GMC sets out expectations for doctors' reflective practice

The GMC has joined forces with eight other healthcare regulators to highlight the importance of health professionals undertaking reflective practice and set out 'common expectations' about reflection.

(Photo: Hero Images/Getty Images)
(Photo: Hero Images/Getty Images)

In a joint statement, the GMC said it would not request written reflections when investigating a concern about an individual – but it said doctors could choose to offer this as evidence of insight into their practice.

The statement, called Being a reflective practitioner, says reflection should not be a ‘tick box exercise’ and should involve reflecting on both positive and negative experiences.

It said that when things go wrong there should be opportunities for multidisciplinary teams to ‘reflect and discuss openly and honestly’ about what happened. ‘These valuable reflective experiences help to build resilience, improve wellbeing and deepen professional commitment,’ the statement added.

The GMC issued the statement with organisations including the Nursing and Midwifery Council, the General Dental Council and the General Pharmaceutical Council.

Group reflection

The GMC separately said that group reflection should be encouraged by doctors' employers and training providers because it ‘provides mechanisms to identify complex issues and effect change across systems’. It also said that time should be made available for doctors to both self reflect and to reflect in groups.

The MDU said it was hopeful that the statement would help to reassure doctors about some of the ‘misconceptions about reflection and the contents of reflective notes’.

MDU head of advisory services Dr Caroline Fryar said: ’As the new statement points out, reflections should be anonymised and focus on what has been learned, rather than the identifiable details of those involved or the event.

‘The statement explains that the regulators will not ask for personal written reflections in order to investigate a concern against a registrant. However, the MDU’s experience shows it can be helpful for doctors to offer evidence of their reflections when responding to a GMC investigation, for example to demonstrate they have learnt from the experience.’

Guidance on reflection

The GMC produced new guidance on reflective practice last year in partnership with the Academy of Medical Royal Colleges (AoMRC), the Conference of Postgraduate Medical Deans (COPMeD) and the Medical Schools Council. The guidance followed concerns raised by the profession about how reflective notes are used following the high profile case of Dr Hadiza Bawa-Garba.

Although reflective entries from Dr Bawa-Garba’s eportfolio were not used as evidence against her, notes made by her duty consultant on a meeting he had with her after the incident formed part of his witness statement, which caused some GPs to boycott reflective notes altogether.

The GMC guidance says that although courts may demand to see the contents of doctors' reflective notes, the GMC itself 'does not ask a doctor to provide their reflective notes in order to investigate a concern about them'.

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