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Reflection- made easy!

Updated: Apr 6, 2022

Do you want to write reflections for your portfolio quickly and easily but not quite sure where to start? In this post I will describe a strategy that will make reflective writing straight forward and a valuable addition to your portfolio.


What is reflection?

Reflection is the process of reviewing events and thoughts, evaluating what you have learned and identifying how you can improve.



Three reasons to reflect:

  1. Demonstrates continuous learning, an important aspect of medical practice.

  2. Helps to make sense of challenging situations and interactions with patients and colleagues.

  3. An effective tool in consolidating knowledge gained in conjunction with other learning methods.


What can you reflect on?

The short answer to this question is everything! We all reflect informally on both medical and non-medical events, often without realising that it is a form of reflection. For example, if you set off from home at 7.45 in the morning and you run into traffic making you late for the ward round you would set off earlier the next day to ensure you are on time for work.


I have listed common reflection topics in medicine and these are often linked to other assessments that you can complete.

  • Practical procedures

  • MINI-CEX

  • Case based discussions

  • Rare cases/ unusual presentations

  • Patient encounters (e.g. challenging cases or an example where you picked up a significant issue)

  • Teaching for students/ doctors

  • Shift reports (often in the emergency department a senior doctor assesses how you managed the work flow and supervision of junior doctors)

  • Staff encounters (e.g. conflict or challenges in communication)

  • Feedback from supervisors and senior doctors

  • Conferences/ lectures/ courses

  • E-learning events/ webinars


Reflection model- the Gibbs reflective cycle

There are many models of reflecting on events in literature but the most commonly used is the Gibbs reflective cycle. The different sections in this cycle are description, feelings, evaluation, analysis, conclusion and action plan.


Description

  • A short summary of the event you are reflecting on.

  • Must be factual.

  • Common pitfall: making this the largest section and describing the event rather than reflecting on it.


Feelings

  • Describing your feelings through the event that you are reflecting on as well as after the event when you look back on it.

  • Also consider the feelings of the other people involved in the event (e.g. patient, another staff member, relatives).

  • After each description of your feeling, describe why you felt the way you did.

  • Common pitfall: only taking one point of view and not exploring the other people’s feelings and emotions.


Evaluation

  • A breakdown of the events, can be chronological or based on what elements went/ not went well and describing why.

  • The ‘why’ element of the evaluation is critical and forms the most important part which is reflection.

  • Common pitfall: not describing why an event went well/ not went well.


Analysis

  • The reasons for events which went well or did not, can be based on past experiences and learning which is different for everyone.

  • This section can be interwoven into the evaluation section after each description of events that went well/ not went well if it makes the writing flow easier. I certainly link these two elements together when I write my reflections.


Conclusion

  • A short summary of your reflection and identifying any learning needs.

  • Common pitfall: not recognising at least one learning need.


Action Plan

  • Using SMART (specific, measurable, achievable, relevant, time-orientated) goals to plan how to meet your learning needs.

  • Common pitfall: not coming back and evaluating the action plan to see if it has been satisfactorily completed. Also setting unrealistic deadlines (e.g. learning everything about cardiology in one week).


Final step- creating a template

A lot of medics often procrastinate when staring into a blank page when it is time to write a reflection, I know I used to! You will be happy to know that there is a shortcut to making this process easier by creating a template (e.g. on Microsoft Word) to use each time you would like to reflect. In this template, I use section headings similar to the Gibb’s cycle with question prompts which helps me to ensure that I have covered the important aspects. I have summarised what my reflection template looks like with my prompt questions but feel free to add or remove anything to suit your reflection style.


1. Background


2. What I am reflecting on and why


3. What went well and why?

Prompts: verbal and non-verbal communication, consider past experience/ events/ training.


4. What could have been improved and why?

Prompts: my own/ patients/ staff.anizational factors that contributed.


5. Feelings and emotions- why I felt this way?

Prompts: my own/ patients/ staff


6. What I have learned from this event

Prompts: identified any new perspective? Any learning from guidelines/ e-learning/ literature after the event.


7. Discussion with supervisor, written feedback received (if appropriate)


8. Action plan

Prompt: SMART goals (specific, measurable, achievable, relevant, time-orientated).


9. Action plan completion statement

Prompt: add in date completed with any issues encountered.



Summary

Reflection is a really important tool in professional development and by making it easy to complete, by using a template you can save time and effort. Over time you can add in or modify different sections to suit your learning needs and reflection style as one size does not fit all! Have fun reflecting!



Reference

Knight et al. Reflection: how do I do it? BMJ 2013; doi 347: http://doi.org/10.1136/sbmj.f6387

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