Reflective Template:  Patient Surveys

This reflective template has been designed to use with the SOAR Database (Scottish Online Appraisal Resource).  When you have completed this reflection, please upload it to SOAR / Form 3 and submit it to your interview to share with your Appraiser.	3-step guide to completing this form:

1)	Save this form (using “Save As”) to your computer (e.g. My Documents, Desk top), and customise the file name (e.g. Patient Survey Reflection 2012)
2)	Proceed to filling out the form - when finished, Save and Close the document.
3)	Login to SOAR and Upload this file from where you had saved it (from step 1), either to the Documents Library, or directly to Form 3.	

This reflection template form should be used for Domain 3: Communication, Partnership and Teamwork.

This template is used for reflecting on a recent Patient Survey which you had done.

The boxes will expand automatically as you type into them.
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Please confirm - Have you had formal feedback from Patients this year?
Please mark with “x” in box
X	Yes.	
	No (in which case you should use “Patient and Carer Involvement” instead).	

How do you feel about this?
Pleased.
Results for all doctors were available which allowed for some benchmarking.	

Your appraiser will need a copy of your survey results to discuss them with you. The aim will be to reflect purposefully on any positive feedback, and on any negative feedback. However you may wish to consider these questions in advance.

What positive features have you identified from the feedback?
Apart from 2 fair scores I felt it was all positive. I scored best at making you feel at ease, showing care and compassion and being positive, three things I would take pride in as my strengths.	

What negative features have you identified?
I had 2 fair rankings, on fully understanding concerns and showing care and compassion. It is impossible to know if these are from the same person who I obviously did not engage well with. My lowest numbers of excellents were with helping you take control and making a plan of action with you. I often find that patients do not want to make choices regarding treatment, and are occasionally put out that you wish them to participate in decisions.	

What are the possibilities for addressing any concerns that have been expressed?
No real concerns. I will strive to consult to the best of my ability given the time restraints.