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Reflective writing is being introduced in many medical schools in the United States and abroad for a variety of reasons and with a variety of goals in mind. As Wald and colleagues write, multiple methods, including the rubric introduced in their study, have been proposed for rating or grading this writing to quantify the gains obtained. The authors of this commentary detail the assumptions both about reflection and about writing implied in Wald and colleagues' work. They then describe a reciprocal model of writing as discovery, suggesting that the writing itself is what teaches the skills of reflection. Equipping medical students with a sense of story may well be the active ingredient in whatever gains are observed in teaching reflective writing.
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