This Blog explains the meaning and importance of reflection in a doctor’s appraisal
Reflection is a professional habit that all doctors should have. No-one would want to be treated by doctors who never considered how effective their care was or whether it could be any better. We all reflect on what we do. Reflection – thinking critically about what we do, why and how and where and when we do it, and whether it could have been done differently – is something doctors do all the time. It is part of our professional training.
Like any habit, for some doctors, reflection can be such a subconscious activity that it can be hard to bring it to conscious awareness in order to capture it or write it down – for appraisal or any other reason. The difficulty for many doctors is in recording their reflection in a way that feels as natural as the act of reflection itself. Many doctors find that their appraiser facilitates their reflection through active listening, careful questioning and feedback. The appraisal discussion is an important trigger to generate new reflective insights which can be captured in the appraisal summary.
Another difficulty for many doctors is a feeling that they have to record all their reflections – which feels like having to record every thought about patient care and practice that they have every day. This would clearly be disproportionate. It is important to find a method of capturing reflection that works for you and to keep it simple and proportionate. Some people are more ‘natural’ reflectors than others – and it is helpful to understand your own preferred ‘learning style’. Well trained and supported appraisers can be a useful resource to discuss this with.
Documented reflection should be brief and to the point as far as possible. Capturing the key learning points that have influenced, or will influence, your practice, and thinking about any changes that you may make as a result can be recorded in bullet points, a couple of sentences, or a short paragraph. Some doctors are experimenting with recording brief audio reflections. Do what is appropriate for the particular reflection. Experiment with a variety of styles. Some methods may work better for some types of learning than others. While it is possible that you might choose for your own benefit to write a whole reflective essay, including a literature review (particularly if you are doing a postgraduate qualification), in most circumstances this would be disproportionate.
Some doctors find structured reflective templates that walk you through a process of reflection helpful. Others prefer not to be constrained. The RCGP recommends that you keep it simple and record what is meaningful to you.
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