The Use of Memes to Evaluate Reflection Levels in an Evidence-Based Practice Course for Nutrition Graduate Students: A Cross-Sectional Observational Study

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 level of reflection demonstrated in 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. Methods: Participants were graduate-level dietetic students (n = 55) enrolled in an Evidence Based Practice course in a Master of Science/Dietetic Internship Program. Students were instructed to create a meme about content from the course. Memes were analyzed for depth of reflection using an existing quantitative framework and researchers conducted a hybrid thematic analysis. Results: 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 identified were Ethics, Philosophy of Science, Art of Science and Science and the Public. Conclusion: Our findings confirm that the use of a meme creation assignment is an educational tool that promotes student reflection. Students displayed a higher-than-expected level of transformative or critical reflection which may be due to the playful, visual format of memes.