Make categories of reflection less restrictive

Most doctors are naturally reflective. There is good evidence that more reflective clinicians learn from their experience and progress and develop. In this world of evidence, the powers that be have decided you need to prove that you are reflecting by logging it into your ePortfolio. This is very frustrating for many people. But if we can’t change the rules (yet), then we should make the systems work for us to make this generating-of-evidence-of-reflection less painful.

Reflection is a broad concept, but this is not reflected (ha ha!) in the current ePortfolio.

Today I listened to a podcast on my way into work, read a news article about the assisted dying bill on my laptop, had a chat with a colleague over coffee about a patient with a rare diagnosis, and moaned to my mum on the phone about a rude and unprofessional colleague. All of this is reflection. But where could I log any of this in my ePortfolio?

We need open categories, and the ability to log URLs/web links and comment on them. This needs to be fast and easy.


6 responses to “Make categories of reflection less restrictive

  1. I agree. Most of my reflecting is done with my team and with nursing staff, or on an ad-hoc basis by following a link from Twitter or from a newspaper article. And if people are bad at reflecting then doing forced reflections in eportfolio won’t hlep them. They need a sit down with a senior for some training.

    For me, the most frustrating thing about the current reflection section is how many boxes you have to fill in (how did it afffect you/the patient/the team/the ward clerk/the canteen staff/the patient’s cat etc etc), and the fixed box size which means you can’t just scan up to see what’ you’ve just written, you have to scroll through 5 lines at a time.

    I think one box for title, one for background and how it affected you, and one for what you’ve learned/will do differently/what you’ve done since then, with the ability to link to URLs. With variable size to accomodate more text without scrolling.

  2. I agree that these are excellent topics for reflection, but surprised that you can’t enter it. I am only familiar with the GP Trainee portfolio and not foundation – certainly I would encourage my GP trainees to put entries like this and it’s a real shame if the foundation portfolio is not flexible enough to allow it.

  3. Now I am worried, introducing a similar system for Consultants appaisials, without the evidence that it has been successful with our junior colleagues As you said speed and ease of use is also a very strong determining factor.
    I wonder also we do we need further education on reflection and it categories . With a definition of a good reflection ?

  4. We don’t talk nearly enough about what reflection is or how to get better at it. I came across this paper last night which is about helping student teachers develop skills in reflection. They had exactly the same attitude as many doctors and students to the tasks they were given, until this instructor banned the R-word, and started a dialogue in text with the students. They got it.
    It’s really worth the read, and I think we need some examples like this in medical education. We need to model what we mean by reflection and not ask those we are mentoring to do a task that we wouldn’t do ourselves.

  5. These are all great comments that must be fed back to the Royal Colleges – keep them coming!

  6. I absolutely agree that the restriction of reflections to a number of pre-titled forms is a major hindrance to foundation trainees, who legitimately want to make reflective practice a useful part of ePortfolio. I did voice these concerns to the ePortfolio team at the time the changes appeared, as well as with the deanery….I was told the changes were to make things ‘less confusing’ – for whom I wonder? It is moves like this which make me feel that ePortfolio is in danger of leaning towards becoming a tool for administration to easily prove that we are ‘meeting standards’, rather than as a tool with the aim of enabling my learning.
    Before the change, I routinely reflected on day to day events, interesting articles I had read or interesting cases I had been exposed to. If the aim is in fact to make things more straight forward, why not have a blank form with a blank title that they user can fill in themselves?!! Short guidance on ideas for reflection could be put in the ePortfolio handbook for trainees who find themselves in need of inspiration.
    To my mind, reflection is about me taking responsibility for my development as a doctor. It is about developing an understanding of how my day to day experiences fit into my development as a doctor. It is a tool for me to assimilate my experiences, whatever they may be…..and whether they fit into the ‘boxes’ pre-defined by ePortfolio is, in my opinion, irrelevant to their potential importance.

    Just give us white space!!!

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