Outcome and competency-based undergraduate and graduate medical education is the desired standard embraced by many medical educationists worldwide. Reflective capacity is an
integral component of that strategy and reflective writing
has shown tremendous potential as a delivery tool. But
there are various challenges in the implementation of
the initiative. Efficacy as a delivery tool, achievement
of pedagogical outcomes, reliability issues, challenges in
assessment outcomes/tools, and whether it can be taught
and learnt, need to be addressed. Many questions are still
not satisfactorily answered, and this review attempts to
offer some perspective on the issues.