The use of memes as an educational tool to evaluate reflection levels in an evidence-based practice course for nutrition graduate students (Preprint)

BACKGROUND Memes are a popular online communication tool that are participatory, playful and contextual in nature. While the use of meme creation as an education tool in higher education has been limited, meme creation requires students to reflect on material presented in the classroom, synthesize new content from learned concepts, and present it in a contextualized manner. OBJECTIVE The objective of this study was to examine the outcomes of a meme creation assignment introduced into a master's level nutrition course which covered systemic and ethical issues related to nutrition, research, and clinical practice. Additionally, we explored the topics students chose to engage with in the meme assignment and how they aligned with course objectives. METHODS Participants were graduate-level dietetic students (n=55) enrolled in the Evidence Based Practice course in the Master of Science/Dietetic Internship Program offered by the Department of Nutrition Sciences and Health Behavior in the School of Health Professions at the University of Texas Medical Branch. The team conducted a two-phase analysis of the memes. First, we assessed each meme for depth of reflection using an existing quantitative framework ranging from 0 (description) to 4 (critical reflection). In the second phase, we conducted a hybrid thematic analysis using inductive codes and deductive codes associated with the learning objectives of the class. RESULTS Most students enrolled in the class were female (92.7%) and non-Hispanic white (63%) with an average age of 23.8 y. Of the 82 memes submitted, 9 (11%) were rated as reflection level 0 (description), 11 (13.4%) as level 1 (reflective description), 26 (31.7% as level 2 (dialogic reflection), 15 (18.3%) as level 3 (transformative reflection) and 21 (25.6%) as level 4 (critical reflection). Four primary themes, Ethics, Philosophy of Science, Art of Science and Science and the Public were identified, which aligned the learning objectives of the class, namely for students to develop a wider perspective of the philosophy of science and research paradigms, as well as ethical issues and scientific communication. CONCLUSIONS Our findings confirm that the use of a meme creation assignment is a feasible and acceptable education tool to promote student reflection in the context of an evidence-based practice class for graduate students. Students displayed a higher-than-expected level of transformative or critical reflection which may be due to the playful, visual format of memes. Future work is needed to investigate if our results are generalizable to other student populations or courses.