For: College | Medical Students | Physicians | Surgeons
The guidance has been produced on the back of concerns regarding legal requests to release information held on e-Portfolios without the trainee’s consent, and feedback from trainees which suggests they are receiving conflicting and confusing advice on this issue.
Academy advice on using portfolios:
- Keep reflective notes, as fully anonymised as possible. Other practitioners, patients, parents and staff should not be named or be readily identifiable from the information you provide. For example, instead of referring to patient Jane Smith, refer to them as patient X. Never include the patient ID number or name. Avoid including date of birth (if necessary refer to the patient’s approximate age), addresses or any unique condition or circumstance of that patient which may allow someone to identify them when used in conjunction with other information they have access to. Occasionally it will be unavoidable as the condition of a particular patient will be unique, but try and minimise the patient identifiable information that you provide.
- Word the reflective notes in terms of:
- Brief Description: what are you reflecting on? Outline the circumstance in general terms. Ensure that you anonymise data. You can describe a situation without including identifiable data. For example use ‘patient x’ or ‘Dr S’ instead of names or patient numbers.
- Feelings: what were your reactions or feelings to the event in general? Try not to be judgemental, both to yourself and others, particularly when your reactions and feelings are still raw.
- Evaluation: what was the outcome? What was good and could have been done differently about the event?
- Analysis: what have you learnt? What steps will you now take on the basis of what you have learnt? – This is the most important section and will allow the other sections to be brief, generic and unidentifiable. This section will demonstrate both the learning outcome and reflection.
- Take advice from a senior, experienced colleague when writing reflection about cases that may be contentious or result in an investigation
Most importantly, e-Portfolios are an educational tool and not a medical record. It is important that trainees and trainers continue to participate openly and meaningfully with the appraisal process by continuing to use e-Portfolios for genuine and detailed reflection that adds value to learning. However, this should be done without including patient identifiable or personal data. In the event you are referred to the GMC (a rare event, but more likely than a criminal prosecution), they will want to see evidence of refection. Good reflective learning will support you.
Over emotional reflections, written in the heat of the moment should be avoided, as should criticism of others or discussion of personal differences.
If you are unfortunate enough to be involved in an incident with a serious outcome, it is helpful to set out the narrative on paper immediately so that the events are recorded while still fresh in your mind , but formally documented reflection is probably better done after some consideration.
Access the full Academy guidance.