REFLECTIVE notes do not need to capture full factual details of an experience but should focus on learning or actions taken from a case or situation, says GMC guidance published to reassure registrants in light of the Bawa-Garba case.
The new guidance has been developed jointly by the GMC, the Academy of Medical Royal Colleges (AoMRC), the Conference of Postgraduate Medical Deans (COPMeD) and the Medical Schools Council. It confirms the importance of reflection for personal development and learning and highlights how reflection can help maintain and improve standards of professional practice, helping to drive improvements in patient safety.
Key advice on being a reflective practitioner also includes:
- Reflection is personal and there is no one way to reflect.
- Having time to reflect on both positive and negative experiences is important.
- Group reflection often leads to ideas that can improve patient care.
- Tutors, supervisors, appraisers and employers should support individual and group reflection.
The guidance acknowledges that recorded reflections, such as in learning portfolios or for revalidation or continuing professional development purposes, are not subject to legal privilege and disclosure might be requested by a court if considered relevant. But it states that the GMC does not ask a doctor to provide reflective notes in order to investigate concerns, as the focus in fitness to practise investigations is on "facts and evidence relating to a serious allegation".
It adds: "Following a significant event or a serious incident, factual details should not be recorded in reflective discussions but elsewhere, in accordance with each organisation’s relevant policies."
Professor Colin Melville, director of education and standards at the GMC, said: "The GMC doesn’t ask doctors for reflective notes to investigate concerns; in fact we have called for those notes to be given legal protection.
"However, we know there is some uncertainty around reflection, and this new guidance provides practical support to help doctors and medical students."