Context and Introduction

The notion of ‘reflective practice’ is not a novel one. The term was coined by Schoen in the 1980s, building on the seminal work of Dewey at the start of the 20th century, and can defined as, 'the capacity to reflect on action so as to engage in a process of continuous learning’.
It is, according to the Schoen, ‘one of the defining characteristics of professional practice’.

GPs and specialty doctors have been informally reflecting on their practice since time immemorial, and written reflective practice as a therapeutic instrument has been popularized amongst clinicians by Moon and Bolton amongst others for many years.

However, it is only since 2007, with the introduction of the so-called ‘new’ membership exam for qualification as a GP in the UK (nMRCGP) that written reflective practice has been a compulsory component of the assessment of GP trainees. More latterly, it has been tentatively introduced into the revalidation eportfolio for qualified GPs.

At the time of writing, GP trainees are required to maintain an ‘eportfolio’ – an online record of their progress, including workplace based assessments, clinical encounters, and other learning experiences. Trainees are expected to write ‘reflective’ log entries, which aim to develop personal learning. By demonstrating curriculum coverage and development of ‘competencies’ the trainee’s Educational Supervisor assesses progress on an ongoing basis.

As a novice ST1/2 small group facilitator, it became apparent that my trainees were completing their entries only with reluctance. Their educational supervisor voiced concerns with the poor quality and lack of depth to their eportfolio entries. To an extent, I sympathized with the trainees' moans, recalling my own uncertainties about what was expected of my as a trainee in terms of my reflective entries. It was not until I attended a workshop on clinical reflective writing (having completed my GP training), that I really ‘got’ what rigorous, disciplined reflective practice was all about.

In an attempt to tackle this issue, which was dominating the small group work on occasion, I devised and led a workshop, which aimed to refocus the trainees’ view on the potential for personal development through the writing, whilst still targeting the curriculum statements. The resources on this page are designed to help other GP educators faced with similar difficulties.

Please feel free to use the accompanying resources!

Andrew Boyd 2011

andrewboyd@doctors.net.uk

Reflective Writing Workshop Resources

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Powerpoint Presentation - Reflective Writing (93 k)

Feedback form - Reflective Writing Workshop (74 k)

Reflective Writing Workshop 2 (108 k)

Reflective Practice Workshop 1 (113 k)

A Proposed Workshop Format

The linked documents offer the structure I developed for my workshop; needless to say some adaptation will be needed to fit your requirements!

Broadly, the workshop's aims to:

- Find out where the trainees 'are' in terms of reflective practice and the eportfolio itself
- Give them an opportunity to explore for themselves the value of critical reflective writing, with the sole aim of personal development, and separate to the eportfolio
- Offer trainees a structure for future eportfolio entries, interpreting the eportfolio framework after familiarising themselves with relevant curriculum statements

I advise the reader to try and familiarise themselves with at least some of the publications on the linked reading list before running the session.

Some considerations:

Timing
I will endeavour to run future sessions a few months into the ST1 (first year) of GP training; late enough that the trainees have got to grips with the eportfolio, had a go at reflective entries and received some feedback from their supervisor, but soon enough that they don’t develop resistance to the process!

Trainee numbers
I think a group size of between 6 and 10 is ideal for the workshop, but it could be attempted with a larger group – up to 20 if needs be. The problem with larger groups would be for the group discussions – detailed below – but the writing tasks would be very manageable with a bigger group.

Format
Precisely how an educator chooses to run his or her session will depend predominantly on time available. The monthly ‘full day’ release programme in Dorset allowed me to devote two full afternoon sessions to the workshop (2pm -4.30pm). A revised version of the workshop could be implemented in two two-hour sessions, or even one session at a pinch!

Materials

For each workshop you'll need:

Enough paper for everyone to write lots
A quiet room with enough space for one-to-one discussion
A group of bemused trainees...

Reflective Writing Workshop

Context and Introduction

Reflective Writing Workshop Resources

A Proposed Workshop Format

Further Reading

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