Appraisal - Reflective entries in your portfolio

Professor Rodger Charlton advises on how to make your portfolio entries truly reflective.

Take time to reflect on your learning
Take time to reflect on your learning

To make our learning relevant, we need to reflect and ask ourselves if this learning confirms good practice, or whether it should lead to a change in our practice, to benefit patients.

What is reflection?

If we write notes verbatim from a meeting or ask for a handout, are we really learning? We need to think all the time how learning relates to our clinical practice.

So what?

Faced with an electronic appraisal portfolio, you need to fill in a reflective template and will sometimes struggle to know what to write.

When your meeting or learning event is complete, which in our busy lives could just as easily be reading a journal or an eModule, ask yourself the question: 'So what?'

In other words, what does this mean for your current daily practice, your patients and the team? This 'so what' may be that you are already following correct practice or reflecting like this, or it may suggest that you need to change.

How did it make you feel?

You may still feel stuck for what to write in the template.

If so, perhaps you should ask yourself the question: 'How did it make you feel?' Possibly it was a situation where you felt irritated or you were frustrated about how best to help your patient.

The Clarity Appraisals Toolkit refers to quality improvement activities and in particular, to case reviews as part of that activity and an area to reflect upon.

This can apply to many areas of learning, including, for example, the review of a case or significant event, or a clinical audit.

How to be reflective

Ask yourself

  • - So what?
  • - How did it make you feel?
  • - Take a step back, be objective and identify areas for improvement.

Reflective entries

There is no right or wrong, but the answers to these questions should form the basis of a useful reflective entry. Length is not important for the reflection; think quality rather than quantity. Reflection is thinking and putting our thoughts into words about us and our patients and the illnesses they are experiencing.

The process of reflection should allow us to take a step back, be objective and identify areas where we might improve. It should enable us to identify learning needs and make changes to our practice.

  • Professor Charlton is a GP and professor of primary care education at Nottingham University.

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