Reflection – A guide to reflective writing

As this is quite a big topic and key to many areas in your ePortfolio (and future career as an independent practitioner) this has its own separate page.

Why?

What?

How?

How much?

When?

Examples

Links and Tips

Why should I write reflections?

Your ePortfolio (currently hosted on FourteenFish) is an opportunity to share evidence of your learning and development.

Not only is it useful for your own progress, but a good reflective entry allows your supervisor to assess you and confirm your skills in becoming an independent General Practitioner.

The whole practice of reflective writing isn’t just to get you through ARCP and appraisals, it’s a core part of being a GP.

What should I write about?

The entries you choose to write about needs to have some meaning to you in order to demonstrate your skills across the capabilities and clinical experience groups.

You can reflect on areas that you feel you’ve done well and have become confident in and why. More interesting entries focus on providing that evidence of your progress by highlighting areas that you feel less confident about, why they made you feel like that, the impact on you/the patient/your colleagues and importantly how you plan to address these learning needs you have identified.

How should I write my reflections?

You can write your entries under ‘Clinical Case Reviews’.

The template on FourteenFish Clinical Case Reviews currently as follows (click to expand).

Date of event

Brief description means brief description. It’s not about having lines of text that tells us the precise details, but just enough to give context onto the main part of your Clinical Case Review which will be the reflection.

GP, Hospital, Out of Hours

Here you’ll select which (3 maximum) areas this event covers.

1. Infants, children and young people [under the age of 19yrs]2. Gender, reproductive and sexual health (including women’s, men’s, LGBTQ, gynaecology
and breast)
3. People with long-term conditions including cancer, multi-morbidity and disability
4. Older adults including frailty and/or people at end of life
5. Mental health (including addiction, alcohol and substance misuse)
6. Urgent and unscheduled care
7. People with health disadvantage and vulnerabilities (including veterans, mental capacity
difficulties, safeguarding and those with communication difficulties/disability)
8. Population Health and health promotion (including people with non-acute and/or
non-chronic health problems)
9. Clinical problems not linked to a specific clinical experience group

Here you can select up to three capabilities that you think your entry provides evidence for.

When you select a capability, you will need to write a brief comment as to why your entry shows evidence for this specific capability. When your Supervisor reviews your entry, they’ll make a commend against the specific capability, highlighting that either it shows:

  • Indicators of Potential Underperformance
  • Needs Further Development
  • Competent
  • Excellent

At the start of training, it’s normal to have Needs Further Development as your ePortfolio aims to show your development through training.

The 13 capability categories are:

  1. Fitness to Practice
  2. Maintaining an ethical approach
  3. Communication and Consultation Skills
  4. Data Gathering and Interpretation
  5. Clinical Examination and Procedural Skills
  6. Making a diagnosis /decision
  7. Clinical management
  8. Managing medical complexity
  9. Working with colleagues and in teams
  10. Maintaining performance, learning and teaching
  11. Organisation, Management and leadership
  12. Practising Holistically, Promoting health and safeguarding
  13. Community orientation

You’ll find more info here or at igp.wales/capabilities

This section asks you to reflect on:

  • What Will I maintain, improve or stop?
  • Learning Needs Identified from this Event.

What will I maintain, improve or stop?

What went well that you would like to continue this again?

What didn’t go so well that you should either avoid this or do something to improve?

How much should I write in my Reflection?

One of the recommendations that stuck in my mind whilst training to be a GP Trainer by one of our Associate Deans was the Oak Tree and Christmas Tree Model.

This suggests that the majority of our content should weigh more towards the bottom, the actual ‘Reflection’ and ‘Learning Needs’ tends to sit there.

I was part of the last group that had their ePortfolio when it was still hosted on the RCGP website. Back in 2020 (on the cusp of the COVID-19 Pandemic) the Clinical Encounter template was:

  • What Happened
  • What if anything happened Subsequently?
  • What did you learn?
  • What will you do differently in the future?
  • What further learning needs did you identify?
  • How and when will you address them?

Although it’s a little different now, the main focus should still sit more on the areas of reflecting on the event. What will you maintain? What will you improve? What will you stop? And what are the learning needs identified from the event.

When should I be writing my reflections?

You should write when you feel you’ve got something meaningful to reflect on.

As a practical tip, it’s ideal for both you and your supervisor that you write ‘steadily’.

This doesn’t mean writing loads and overloading you and your supervisor.

The pitfalls of leaving the portfolio empty for months at a time and clustering entries together?

  • More pressure on you to write
  • When your supervisor provides feedback and advice on one entry, many entries written at the same time may end up having the same feedback.
  • This can be problematic because it does not allow you to digest the feedback, apply it, and demonstrate that feedback to your supervisor in your next entry.

A tip I heard from a GP appraiser is that they don’t want to have to wade through masses of entries. They want to see quality entries where doctors can convey what impact this has made to you, to your practice, to your colleagues and patients.

Examples of reflective writing

This bit, I’ll need to update.

Links to reflections