Reflective writing in general practice residency: perceived usefulness of complex and authentic situation reports in France

Reflective writing is widely promoted in health professions education worldwide. In France, Complex and Authentic Situation Report (CASR) is the most widely implemented reflective format during general practice residency and is almost systematically required for diploma validation. However, its perceived usefulness has rarely been investigated, despite its potential role in sustaining student motivation and engagement. This study explored trainees’ perceptions and associated factors. A cross-sectional descriptive survey was conducted online between September and November 2024 among French general practice trainees. The anonymous survey link was disseminated through French Departments of General Practice, residents’ unions, and Facebook groups of trainees. Statistical analyses combined bivariate tests with false discovery rate correction and a multivariable ordinal logistic regression model. Among the 608 respondents, only 10.2% considered CASRs “quite” or “very useful” and 39.1% reported having invented or copied a clinical situation when completing a CASR. A smaller number of required assignments (1 to 6) was associated with higher perceived usefulness (p = 0.007). Perceived usefulness was significantly associated with competency development (p < 0.001), considering CASRs a good tool for practice exchange with peers (p = 0.008) and satisfaction from positive evaluation (p < 0.001). In this study, only a minority of trainees perceived CASRs as useful. Low levels of trainee motivation and reports of invented or copied clinical situations suggest limited adherence to the exercise. Perceived usefulness was associated with contextual factors that may be modifiable within training programs.