Reflective practice and CPD
The recent joint statement of the UK’s statutory health regulators, including the GDC, Benefits of becoming a reflective practitioner [1] asserts their encouragement to registrants to be reflective practitioners. Each regulator has its own approach to this – the GDC has made reflection a key part of its Enhanced CPD scheme and encourages each registrant to do it “in the way that suits them best” – but the overall concept is very similar across the healthcare sector.
A starting point could be the maxim of psychologist and educationalist, John Dewey in 1890s that you should have “active, persistent and careful consideration” [2] of what you know and why you know it. For dentists this will be an intrinsic part of how you work, thinking about how each course of treatment has gone, but the regulators want to make this even more deeply ingrained by encouraging active reflection and wanting you to consider how you develop your skills throughout your professional life.
When doing your CPD, reflection will involve your PDP and CPD log. You should record the insight that you have gained through your CPD – both when planning and anticipating a CPD activity and afterwards in putting it into practice. This need not be long, but should indicate how useful the CPD activity was and whether and how it has changed your work systems, procedures or behaviours.
The joint statement makes clear that this record will not be requested by the regulators for investigations. This would stop practitioners from critically identifying and addressing weaknesses in their knowledge or ability. So your PDP and CPD log (which the GDC can ask to see) only needs to record that you have reflected upon your practice and your learning. The GDC’s model log contains a section for reflection looking at how the CPD has been of benefit. The GDC is mainly interested in ensuring that there is a process for planning, undertaking and reflecting on CPD during your cycle, rather than just complying with a requirement for minimum hours. Ensure relevance of your CPD by noting the anticipated development outcomes that will link to each activity, and keep an eye on the timeframes in which you expect to complete your CPD over your cycle. And in any reflective notes you choose to submit, make sure make sure any reflections recorded are anonymised, not least to protect patient confidentiality.
What the regulators want health and care professional to get from reflection is “learning gain and development”. The reflection process may have a number of stages. You might start with thinking about the basis of your knowledge – that is how do you know things and why do you know them? Consider your positive and negative professional experiences; identify learning needs and the actions needed to address them and have a place for building on what went well. Think about the techniques that you can use to embed your CPD. This could be the changes you decide to introduce to your work processes and performance. The process will largely be very personal but there is also a value in working with colleagues and your team on debriefs and case reviews; this might also depend on the setting in which you work.
The GDC does not stipulate how reflection should take place; it could be after each CPD activity, and indeed many CPD providers might decide to offer a way of reflecting as part of their documentation. Or it could be towards the end of the year when you review the PDP and consider the one for the following year. If you are a member of a peer review group, the group could decide to look at PDPs and reflection too, or you could set up in-practice arrangements with your colleagues. It depends on what is suitable for you.
[1] General Chiropractic Council, General dental Council, General Medical Council, General Optical Council, General Osteopathic Council, General Pharmaceutical Council, Health & Care Professions Council, Nursing & Midwifery Council, Pharmaceutical Society Northern Ireland, Benefits of becoming a reflective practitioner – A joint statement of support from the Chief Executives of statutory regulators of health and care professionals, June 2019
[2] John Dewey, How we think, various publishers, original edition 1910
