Reflection
Reflections may be done verbally during the appraisal discussion - they will be captured and recorded by the appraiser in the summary.
The GMC requires us to reflect on our practice, but what exactly is reflection and how do you do it?
The three "whats" of reflection
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What happened?
-I read an article -I went on a course - An urgent referral was delayed |
What's important?
-The guidelines have changed -Never prescribe X with Y -Urgent referrals must be sent within 24 hours |
What next?
-I'll update my colleagues at our next meeting -I'll audit patients taking X and Y -I'll dictate urgent referrals during the consultation |
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Inputs and outputs |
The GMC says, "CPD should focus on outcomes or outputs rather than on inputs.
You must reflect on what you have learned from the activity and how this could help maintain or improve the quality of your practice."
Your appraiser will be looking for evidence that you are applying your learning to your practice. For example:
You must reflect on what you have learned from the activity and how this could help maintain or improve the quality of your practice."
Your appraiser will be looking for evidence that you are applying your learning to your practice. For example:
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Input
I completed an on-line learning module on disease Y. |
Learning
Drug A should not be prescribed with drug B. |
Output
I asked a member of staff to run a computer search for patients taking both drugs. The staff then invited each patient identified to have a medication review. |
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Input
I attended a meeting about hospital bed pressures. |
Learning
There is a new clinical service for patients with disease X. |
Output
I shared the details of the new service with my primary care team via email. |
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Try this spreadsheet for keeping a simple record of the three WHATs, the inputs and outputs, and short reflections. Record your reflections as you go, while it is still fresh in your mind. Store your CPD record and reflections in the cloud so it is available anywhere even on your mobile phone. Upload the complete spreadsheet to your portfolio at the year end. Examples of free cloud storage: Dropbox, Google Drive, OneDrive. |
Examples of anonymous reflection.
Reflection on a significant incident (NHS SSW, March 2018)
Reflection on a prescribing issue (NHS SSW, March 2018)
Reflection on a complaint (NHS SSW, March 2018)
Reflection on a prescribing issue (NHS SSW, March 2018)
Reflection on a complaint (NHS SSW, March 2018)
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Appraisal for revalidation: a guide to the process (Academy of Medical Royal Colleges, July 2014) says,
"Reflection... should not be a complex or time-consuming process, and essentially involves
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Improving feedback and reflection (Academy of Medical Royal Colleges, May 2017) describes reflection as a cyclical process.
It also explains how feedback from, and calibration by the trainer [appraiser?] is important and how they enhance the learning derived from reflection. "Without feedback, reflection amounts only to teaching oneself." (see pages 7 & 8). |
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The reflective practitioner (Academy of Medical Royal Colleges, the UK Conference of Postgraduate Medical Deans, the General Medical Council, and the Medical Schools Council, September 2018) |
Summary of "The reflective practitioner" (Academy of Medical Royal Colleges, the UK Conference of Postgraduate Medical Deans, the General Medical Council, and the Medical Schools Council, September 2018) |