The use of structured reflections for promoting personal understanding and community self-efficacy was examined in 65 occupational therapy college students in a service learning course. Students in the experimental group wrote structured reflections throughout the semester while students in the control groups used non-structured reflections. Outcome measures included quantitative tests of personal understanding and community self-efficacy (Personal Growth Initiative Scale, New General Self-Efficacy Scale, and the Community Self-Efficacy Scale) and a qualitative narrative. Results indicated that students who wrote structured reflections significantly increased in personal growth and personal self-efficacy, whereas those using non-structured reflections showed no change. Both groups improved in community self-efficacy scores with no significant difference between groups.