What do General Practitioners think of written reflection? A focus group study

Background: Written reflection has become a key part of evidence for assessment for General Practitioners (GPs) and GP Specialist Trainees (GPSTs), as it is thought to enhance the reflective process and demonstrate on-going learning. However, the educational value of mandatory reflection has been questioned, and there is little evidence on the acceptability of written reflection to clinicians. Aim: To explore the views of GPs and GPSTs on the use of written reflection in the MRCGP and NHS appraisal. Design and setting: A qualitative approach with GPs and GPSTs from the South of England. Method: Three focus group discussions with 11 GPs and 14 GPSTs. Thematic analysis was used on the coded texts. Results: There were diverse views on the value of written reflection. Some participants with particular learning styles found it useful; some viewed it as a 'tick-box' exercise and as a game. Some questioned its value as a tool for quality improvement. Its use may have opportunity costs on clinical work, other learning and leisure time. Conclusion: Written reflection produced strong feelings among participants. Research is needed to gauge how commonly these feelings are held, to allow informed decisions on the place of written reflection in education and assessment.