General Practice 2 Handbook 2023/24

What is reflective writing?

Reflection is a key skill for all healthcare professionals and learning how to develop reflective practice is an essential part of medical education. Creative enquiry has been found to extend reflection and understanding and engage the student voice and perspective [See Appendix 1]. 

Reflective writing holds significant importance for second-year medical students as it serves as a valuable tool for enhancing their learning, self-awareness, and professional development. This form of writing involves the exploration of personal experiences, thoughts, emotions, and insights related to clinical encounters, patient interactions, and medical practice. Below we have summarised some areas that it incorporates: 

Critical Thinking and Decision-Making: Reflective writing encourages students to analyse and evaluate their experiences. This process cultivates critical thinking skills, enabling students to assess the effectiveness of their decisions and discussions. By reflecting on cases and interactions, medical students can identify areas for improvement and make more informed decisions in future situations.

Clinical Skill Development: Through reflection, students can identify gaps in their clinical skills and knowledge. By examining their experiences, they can recognise which skills were effectively applied and which need further development. This self-awareness allows students to focus their learning efforts on specific areas that require improvement, leading to enhanced clinical competence.

 Empathy and Patient-Centered Care: Reflective writing encourages students to delve into their emotions and perspectives during patient interactions. This introspection fosters empathy and a deeper understanding of the patient's experience, leading to more patient-centered care. Developing strong interpersonal skills is essential for effective communication and building trust with patients.

Ethical and Moral Development: Medical practice often involves complex ethical dilemmas. Reflective writing provides a platform for students to explore and dissect these ethical challenges, helping them develop a strong moral compass. Engaging in thoughtful reflection can aid in making ethically sound decisions while considering the best interests of the patient.

Self-Assessment and Self-Regulation: Writing reflections allows students to assess their progress and growth over time. They can track their learning journey, identify areas of strength, and set goals for improvement. Regular reflection promotes self-regulation, motivating students to take proactive steps to enhance their knowledge and skills.

Professional Identity: Medical education is not only about acquiring medical knowledge but also about developing a professional identity. Reflective writing enables students to explore their evolving roles as medical practitioners, helping them understand the responsibilities, values, and expectations associated with the profession.

Communication Skills: Effective communication is integral to medical practice. Reflective writing hones students' ability to articulate their thoughts and experiences clearly and concisely. This skill is transferable to patient communication, interprofessional collaboration, and academic discussions.

Resilience and Coping Strategies: Medical training can be emotionally demanding. Reflective writing provides an outlet for processing challenging experiences, managing stress, and building resilience. By acknowledging and addressing emotions through writing, students can develop healthy coping mechanisms and maintain their well-being.

Lifelong Learning: Reflective writing cultivates a habit of lifelong learning. As medical knowledge and practices evolve, physicians must adapt and update their skills. The practice of reflection fosters a mindset of continuous improvement and learning throughout a medical career.

Incorporating reflective writing into your learning as a second year medical student  can significantly contribute to your holistic development as future healthcare professionals. By engaging in this introspective process, students not only enhance their clinical competencies but also develop the emotional intelligence and professionalism necessary for a successful and fulfilling medical career.

GP2 Reflective Statement on Teamwork  

Introduction:  

So far in your GP2 block, you have worked in a team both online [analysing consultations and providing feedback to each other] and in person during TBL [Team based learning]. These team working skills are essential for when you are a junior doctor working on the wards or GP practice, both directly and indirectly affecting patients. These benefits include (however not exhaustive):     

·       To allow effective and safe management of patients: working together with colleagues and patients for the best patient care i.e. Calling the cardiologist for advice regarding a patient's ECG. 

·       Conflict resolution: having the skills to work with others to resolve conflict in an effective manner, i.e. You are the GP in an MDT meeting and one of the allied health professionals disagrees with your plan.   

·       To reduce medical errors: working together to ask questions and clarify i.e. You have been asked to prescribe a medication you are not familiar with, leading to asking the pharmacist for advice.  

·       Better communication in emergencies, i.e. you are a medical student taking part in a cardiac arrest and have been asked to perform CPR. This involves following instructions from the ‘cardiac arrest team’.  

·       Better communication amongst team members means reduced stress and improved job satisfaction.  

The GMC highlights the importance of communication partnership and teamwork in its Good Medical Practice document. Alongside this, Royal College of Physicians also highlight the importance of teamwork, in the follow document: Improving teams in healthcare.  

Purpose of the task:  

·       This is an opportunity for you to reflect on your team working skills during TBL, understand your role in a team and identify areas to improve on.  

The task:  

Options:  

1.       250–500-word reflective statement on how your TBL/online team worked together to complete a task during GP2 or 

2.       Creative enquiry – produce a creative piece (poem, drawing, painting) + 250-word piece on how your TBL/online team worked together to complete a task during GP2.  

Leniency is +/- 10% of the word count.

Consider: 

1.       What: What have you learnt about your teamwork skills? Consider how did your team deal with communication, decision-making, and any challenges?  

2.       Why: Why are team working skills important for your role in the medical profession?  

Submission details:  

Please submit your pieces to QM Plus (under the General Practice 2 drop down) before the deadline for your group as below. If you have any issues with uploading, please contact Francesca Langridge f.langridge@qmul.ac.uk. 

