Evaluating objectivity in reflective writing assessments: A comparative study of Niemi’s and Moon’s approaches

Objectives: Reflective writing is a key component of competency-based medical education, promoting critical thinking, professionalism and the integration of knowledge into clinical practice. However, assessing reflective writing remains inherently subjective. This study aimed to evaluate student reflections from two MBBS batches using two different assessment approaches and to determine if there were differences in grading between the two methods. Materials and Methods: We conducted a retrospective audit of reflections from MBBS students in the 2021 and 2022 batches, focusing on their perspectives regarding the doctor-patient relationship, a crucial part of the ethics module. Following an instructional session on Rolfe’s model of reflection, conducted 1 week after the attitude, ethics and communication session, reflections were graded using Niemi’s and Moon’s approaches. Reflections categorised as ‘diffuse’ by Niemi and those receiving grades E or F by Moon were considered below standard. Results: In the 2021 batch ( n = 156), 16.02% of reflections were categorised as ‘diffuse’ according to Niemi, with 55.76% receiving grades A and B, and 10.24% receiving grades E and F by Moon. In the 2022 batch ( n = 146), 11.64% were classified as ‘diffuse’, 53.41% received grades A and B, and 4.78% received grades E and F. Analysis revealed significant overlap in grades using Moon’s approach. No statistically significant difference was found between the assessments of the two batches using Niemi’s approach, suggesting greater reliability of this method. Conclusion: Our study supports the use of Niemi’s approach for a more objective evaluation of reflections. The findings highlight the need for refining assessment criteria and minimising interrater variability to ensure more accurate and equitable evaluations.