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- Page navigation anchor for Written reflection in NHS appraisalWritten reflection in NHS appraisalCustis et al1 found that a majority of their respondents “did not find mandatory written reflection helpful or valuable. Respondents reported that written reflection was time consuming, with an adverse impact on other learning opportunities”. Their proposed alternatives have merit but they are not so much a solution to the tedium of excessive recording as alternatives to appraisal information. For example, videotaped consultations and case discussions are ways of improving quality, not just opportunities to capture reflection. Such activities, valuable though they are, will not be any less time consuming. There is a solution to the (non)problem of reflection already at hand and that is selective recording. Here in Suffolk, we have been telling our appraisees that they should aim to record a handful of genuine reflections on things that truly matter. That is more valuable in demonstrating their abilities to reflect than recording superficial, often formulaic, thoughts on practically every event. Unfortunately the latter is encouraged by current systems. Trainees are expected to reflect on every log entry. The design of GPs’ ePortfolios, such as Clarity do not have a system of flagging only significant reflections and every event has a box for entry of reflections.Making reflective practice meaningful means reflecting only on things that matter and doing so genuinely, this approach is supported by Colleg...Show MoreCompeting Interests: None declared.
- Page navigation anchor for Clinical reflection - part of being a good doctor and a necessary ingredient for high quality patient care, and lifelong learningClinical reflection - part of being a good doctor and a necessary ingredient for high quality patient care, and lifelong learning
I very much appreciate the article by Harris and colleges flagging up the topic of reflection in NHS appraisal and the negative experience and feedback on reflective writing.1 Reflective practice, is an essential activity for health care professionals and should be an integral part of all aspects of health care delivery, as it aids the development of professionalism by facilitating life- long learning and it can reduce diagnostic errors.2. Reflective writing can help to process emotions, improve mood, prevent burnout and improve patient's care.3 Clinical reflexion is not developed spontaneously and therefore is an essential part of the curriculum development.4
Unfortunately, despite being part of the undergraduate education, some students perceive reflective writing as irrelevant or even a nuisance or a waste of time. Reflexion and reflective writing is a clinical relevant skill, being practiced can help to become a better physician. Clinical reflexion should not merely be reduced to a tick box exercise, but should progress to a powerful tool, which should be individualised by the user in cooperating up to date learning and teaching methods.5 Further studies are needed in order to evaluate the effect of different educational strategies and supportive tools to promote its development and prevent reflection fatigue.6
References
1.Curtis P, Booth P, Frankland S...
Competing Interests: None declared.