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GPs go forth

RCGP to discuss 'feasibility' of reflections in light of Dr Bawa-Garba case

The RCGP will be discussing the ‘feasibility’ of reflections for training purposes at its next council meeting, after a junior doctor was struck off the medical register.

The RCGP will discuss a motion put forward by GPs in the Wessex faculty to ‘consider the patient safety, ethical and legal implications’ following the Dr Hazida Bawa-Garba case.

The motion asks that the council debate ‘the feasibility and process of honest reflection, documentation and meaningful learning for training and continuing professional development if the information may be used for litigation’.

It adds that the council should also discuss ‘the duties, obligations and practical steps a doctor needs to take when working in situations where there are significant patient safety concerns’.

The debate comes after the GMC won a High Court bid to strike off Dr Bawa-Garba from the medical register following her conviction of manslaughter.

The decision from the High Court raised concern among GPs as to whether their reflections, used in an e-portfolio, could be used against them in court.

Pulse revealed, in the case of Dr Bawa-Garba, that her reflections were never submitted to court, with the MPS – which represented Dr Bawa-Garba – encouraging all doctors to continue to engage in reflective practice.

The motion also urges the RCGP, along with the GMC, the DH, AoMRC, HEE and the BMA to work on new guidance and changes to legislation ‘to ensure an open culture of learning, quality improvement and patient safety’.

This comes after the health secretary ordered a ‘rapid review’ into the application of gross negligence manslaughter charges in medicine, which is scheduled to report back by April 2018.

The RCGP Council will meet later this month.

Readers' comments (10)

  • Reflection is a useful tool for some but has been elevated to cult like status by the educationalists. There are in reality many different learning styles. I find the constant demand for proof of insight and self analysis at best a bit creepy and at worst destructive.

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  • I understand the MPS states that the eportfolio of Dr Bawa-Garba was not provided as evidence and used against her in court. However, they are just being picky, as a letter from her educational supervisor published in the BMJ clearly states that her reflection of the incident and her consultants comments about this written in her ‘training encounter form’ was provided to the prosecuting counsel and this was used against her.

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  • Dear All,
    I wonder if Mr Hunt reflects?
    Paul C

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  • This comment has been moderated.

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  • In Life there are reflectors and non reflectors that doesn't mean one is better than the other only that the reflectors have managed to convince everyone that they are correct. It is a personality type that enjoys reflecting and gets the most out of it. others are just good at getting on with the job that is needed at the time.

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    Hi my name is Dr Acula ..
    I habve trouble reflecting (in mirrors)

    Too much reflection can equate to self doubt
    and can lead to a loss of confidence

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  • What are 'significant patient safety concerns'?

    To me, as a patient, ANY concern about safety (including stafing, facilities, bed availability etc)are significant.

    Significance is in the eye of the beholder.

    All patients should be told about ANY concerns, and the fact they have been told should be included on the consent form for treatment.
    They (we) cannot give informed consent otherwise.
    If some are put off having treatment - so be it.
    That is the standard of the GMC's own making.

    Richard Rawlins

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  • David Banner

    Folks, the message loud and clear is that your reflections are NOT confidential. Eager ambulance-chasing solicitors following the fall-out from this tragic case will be gagging to lay their hands on your “confessions” plastered all over GPs’ e-portfolios. Reflect on trivial fluff only, or risk your career going down the toilet.

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  • @Paul Cundy
    I would be fairly sure that man has no reflection.

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  • Medical curriculum in UK is now replaced with reflections as opposed to learning and studying real knowledge based medicine.
    This is a safety concern issue, as the new doctors are ill equipped knowledge wise to tackle practical medical problems instead they prefer to stand aloof reflecting, reflecting and writing pages on reflections.
    I once asked my student to name 10 differential diagnoses of an Inguinal lump. He stood looking puzzled and then told me he will reflect on that and get back to me.

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