Deadline:  

Group CD: 20th Feb (3 weeks after day 4) 

Group AB: 27th Feb (3 weeks after day 4) 

Engaging with the feedback process is a key part of students’ learning and professional development. This involves learning about both the giving and receiving of constructive feedback and understanding how these feedback processes can support their own, peers and their tutors’, professional development as well as guiding the ongoing development of the placement. 

Students and GP tutors/facilitators will be asked to provide feedback about their TBL and central teaching experience via online forms. 

Feedback based on the online sessions: 

• Students will be asked to submit their feedback about their online experience at the end of the placement. This consists of both individual and group feedback. They will be sent links to these online feedback forms and instructions on how to complete these prior to the final placement days. 
• Students are encouraged to approach their GP tutor/facilitator and/or the unit convenors if they have any queries or concerns during their GP2 days. 
• Tutors/facilitators will be asked to submit their feedback about their teaching experience at the end of the placement. They will be sent links to these online feedback forms and instructions on how to complete these. 

Tutor/facilitator feedback based on reflective essay/creative enquiry

• Tutor/facilitators will be sent online forms for the student assessments as outlined in the assessment information. 

Tutor/facilitator feedback based on student consultation performance

• Tutors are also required to provide formative feedback to each student to support the develop of their reflective practice and overall professional development. This also serves to model the constructive giving and receiving of feedback to their students. This formative feedback can be delivered verbally and/or in a written format.  
• The use of informal feedback, to review learning experiences and ensure students’ learning needs and the placements learning outcomes are being met, during the placement is encouraged and can be collected as the placement progresses. For example, using Mentimeter to set up anonymous polls or Q&As at the end of each placement day or using post-it notes on Jamboard (or a real whiteboard if onsite). 

• Start to evaluate the environmental, social, behavioural and cultural factors which influence health and disease in different populations 

• Start to assess, by taking a history, the environmental, social, psychological, behavioural and cultural factors influencing a patient’s presentation, and identify options to address these, including advocacy for those who are disempowered 

• Start to evaluate the determinants of health and disease and variations in healthcare delivery and medical practice from a global perspective and explain the impact that global changes may have on local health and wellbeing.    

1. Identify the core principles and components of holistic care in the medical field. 

2. Analyse the importance of incorporating holistic care in the overall management and treatment of patients. 

3. Explore the potential benefits and limitations of using holistic care approaches in medical practice. 

4. Apply a holistic care framework to assess and address the physical, emotional, social, and spiritual needs of patients. 

5. Evaluate the role of effective communication and empathy in establishing trust and rapport with patients in a holistic care context. 

6. Collaborate with team members to develop comprehensive and patient-centered treatment plans that integrate holistic care principles. 

7. Examine the impact of cultural, ethnic, and socioeconomic factors on the provision of holistic care and health outcomes. 

8. Discuss ethical considerations and potential challenges associated with incorporating holistic care into standard medical practice. 

9. Engage in critical thinking and problem-solving exercises to analyse case studies or scenarios that require the application of holistic care principles. 

1. Understand the concept of multi-morbidity: 

2. Recognise medical complexity: 

- Define medical complexity and its various dimensions (e.g., medical, social, psychological). 

- Identify factors that contribute to medical complexity, such as age, socioeconomic status, and healthcare access. 

3. Comprehend the challenges in managing multi-morbid patients: 

- Identify the potential complications and interactions between co-existing medical conditions. 

- Describe the impact of polypharmacy in multi-morbidity management. 

- Understand the role of healthcare system and provider factors in managing medical complexity. 

4. Strengthen communication and teamwork skills: 

- Understand the importance of interdisciplinary teamwork in managing medical complexity. 

5. Engage in self-directed learning and continuous improvement:  

• Students' awareness of LTC  

• Debate the impact of LTC on patients' life 

• Students to recognise the impact of LTC on patients 

• To draw upon a real-life scenario   

• Students to think about different LTC within the community  

• Students to look at different roles of HCP involved in patients with LTC  

Reflection is a key skill for all healthcare professionals and learning how to develop reflective practice is an essential part of medical education. The GMC (General Medical Council), in collaboration with the Academy of Medical Royal Colleges, the UK Conference of Postgraduate Medical Deans (COPMeD), and the Medical Schools Council (MSC), recently published a guide for medical students on how to reflect as part of their practice. 

The key idea of reflective work is to promote self-awareness. It enables students to explore their understanding of themselves as medical professionals and how they relate to patients. It also provides a space where students can consider and challenge their own attitudes and perceptions, including highlighting learning points for themselves and others.  

There are many formats that can be used for reflection, including verbal, written and art. Creative enquiry is an educational approach that invites learners to engage with their lived experience through the arts. Using multiple languages of expression, arts-based and prose reflective writing, has been found to extend reflection and understanding and engage the student voice and perspective. 

Resources for reflections: 

Here are some resources for reflection that you may find helpful:

From QM Plus: 

https://www.qmul.ac.uk/queenmaryacademy/educators/resources/education-practice/reflecting-on-practice/

The websites, Human Flourishing and Out of Our Heads, have more information about creative enquiry and lots of examples.