Enhancing Clinical Excellence Through Reflective Practice

1. Reflective Practice Dr Caroline Whelan GP Registrar August 2012

2. Why do we need it? • We have to do it to pass • To find gaps in our knowledge so we can address them & then apply what we learn • To widen our professional boundaries • To benchmark our performance against our peers & supervisors • To develop as adaptive experts • To generate the questions that might enable service improvement or research

3. What constitutes reflective practice? • Observing • what is obvious & less obvious • look for the unfamiliar • Self-awareness • What you sense or feel about the experience • Use of I • Self-regulation • Recognise your own boundaries • Check against competencies

4. What constitutes reflective practice? • Internal conversation • How you feel about the situation • Write about your reaction to the situation • Use feeling words • Openness • You are willing to highlight areas of your performance that fall short of what might be expected • Learning • Show what you need to learn & be specific about how you are going to achieve this

5. How do we actually do it? • Learning log • Record of professional development • Quality not quantity • But......if there is insufficient quantity then it is unlikely that an adequate quality will have been demonstated & the areas of the curriculum are unlikely to have been covered.   • A list of descriptive entries is not acceptable

6. What to write about • Chose meaningful experiences • Important to think why have you chosen this specific case • Cover all areas of the GP curriculum (check by clicking on review preparation) • Difficult patient encounters • Difficult encounters with staff • Things which went well • Significant event analyses

7. The e-Portfolio template • What happened? • What if anything happened subsequently? • What did you learn? • What will you do differently in future? • What further learning needs did you identify? • How and when will you address them?

8. What happened? • Brief synopsis which puts the case into context • Include emotions you were feeling at the time so reflections can be made on these • Did the case remind you of a previous case or past experience?  • Don’t be afraid to be critical of your own actions   • How did your colleagues react to the situation?

9. What if anything happened subsequently? • Complete the story • Reflect on how you feel about the situation now

10. What did you learn? • New medical knowledge • How will this help you in your future practice? • Concerns about your own ability/thought processing • How it will make you change? • Insight into your own attitudes & beliefs • How did the case challenge you? • How will it make you change? • Implications on service provision

11. What will you do differently in future? • Turn your learning needs into actions • What will you do differently next time  • What would you like to improve

12. What further learning needs have you identified? • Specific short term goals • Relate these to the GP curriculum • Can be knowledge/behaviour based  • Plus longer term goals to help you become a good GP • Break it down into manageable tasks • Set a time scale (be realistic)  • Move it to your PDP (then do a log entry about your learning to complete the cycle)

13. PDP • Simple • Measurable • Achievable • Relevant • Time based

14. Useful websites • http://eastkentgpvts.co.uk/education.htm • East of England Deanery GP page – click on resources and download the Being a Reflective GP PDF