Journaling as an effective tool to promote metacognition and enhance study methods in a pharmacology course, during and after the pandemic

Introduction Reflection on one's own actions is undoubtedly one of the most important lessons required throughout a career in medicine or pharmacology, due to the series of dilemmas and decisions that health professionals must face when providing care to patients or communities, teaching other professionals, or conducting biomedical research. Given the complexity of the challenge, there is surprisingly little literature on effective pedagogical strategies that enhance ongoing reflection in medical students. This self‐reflection is particularly important in the current moment where in the wake of the COVID‐19 pandemic and the social distancing it has brought, young students have seen reduced opportunities to interact with and learn from others. The practice of journaling is an effective strategy for prioritizing tasks, managing stress, reducing anxiety, and increasing productivity. The objective of this study is to evaluate the usefulness of journaling as an element that promotes better study habits and mental health in students of a medical pharmacology course. Methods Since the second semester of 2020, the pharmacology course (second year of the medical career) has included weekly journaling as part of the course activities. Each week students must choose and reflexively answer 4‐5 questions from a list of 35 items in different domains (emotional and health perception, goals and commitments, study method and habits, learning perception and teamwork). The exercise was graded according to the level of fulfillment of the task (number of items answered in a reflective and timely manner), without criticizing the content of the students' answers. At the end of the semester the students answered a short survey that evaluated their perception of the usefulness of the tool, through Likert‐type questions. Results Most of the students reported that keeping a journal was useful to improve their physical and mental health (57%), organize their homework and assignments (69%), achieve their goals (85%), reflect on their role as a person (77%) or student (88%). In addition, students also agreed that the journal was helpful in increasing their confidence (51%), developing creativity (54%), and strengthening their communication skills (54%). The students' favorite domain for personal reflections was “physical and mental health care”, with 66% of responses. More than 80% of students considered that writing about their goals and commitments, and about their study method and assignments, helped them to better organize their time. Moreover, 83% of students stated that they would like to continue with the habit of keeping a journal to organize their academic activities. Conclusions Students positively valued the journals as a planning tool in their academic tasks. Importantly, students also positively evaluated the value of journaling as a useful tool for maintaining better physical and mental health. This is an important achievement given the emotional stress, anxiety and burn out that many medical students deal with, especially in times of the pandemic. Journaling is a cost‐effective and easily implementable method in different STEM areas to promote metacognition and mental health in students.