":"Bernard","year":"2012","journal-title":"Acad Emerg Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e10899","DOI":"10.1002\/aet2.10899","article-title":"The utility of an online discussion board for reflective writing in an emergency medicine rotation","volume":"7","author":"Pandit","year":"2023","journal-title":"AEM Educ Train"},{"key":"B18","volume-title":"Learning by Doing: A Guide to Teaching and Learning Methods","author":"Gibbs","year":"1988"},{"key":"B19","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","article-title":"Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness","volume":"24","author":"Graneheim","year":"2004","journal-title":"Nurse Educ Today"},{"key":"B20","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","article-title":"The qualitative content analysis process","volume":"62","author":"Elo","year":"2008","journal-title":"J Adv Nurs"},{"key":"B21","volume-title":"In Over our Heads: The Mental Demands of Modern Life","author":"Kegan","year":"1994"},{"key":"B22","volume-title":"Learning Partnerships: Theories and Models of Practice to Educate for Self-Authorship","author":"Magolda","year":"2004"},{"key":"B23","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1002\/ace.7401","article-title":"Transformative learning: theory to practice","volume":"1997","author":"Mezirow","year":"1997","journal-title":"New Dir Adult Contin Educ"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1186\/s12909-025-07611-y","article-title":"Exploring aspects of medical students\u2019 professional identity through their reflective expressions","volume":"25","author":"Avargil","year":"2025","journal-title":"BMC Med Educ"},{"key":"B25","doi-asserted-by":"publisher","first-page":"27","DOI":"10.3390\/ime4030027","article-title":"MD student perceptions of ChatGPT for reflective writing feedback in undergraduate medical education","volume":"4","author":"Haider","year":"2025","journal-title":"Int Med Educ"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1111\/medu.15750","article-title":"Can educators distinguish between medical student and generative AI-authored reflections?","volume":"59","author":"Wraith","year":"2025","journal-title":"Med Educ"},{"key":"B27","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1111\/j.1469-7610.1976.tb00381.x","article-title":"The role of tutoring in problem solving","volume":"17","author":"Wood","year":"1976","journal-title":"J Child Psychol Psychiatry"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1515","DOI":"10.3389\/fpsyg.2019.01515","article-title":"(Re)introducing Vygotsky\u2019s thought: from historical overview to contemporary psychology","volume":"10","author":"Vasileva","year":"2019","journal-title":"Front Psychol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"37","DOI":"10.3352\/jeehp.2025.22.37","article-title":"The impact of artificial intelligence-driven simulation on the development of non-technical skills in medical education: a systematic review","volume":"22","author":"Loubbairi","year":"2025","journal-title":"J Educ Eval Health Prof"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1111\/medu.15746","article-title":"The impact of generative AI on health professional education: a systematic review in the context of student learning","volume":"59","author":"Pham","year":"2025","journal-title":"Med Educ"},{"key":"B31","volume-title":"Reflection: Turning Experience into Learning","author":"Boud","year":"1985"},{"key":"B32","first-page":"199","article-title":"A method for assessing reflective journal writing","volume":"34","author":"Plack","year":"2005","journal-title":"J Allied Health"},{"key":"B33","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/978-981-15-3344-0_32","article-title":"Reflective practice in health professions education","volume-title":"Clinical Education for the Health Professions","author":"Weller-Newton","year":"2023"},{"key":"B34","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1146\/annurev-biodatasci-103123-094756","article-title":"Generative artificial intelligence: implications for biomedical and health professions education","volume":"8","author":"Hersh","year":"2025","journal-title":"Annu Rev Biomed Data Sci"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1942949\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:27:17Z","timestamp":1789446437000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1942949\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":34,"alternative-id":["10.3389\/fmed.2026.1942949"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1942949","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"article-number":"1942949"}}