Team reflection key to a learning culture says GMC Chair

Regulators and employers must work together to help create the right conditions for health professionals to reflect and learn when errors occur the General Medical Council’s Chair has told a conference focused on better management of medical error.

Speaking at the Better Way Symposium in Belfast on Friday (26 October) Prof Sir Terence Stephenson said to delegates that the increasingly complex healthcare environments in which multi-disciplinary teams find themselves call for a new approach to ensure an open, learning culture can truly take root.

The GMC has, along with the Academy of Medical Royal Colleges, Medical Schools Council and the Conference of Postgraduate Medical Deans, published updated guidance for doctors on reflection. The guidance outlines the importance of reflection for personal development, as a way of demonstrating insight, to help learning and to identify opportunities to improve patient safety.

In addition the GMC has set out plans to roll out Human Factors training for all its staff who investigate and take decisions on fitness to practise referrals, to ensure that the context of the environment that doctors work in is taken into account when assessing decisions and actions.


"The GMC is now more focused than ever on prevention of harm, rather than simply picking up the pieces and investigating when things have already gone wrong. "

Prof Sir Terence Stephenson

GMC Chair

But a joined-up approach to reflection and learning is also needed to enable errors to help prevent future harm happening to patients, Prof Stephenson told the symposium.

The GMC is working with the other health and social care professional regulators on a joint approach on the benefits of reflection, especially for multidisciplinary teams. It aims to improve the way colleagues work together through shared expectations that value and recognise reflection for teams, leading ultimately to more effective and safe ways to care for people.

Prof Sir Terence said:

‘The GMC is now more focused than ever on prevention of harm, rather than simply picking up the pieces and investigating when things have already gone wrong. If we, other regulators and employers are serious about better management of error then prevention through learning has to be at the heart of that.

‘As a young doctor, I got the most out of reflection when I shared experiences informally with colleagues. To allow doctors to get the most out of reflection, I believe we must rebuild that peer-to-peer shared experience.

‘Doctors are working in increasingly complex environments in multi-disciplinary teams and we must be ready to adapt to give all of the medical workforce the tools and the space they need to continue to learn throughout their careers. That’s why we are now actively exploring with other regulators how team-based reflection might work and the scope for joint guidance.’


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