The GMC has highlighted the importance of reflection for doctors and the role it plays in revalidation:
Medicine is a lifelong journey, immensely rich, scientifically complex and constantly developing. It is characterised by positive, fulfilling experiences and feedback, but also involves uncertainty and the emotional intensity of supporting colleagues and patients.
Reflecting on these experiences is vital to personal wellbeing and development, and to improving the quality of patient care. Experiences, good and bad, have learning for the individuals involved and for the wider system.
In the ever-evolving landscape of healthcare, the ability to reflect meaningfully on one’s practice is more than professional expectation - it is a cornerstone of safe, compassionate, and high-quality care. Reflective practice, especially within the context of medical appraisal, plays a vital role in fostering continuous learning, professional development, and patient safety.
Medical appraisal is not a tick-box exercise. It is a structured opportunity for doctors to evaluate their professional activities, identify areas for improvement, and set goals for future development.
At the heart of this process lies reflection.
Reflection enables doctors to critically assess their experiences - both positive and challenging - and extract meaningful insights that inform better clinical decisions and interpersonal interactions.
Objectivity in self-reflection can sometimes prove challenging, which is where the role of the appraiser is crucial to help the appraisee to acknowledge and celebrate the successes, as well we reviewing together, as a trained peer, on what might have been better.
Reflective practice is deeply personal and is often shaped by cultural norms, values, and communication styles and as such, some may find reflection a challenging exercise.
In cultures with strong hierarchical structures, junior staff may be less inclined to reflect critically on team dynamics or challenge decisions made by senior colleagues. Equally those from a culture that values humility may understate their achievements or avoid discussing personal strengths during appraisal.
But being able, or open to reflecting is crucial for doctors in order to demonstrate insight, which can influence how their competence and integrity are perceived. Failure to engage in reflective practice may raise concerns about a doctor’s commitment to learning and improvement [1].
By analysing clinical encounters, communication breakdowns, or ethical dilemmas, doctors can identify patterns, learn from mistakes, and implement changes that enhance outcomes. This process contributes to a culture of openness and transparency - values that underpin public trust in the medical profession.
But oftentimes we forget to celebrate and learn from successful case studies. If you had a particularly good patient or colleague experience, have you stopped to think, what worked to contribute to the success? Better yet, how can it be better?
Medicine is a lifelong journey, and medical professionals are expected to maintain their continuous learning journey with it.
Some clinicians have expressed concerns about the legal implications of written reflections, particularly following high-profile cases such as that of Dr Bawa-Garba. However, NHS England has clarified that reflective documents were not used in court proceedings and that the Medical Protection Society has never known e-portfolio reflections to be obtained via court order [1].
Doctors are encouraged to write reflections professionally and factually, anonymising patient details and focusing on learning outcomes. The GMC does not require reflective statements during investigations, reinforcing the safety and value of honest reflection [1].
Reflection is not only about clinical competence - it also supports emotional wellbeing. The GMC highlights that having time and support for reflection helps doctors process difficult experiences, build emotional intelligence, and maintain resilience [2].
To support effective reflection, the GMC and the Academy of Medical Royal Colleges have developed resources such as the “What, So What, What Now” template. These tools guide doctors in articulating their experiences, analysing their significance, and planning actionable steps for improvement [2].
The Medical Appraisal Scotland website also offers different reflection templates for different supporting categories. Whilst it might not be practical to reflect on every piece of supporting information (especially if you have lots), focus on the ones that are more important to you - consider why they are important, and what impacts they have on your patient care.
Reflective practice is not a one-off activity - it’s a mindset. When embedded into daily routines and appraisal discussions, it becomes a powerful driver of growth, safety, and excellence. As healthcare professionals, embracing reflection is not just about meeting appraisal requirements; it’s about honouring our duty to patients, colleagues, and ourselves.
Video resource: Understanding Reflective Practice (YouTube 3:13)
References:
[1] ROAN information sheet 12: Written reflective practice in appraisals
This page was last updated on: 15/10/2025
