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Summary of week one

All healthcare professionals regularly reflect on the knowledge, skills and attributes that they have developed.
Hi my name is Dr. Jane Goodfellow. I am an associate professor at Leicester Medical School in medical education. I just wanted to take 10, 15 minutes, just to give you a bit of an introduction into reflection. I think sometimes when we hear about reflection, it can sound a bit scary. It’s sometimes quite difficult to do because we have to be really honest with ourselves. So I hope by going through this and introducing you to reflection helps just to make that process a little bit easier. Because if you want to go on to become a good doctor or a good health care professional, it’s a really important skill that you need to be able to master.
So in this, kind of, mini lecture, we have to think about what reflection is, why we should reflect, how we can do that. There are different ways that you can do that. We’ll also have a think about a reflective diary, and why keeping one can be quite useful. So let’s have a think, first, about what reflection is. And reflection, really, is thinking. And people do their thinking in all different sorts of ways, and you need to think about, for you, how does your mind work and at what point do you kind of think about things. Do you do it when you’re walking the dog? Do you do it when you’re having a shower?
When you’re on your commute to school or to work, for example. Think about when you do your thinking and when those ideas come to you, when the inspiration strikes. And how do you make sense of your day and get things straight in your mind? And what are you doing when those happen? Because all those kind of things are reflection. So as you’re thinking, you’re mulling over what’s happened. You’re trying to make sense of the day, make sense of what’s happened, how you’ve spoken to people, how you’ve interacted with people, what’s happened. All of those types of things are reflections.
So you might think or reflect on different events that happen with friends or family, what happened whilst you were at school and whilst you were at work. For different people we do different things to help us to think. Sometimes we need some time on our own to give us some peace and quiet, headspace. Sometimes we might want to be listening to music. Sometimes we might be meeting up with friends or family members and talking things through. Sometimes it might be doing activities like walking the dog or exercise. Might be while still on your commute. Some people keep a diary, and they write and reflect as they keep a diary.
So all these different things that you do to help you to think are things that you can do to help you to reflect. Because reflection is just trying to make sense of your thinking, and thinking about how you can then use that newfound insight in order to perhaps change and develop a little bit.
And that’s kind of why we reflect. We reflect to try and grow and to try and develop. So we might reflect to make sense of something that might be happening at work or at school, or perhaps something about ourselves we’ve maybe got a bit more insight. Perhaps we were in an argument with a friend, and we realised we actually did lose our temper a bit quicker than we wanted to. So you might think about what you could do to try and stop yourself from losing your temper or keeping calm as we’re having conversations. You might grow and develop by deciding about what we might do at work. Perhaps there’s a problem at work.
We might need to make a plan about something, try and come up with a solution. Reflection can help us to do all these different things. Might help to make things at work or at school better. And we reflect to become a better health care professional. Because if we’re going to be a really good health care professional, and we’ve got our patients’ needs kind of forefront of our mind, we need to be the best person that we can be. We need to continue to develop to make sure that our communication skills are as strong as they could be. We need to make sure that we are keeping up to date with knowledge and new information.
We need to make sure we’re able to explain that clearly to patients. We need to make sure that we can work well as a member of a team because you can’t treat the patient alone. We only work, and work as good health care professionals, as part of a multidisciplinary team. So we have to continue to develop and to grow if we’re going to be really good health care professionals. And we do that by becoming a bit more aware of our thinking, of knowing yourself and your limitations, of knowing how you think and feel about things, and perhaps how you’re going to respond in certain situations. And we might do this to learn how to change ourselves.
So you already are showing lots of the skills and the attributes that we’re looking for as future doctors and future health care professionals. But actually, there might be some areas that could benefit from working on. In fact, I would say for every person, there’s always something that you can work on, and you can develop. So part of a reflection is being able to create an action plan in order to develop those skills and those abilities. But we can only do that if we can work out what they are in the first place.
So if you want to be a really good health care professional, you have to be able to reflect, you have to be able to develop and change and grow. And these are skills that are really, really tricky. And the more you practise and the earlier you start practicing them, the easier it is to reflect and the better health care professional you become. And now is the time to start practicing them. So how can we reflect? Well, you need to give yourself time to think and to process new experiences and new information. So for some people, they might come out of, I don’t know, perhaps you had a conversation with someone at work, and they can straightaway think, oh, God.
You know, I shouldn’t have said it like that. I should have said something different. For other people, it might be a day or two, or a time, before they’re able to think about that. Or they might need to have conversations with a few family members or a few friends to help them process that information. And that’s absolutely fine. Everybody thinks and reflects in different ways. And so, as we reflect, we need to ask ourself questions to probe a little deeper, to try and understand how you were feeling when something happened, why you were feeling like that, and perhaps what you might be able to do next time.
