Things to remember about reflection

Writing a reflection is not the same as reporting serious incidents

You cannot use reflection as a substitute for following policies to discuss, record or escalate significant events or serious incidents. Make sure you tell your medical school if you are involved in a significant event or serious incident; they will be able to advise and support you in these situations. Where appropriate you may also be asked to be involved in the responsible organisation’s formal response to serious incidents.

But reflection can be an important part of how individuals and teams learn from serious incidents and significant events. You can write your own reflection as part of your personal response (fully anonymised and focusing on learning and future plans). Doing a reflective exercise can help you understand your feelings in relation to a serious event and may help you identify areas you would like to talk though with your personal tutor or the alternative pastoral support your medical schools provides. Where appropriate, you can join in with a team based reflective activity.

See the ‘WHOA!’ model of reflection, an example of a reflective practice model created by staff and students at Warwick Medical School, for thinking through professionalism dilemmas.

Being open and honest with patients

Reflection does not replace the need to be open and honest with patients if something goes wrong. If you are involved in delivering care that goes wrong make sure you follow the advice in Achieving good medical practice and get support from your supervisor and your medical school. Once the event has been dealt with you may find reflection a helpful tool to help you think about your feelings concerning the incident and how something similar could be avoided in the future.

What Achieving good medical practice says about significant events and openness and honesty with patients

"During your medical training, you may witness or be involved in something going wrong with a patient’s care, and you may be asked to contribute to an internal inquiry. Although your medical school will normally be told about significant events, you should contact senior staff (for example, your year director or personal tutor) at an early stage, so they can arrange support for you. This will protect patients and allow the clinical team you are working with to respond appropriately.

You must contribute honestly and openly to the process. Openness and honesty are key to being a good medical student and a safe and trustworthy doctor. You may hear this referred to as your professional duty of candour."

Achieving good medical practice, 2016 (paras 18-19)

"As a medical student, you won’t be directly responsible for patient care because this responsibility will lie with your supervisor. But if you think any aspect of care that you are involved in has gone wrong, you should tell your supervisor as soon as possible. Your supervisor will support you, and if necessary will help you to put things right, which may include explaining to the patient what has happened and offering an apology."

Achieving good medical practice, 2016 (para 67)