Teaching and assessing reflective practice using the Eportfolio

Plan for session

9.30 – 10.00 Intro to assessing and teaching reflection

10.00- 10. 15 Small group discussion about educator comments

10.15- 10.45 Looking at Eportfolios in 2’s

10.45 –11.00 coffee

11.00 – 11.15 Ideas for ways to encourage reflection in trainees.

11.15 – 11.45 – Any other business

Why?

Helps trainees develop thinking skills

Trainers ‘assessed’ via visits ( virtual or face to face)

‘Reflection is a metacognitive process that creates greater understanding of self and situations to inform future action’

Sandars’ definition demonstrates that the process of reflection is focused on the learner’s thoughts and feelings as well as their ability to utilise this learning in future situations.

Reflection is normally prompted by a complex problem or situation.

From OXVT3 - evidence in EPortfolio

You are familiar and up to date with administrative and technical aspects of MRCGP including the ePortfolio and are actively involved in using the ePortfolio to the benefit of the GPStR

You encourage your GPStR to direct their own learning and to develop self-awareness and critical thought evidenced by their full engagement with the ePortfolio in a timely way

Undertake regular and frequent learning needs assessment of the GPStR and use this for both planning and modifying teacher

Reflective practice is often confused with reflection.

However, it is not a contemplative state; rather, it is a challenging process that can often be best achieved by developing a relationship with peers or mentors.

Educationally and developmentally, self- awareness is vital if there is to be any attempt at a behaviour change

(Johnson and Bird 2006)

Purposes of reflection

There are multiple purposes of reflection:

• To develop or to consolidate practice;

• To provide reassurance or criticality;

• To improve performance or understanding;

• To enhance the quality of patient care;

• To provide understanding of and respite from the complex, demanding workplace.

Ref London Deanery ‘Reflection and Reflective practice’

Reflection theory ……

Reflection

Iterative –

What can I do differently, learning from the event

Schon – “reflection on action”

Deep –

Thinking processes

5 Whys?

Bloom

Research

RCGP expect assessment of reflection in portfolio

Want trainees to write “good” reflection

I suspected this meant different things to different people

Consistency in the Assessments

Grade Senior Educator n=23 Trainer n=22

Entry A Insufficient evidence 3 3

Needs Further

Development

20 19

Competent 0 0

Excellent 0 0

Entry B Insufficient Evidence 0 0

Needs Further

Development

6 6

Competent 16 13

Excellent 1 3

Inconsistent in Criteria

Description:

“Pear shaped entry”

Learning:

“Evidence of learning that will influence future behaviour”

Feelings:

“ How did they and others feel about

Metacogntion /Critical Thinking:

“Narrative moving from description to analysis and synthesis of case and evaluation of outcome”

Reflection is a skill not a style

It is not innate in all doctors

As educators we should be able to teach / develop it in trainees

How?

Interaction through reflective writing

How do you recognise good or bad reflection?

How do you develop it in your comments?

Questions you might ask a trainee

• How well do you feel you dealt with the incident? (Evaluation)

• What would you want to do differently next time? (Evaluation)

• How did you feel about the patient while he was deferring the test? (Bring out emotions etc.)

• How did you feel about him after the event? (Bring out emotions etc.)

• Has this kind of thing happened before? (Review)

• Have you learned things from patients before, or seen their experiences from their perspectives like this before? (Review)

• What learning points arose from this case? (Identify)

• What follow up actions are you going to take? (Establish action)

• How will you gather feedback and evidence those actions? (Feedback)