What is reflection?
A question I often get asked is: ‘What actually is reflection?’ and ‘What makes good reflection?’ Well reflection is a set of processes to identify what you need to change in order to be a better doctor. It is not a case of recording how you feel or listing the content of a meeting but more about what you would’ve done differently.
Most successful professionals are already good at reflection; they just use other terms for the process. For example, as doctors we might wonder ‘ Am I doing the best I can for this patient?’ This is actually academically referred to ‘reflection in action’ although many doctors probably wouldn’t recognize this.
When should we document reflection?
Reflection also needs to be done after CPD sessions and you should be asking yourself ‘How does this relate to my patients?’ and ‘Do I need to change anything?’
For more significant events or cases it may be beneficial to follow a more recognized structure, of which there are several for example Gibbs, Kolb and Schon. These are the three academic models of reflection of which more information can be found out here.
It is also important that reflection doesn’t just lead to plans but actually leads to some kind of action – this may be in the form of an audit, new practice policy or even demonstrated in the real impact for patients by reporting cases where the management was different as a result of reflection.
How should you go about documenting reflection?
The real challenge with reflection is documenting it rather than doing it. So what is a practical way of doing this?
1. Well we don’t see a lot of this now but we do still see doctors that just put down certificates as a part of their CPD. If you are one of those doctors then the very first stage of documenting your reflection is writing down the facts that were transmitted during the CPD.
2. The next stage would be what have you learned from attending that meeting. This in itself isn’t really reflection but they are the first stages of it.
3. The third stage is all about what you are going to do differently as a result of this learning.
4. A fourth stage would be your action plan on what you need to do differently for example try a new diabetes treatment.
5. A final stage is how would you measure whether you’ve carried out your planned stages. Once you reach the fifth stage this is also a quality improvement activity out of your CPD.
Dr John Bibby
Appraisal Director, FourteenFish