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The aim was to determine whether the benefits of reflective learning could be realized in medical education. Two studies were undertaken in sequence. In-depth interviews were held with students who had volunteered for a trial of reflective learning involving learning journals and reflective tutorial groups. Data were collected from students who chose to participate and those who chose not to. For comparison six interviews were carried out with students at another medical school with a PBL curriculum The second phase comprised a package of questionnaires completed by medical students at two UK medical schools. Students who used reflective learning were better able to focus on what to learn and were less driven by assessment. Students at the PBL school showed a marked difference in their approach to learning. In the second study students at a school whose curriculum was PBL based differed in their approach to learning. Medical students who use reflective learning techniques take a more integrated approach to their learning. Medical students at schools with different curricula demonstrate differing approaches to their learning.