SIGNIFICANCE: Service learning experiences are common to occupational therapy curricula. Service learning has the potential to affect students’ professional development through promoting civic responsibility, personal growth, and understanding social complexity. Although self-reflections are considered key to linking personal insights with real-world experiences, the structure of written reflections related to service learning outcomes is not clear. In this study, we seek to optimize the depth of service learning experiences through examining the use and quality of written reflections.

INNOVATION: This study is unique in examining the specific use of formal, structured written reflections versus informal reflections to achieve service learning outcomes. Further, standardized tests are used to measure service learning outcomes rather than relying on subjective data. The study informs educators about the use of structure service learning reflections for chosen outcomes.

APPROACH: Research questions included the following: Does service learning promote personal growth, self-efficacy, civic responsibility, and social understanding in junior occupational therapy students? How do formal versus informal written reflections affect service learning outcomes?

Service learning experiences are assumed to deepen students’ understanding of personal, social, and community responsibility. Although written self-reflections are considered key to such insight, the optimal means to utilize reflections and to measure service learning outcomes are not clear.

METHOD: A mixed-method design was used to gather the data. Eight service learning groups (6 to 8 students) participated, with four designated as control and four as experimental. Experimental groups wrote structured reflections after each community experience; the control group wrote informal reflections with no specific format. All students wrote a final cumulative reflection assignment. Three standardized pre-/posttests were used to measure personal growth and civic responsibility outcomes. A final reflections paper was analyzed qualitatively for understanding of complex social issues. The setting was a university.

Sixty-six junior occupational therapy students were recruited through the first class meeting and through an e-mail invitation. Inclusion criteria were matriculation in the class and agreeing to complete testing and final paper analysis. Outcome measures of personal self-efficacy (New General Self-Efficacy Scale), personal growth (Personal Growth Index), and civic responsibility (Community Self-Efficacy Scale) were collected through pre-/posttest at the first and last class of a semester. Data for students’ understanding of social complexity were collected through a final narrative reflection. We analyzed tests using repeated measures analysis of variance (ANOVA) for within- and between-group differences. Social understanding was analyzed through content analysis. Data were triangulated.

CONCLUSION: Both personal self-efficacy and personal growth scores significantly increased in the experimental group (p < .01) but not in the control group. Community self-efficacy scores significantly improved for both groups (experimental, p = .002; control, p = .012). However, the differences were not significant. Social understanding was deeper in experimental groups.

CONCLUSIONS: Structured reflections and feedback promoted personal growth in occupational therapy students. Community responsibility improved through the service learning experience but was not affected by the type of reflection. Differences in service learning groups, faculty, and debriefing processes may have influenced