And it can be really useful to write down our reflections because we can look back and we can see how far we’ve come, but it also helps us to organise and to structure our thoughts. And once we can see what’s happened and how we responded, that makes it a bit easier, then, to try and come up with ways that we might be able to do things a bit differently next time. For some people, they can sit down and just write all of that. I’ve never been one of those people. And sometimes it can be much easier to kind of do it out loud first before you try and write those reflections down.
That might be through having a conversation with a friend or family member. Maybe they can ask you some questions and probe a little deeper. Or sometimes you could just do it yourself and record a memo on your phone. And I always reflect a bit better when I talk about something than when I have to just sit and write things. And there are lots and lots of different tools available. This is one of the ones I like the best. So it was done by Rolfe et al. That means, just, and others. So there was a group of them that developed this. The first thing you ask is what happened. So you say, what was the situation? What happened?
What were you doing? What were others doing? So you sort of slightly describe the situation, and then you ask yourself, well, so what? And you might probe a little bit more. You might say, well, did I really need to know how to help me deal with that situation? So what? What else could I have done? And then, finally, you think, well, now what? So as you understand things a bit better, now what will I do to make things better? Will I be more open to things? How will I do that? What might be the consequences if I did something a bit different?
And this process could be really good to help you– if you go round and round in circles a few times, to really dig at what’s happening. So let’s have a think about an example. Perhaps you were doing a group project at school, and there was conflict in your group, and you had one idea. Someone else had another idea, and you voiced your opinion quite forcefully because, actually, you knew that that was the best way of doing something. But as a result, someone else got a bit upset, and you ended up having a bit of an argument about it. So that was the “what” that happened. The “so what” might be, so did I really need to be so forceful?
Is there another way that I could have phrased that? How did that person respond? Well, actually, they got really upset doing that. So what was that about? Or perhaps the tone of voice I was using wasn’t the most useful. And if I’d have phrased it in a more positive way, and perhaps watched the tone, that I used as I said the question or I questioned her, actually, that would have been a bit better. And perhaps we wouldn’t have had that awkward fight. And perhaps we would have been able to get on with our project a lot quicker because we would have all known what we were doing.
And I might have actually been able to put my view across in a nicer way, and that person might have been a bit more receptive to it. And then the “Now what” is so what will I do differently next time? I might want to apologise to the person that you’ve upset. But you might also want to think about what you can do to stop that from happening. So if you know that you often are quite confident in your views, and you’re quite assertive as you’re putting those forwards, when you realise that perhaps you might need to say something, you might stop and pause and think about how you might phrase things differently in the future.
You might think, actually, I need to just watch my tone here, or perhaps I could ask them for their thoughts first, before I voice my thoughts. And it becomes more of a discussion instead of me just telling them what I should do. And then if you are in that situation again, you could go through the same thing. And whether, actually, that was much better because you phrased things in a different way. So actually that’s a good thing to carry on doing, and you’ll continue to work on that. So by going around in the circle, it can really help you to unpick what’s happened.
And by keeping a reflective diary can really be useful to help you collect and to group your thoughts. And there is a reflective diary that the Medical School’s Council have put together. So I would say, have a look at that. Read through it. There are lots of amazing tips and tricks in there about reflection. And it can be a really useful process to help you get the most out of what you’re studying now. Now, reflection can be really difficult. And the more you do it, and the more you practise, the easier it becomes.
So even if at first it becomes quite tricky and you get a bit stuck as you try and write your reflection, the more you practise, the more you persevere, the better reflector you’ll become, and the easier it will become.

In week one, we have looked at the history of the NHS, explored the NHS values and started to think about some of the challenges currently facing the NHS. We have also explored the role of a GP and found out about some of the patients they might see.

To help consolidate your learning, it’s important that you reflect on what you have learnt. Reflection is an essential skill for any aspiring healthcare professional, as all healthcare professionals regularly reflect on the knowledge, skills and attributes that they have learnt or developed. This helps them to identify their strengths and any areas for development so that they can continue to provide high quality care to their patients.

To understand more about what reflection is and how to do it, watch this talk from Dr Jane Goodfellow.

After watching the video, take some time to reflect and think about what you have learnt this week before you start week two’s learning. Don’t worry if you find this difficult at first. Throughout this project, there will be lots of opportunities to practice and develop your reflection skills.

Below are some questions you may want to reflect on this week:

  • What did you learn this week that you didn’t know before?
  • What knowledge have you gained about the roles and responsibilities of a general practitioner?
  • Did you learn anything this week that surprised you?
  • Are there any careers you want to go away and research further?
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